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UNDERSTANDING ADDICTION

Written by: Vesna Matić

In January 2024, Vesna Matić, conducted an art therapy workshop for the users of the Day Hospital for Addicts at the Institute for Addictions, Psychiatric Clinic Vrapče.  In a two-hour wor
kshop organized by art therapy in residence Vesna Matić, around fifteen participants took part with the support of Dr. med. Mateja Grizelj Benussi, a specialist in psychiatry.
 
Through art therapy for individuals with alcohol addiction, participants had the opportunity to express themselves creatively and find a space for communication. Engaging in the art therapy process allowed them to explore layers of their emotions, internal experiences, and confront the challenges that come with the recovery process. Additionally, the group dynamics of support provided them with a sense of unity and understanding.

 

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Some of the messages that participants found within their art therapy drawings:

"I am free because I can decide whether to go left or right; therein lies my freedom. I don't know where I'm going, but I know I can choose."
 

"I walked a path that cannot be passed. There is a big warning sign, Stop. I need to find another way."
 

"On my path, there are tall pillars reaching to the sky, guarding me; that's my family. Maybe I miss a bit of sky and sun."

"I love structure, and that's how my drawing is. Structure helps me organize my life; that's how I've been taught since childhood. I return to structure to feel better."

"I always put myself aside; I don't know if I'll be accepted. Here, I am in the center of the drawing, and I am accepted in the group."

"I'm going through a very difficult period, the toughest so far. There's a river on my path, deep, dense, dark, and the weight is felt. The group is important and supports me on this journey."

"I'm moving from the past towards the future. In the past, there's a forest where I got lost, and now I'm halfway, knowing where I'm going."

"I'm heading to a rest stop in Maksimir, having coffee and not thinking about anything. Taking a break from everything is essential to me."

"On my path, people have littered even though there is a recycling place. It bothers me a lot; why things aren't put in their place and released."


What is addiction?

In medical literature and according to standard diagnostic manuals, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM), addiction is categorized as a substance use disorder. This means that addiction is a disorder that includes specific symptoms such as an uncontrollable need to use substances, continued use despite negative consequences, loss of control, and the development of tolerance and withdrawal symptoms. As a disorder, addiction is defined as a condition that affects brain functioning and psychological processes, including the ability to control impulses and make decisions.

Addiction can also be described as a chronic brain disease. Many medical organizations, including the American Society of Addiction Medicine (ASAM), define addiction as a disease because it involves changes in the brain that affect motivation, reward, memory, and related functions. As a disease, addiction is a chronic condition that develops under the influence of biological, psychological, and social factors and is considered to require treatment and long-term support, just like other chronic diseases. Classifying addiction as a disease helps emphasize that it is not the result of a moral failing, but rather a health problem that requires medical attention.

Addictions include alcohol, drugs (such as opiates and cocaine), prescription medications, and behavioral addictions like gambling, internet use, video games, compulsive shopping, as well as food and sex addictions.

When we talk about alcoholism as an addiction, it refers to a condition that develops gradually and is not immediately noticeable to the individual or their surroundings. Alcoholism develops through continuous alcohol consumption. It is a complex disease that affects not only the person who drinks, but also their family, the community in which they live, and their work environment. Prolonged and excessive consumption of alcoholic beverages leads to physical damage and dysfunction.

 

Alcohol and changes in the brain

 

When we talk about alcoholism as an addiction, we are referring to a condition that develops gradually and is not immediately noticeable to the individual or their surroundings. Alcoholism develops through the continuous consumption of alcohol. It is a complex disease that affects not only the person who drinks but also their family, the community in which they live, and their work environment. Prolonged and excessive alcohol consumption leads to physical damage and dysfunction.  Long-term excessive alcohol consumption causes changes in the brain, such as changes in neurons, including a reduction in their size. Addiction can be characterized as a recurring cycle with three phases. These phases primarily involve three domains: incentive salience, negative emotional states, and executive function. These domains are reflected in three key areas of the brain: the basal ganglia, the extended amygdala, and the prefrontal cortex.

 

 

 

 

You can read more about it here: 

Alcohol and the adolescent brain

 

Did you know that adolescent brains are more sensitive to the negative effects of alcohol than adult brains? Alcohol misuse during adolescence can alter brain development, potentially resulting in long-lasting changes in brain structure and function.

Alcohol addiction in Croatia and the world

According to the Croatian Institute of Public Health (HZJZ), there are approximately 250,000 people in Croatia (6,1% of the total population) who are dependent on alcohol. This number includes a significant portion of both men and women, with men making up the majority of addicts. Women also consume alcohol, but men in Croatia traditionally drink more, which leads to a higher prevalence of alcoholism among the male population. However, women often experience more serious health consequences when addiction develops, even though they generally drink less than men. 

According to the WHO, harmful alcohol use is responsible for 6.9% and 2.0% of the global burden of disease among men and women, respectively. Alcohol is the leading risk factor for premature mortality and disability among individuals aged 20 to 39, accounting for 13% of all deaths in this age group. Socially disadvantaged and particularly vulnerable populations have higher rates of alcohol-related deaths and hospitalizations.

During the coronavirus pandemic, the number of people consuming alcohol increased significantly, both in Croatia and in many other countries. The pandemic, along with additional stress caused by earthquakes, worsened the problem, with many people turning to alcohol as a way to cope with emotional challenges. Alcoholism is a significant public health issue that deeply affects not only the health of addicts but also their families and the broader community.

Art Therapy in Combating Alcohol Addiction

The American Art Therapy Association (AATA) has published research demonstrating that art therapy is effective in reducing symptoms of anxiety and depression, especially among individuals battling addiction. This therapeutic method helps clients express their emotions and experiences in ways that might be difficult to convey with words, fostering emotional relief and self-awareness. Art therapy is especially effective during times of crisis or stress, offering a creative outlet that helps clients regain a sense of control over their lives. It has also been shown to improve the overall quality of life during the recovery process, providing a supportive way to work through emotional pain and trauma without the discomfort that sometimes comes with verbal therapy.

Do you respect the personal boundaries of addicts?

 

It is important to respect the decisions and personal boundaries of others, especially when it comes to alcohol consumption. Every person has their own reasons for deciding not to drink, whether they are related to personal health, religious beliefs, or simply personal preferences. If someone clearly states that they do not drink, it is important to support that decision.

Social drinking, or consuming alcohol on special occasions or in social situations, can be particularly challenging for individuals struggling with alcohol addiction. For alcoholics, social drinking is often not a sustainable option because even small amounts of alcohol can trigger a strong urge to continue drinking, which can lead to a relapse into old destructive behaviors. Alcohol addiction changes the way the brain processes reward and impulse control, which means that "just one drink" is often not possible for someone who has previously been addicted. Attempts at controlled or social drinking can reignite the cycle of addiction, undermine progress made through treatment, and increase the risk of relapse. This is why alcoholics are usually advised to completely abstain from alcohol, as even occasional drinking can pose a serious risk to their recovery and health.

Let’s be mindful that pressuring someone to drink can push them into an undesirable state from which it is very difficult to escape. Respect personal decisions and boundaries!

https://www.apa.org/topics/substance-use-abuse-addiction/alcohol-disorders

https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243

https://www.who.int/health-topics/alcohol

https://www.hzjz.hr/repozitorij/alcohol-as-a-public-health-issue-in-croatia-situation-analysis-and-challenges-copenhagen-world-health-organization-regional-office-for-europe-2017/

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