Author: Nino Bekaia
The English word “addiction” means dependence. Addictions can develop to a variety of substances, means, and behaviors, such as alcohol, tobacco, food, computer games, manifested by excessive accumulation of items, and so on. Addiction to psychoactive substances includes both physical and psychological addiction. Physical dependence manifests itself in the form of withdrawal syndrome, when a person experiences physical discomfort as a result of substance abuse. Psychological attitude is manifested in a strong longing and desire for the object of addiction.
In this article I will review the addiction in queer community and its specifics, what is the situation in terms of addictions in Georgia and abroad. Basically, I will talk about addiction to psychoactive substances – what is the impact of addiction on a person and what coping mechanisms are there, as well as what specific techniques are used in practice.
Addiction in the queer community
It has historically been believed that the use of psychoactive substances is high in queer people, as evidenced by empirical studies. According to the U.S. National Center on Psychoactive Substances, more than a third (37.6%) of people aged 18 and older reported consuming marijuana. Also, tobacco consumption is high in LGBT adults compared to heterosexual peers. According to the American Addiction Center, queer people consume 200% more tobacco than heterosexual people.
20 to 20% of queer people have moderate to severe dependence on alcohol. Gay men consume 3.5 times more marijuana than heterosexual men, and gay men consume 12.2 times more amphetamines than heterosexual men.
The high rates of addiction in queer people are due to many factors:
- Discrimination and social stigma
Many queer people experience some degree of stigma and homophobia. Hostile attitudes may come from acquaintances, neighbors, colleagues, and even family members. Constant stress, fear of losing a job, or a constant threat of hate-motivated crime often leads to the use of psychoactive substances.
Homophobia has a negative effect on people, especially a negative effect on hatred of queer people and their self-esteem. In a homophobic environment it is sometimes difficult to accept your own identity. The strong stigma in society forces many homosexuals to resort to self-defense, to convince themselves that they are heterosexual, and to show aggression towards homosexuals. Sometimes they behave as heterosexual, that is, what is accepted as “normal behavior”. Internalized homophobia is also manifested in isolation, self-destructive behavior, and apathy, leading to the destruction of physical and mental health.
- Mental disorders
Clinical depression, stress, and anxiety disorders are common among LGBTQ members because of their homophobic environment and stigma. Eating disorders are also common. This is often accompanied by physical health problems. As a result, queer people seek relief from psychoactive substances.
- Lack of support or none at all
Many queer people hide their identities to avoid discrimination. Hidden lifestyles may create feelings of loneliness and anxiety. Even when a queer person decides not to hide and be seen in public, it is often accompanied by unacceptability from family and friends. Psychoactive substances are often used to relieve constant stress.
Also a problem is the referral of queer people to healthcare professionals. Because there are often objects of judgment or discrimination from the doctors, many refrain from going to the doctor, and financial access is also a barrier. The effects and harmful effects of psychoactive substances are manifested in terms of both physical and mental health, the treatment of which depends on human finances.
The development of addictions is generally facilitated by widespread myths and stereotypes. For example, many young people believe that marijuana is not a drug, cigarette smoking is just a bad habit and the choice of a smoker, tobacco helps to relieve stress and calm down, club drugs are not so dangerous and so on. Cigarettes, alcohol and club drugs are also often used to “unwind” and have fun.
What is dependance and what impact does it have on a person
In fact, marijuana, nicotine, and club drugs are also psychotropic drugs and cause a change in state of consciousness, which in turn affects mental processes and behavior.
Groups of psychoactive substances are: hallucinogens, opiates, depressants and stimulants.
The group of hallucinogens includes cannabis (hashish, marijuana) LSD and PCP. These hallucinogens cause the most fundamental change in consciousness. The group of opiates include, for example, heroin and morphine, the substances contained in them cause strong stimulation of nerve receptors and act on the dopamine part of the brain. The group of depressants includes barbiturates and alcohol, which inhibit mental and physical activity by inhibiting or reducing the transmission of nerve impulses to the central nervous system. Large amounts of alcohol in a short period of time cause overload of the central nervous system. Stimulants include amphetamine, cocaine, nicotine and caffeine. These substances act on the dopamine system and cause an euphoric mood, excessive energy and hyperactivity. For example, nicotine takes the place of natural neurotransmitters in the brain and causes strong addiction. The negative effects of nicotine on health often outweigh the effects of other substances taken together.
There are different definitions of addiction. It is different from emotions and specific beliefs. Attitudes are global assessments of objects and events that arise as a result of their relatively solid existence in memory.
Addiction is often seen as a predisposition to cognitive, affective, and behavioral responses to the object of addiction. This three-component vision forms the basis of the dependency.
- Affective or emotional component – includes the feelings and emotions that an individual has towards the object of dependence. (Positive, pleasant)
- Behavioral component – as soon as an addicted person is able to consume a substance or perform the behavior that is the object of the addiction.
- Cognitive component – the individual’s beliefs and ideas about the object of dependence (positive evaluation of the object of dependence). For example, “Smoking calms me down”, “Alcohol helps me cope with stress”.
The damage caused by psychoactive substances varies from mild to severe, is short-term and long-term, and affects both physical and mental health and aggravates the socio-economic status of people. From mental problems, the most common manifestations are depression, anxiety, paranoia.
- Depression – There is ample evidence for a link between psychoactive substance use and depression. The effects of substances on certain areas of the brain are so great that their consumption can lead to depression and other disorders.
- Anxiety – Some stimulants, such as cocaine and nicotine, cause anxiety disorders and even panic attacks.
- Paranoia – Long-term use of cocaine and marijuana can lead to paranoia. Complicating the health situation is the fact that many drugs are illegal and consumers have a constant fear of being caught one day.
The physical harm that a person suffers as a result of psychoactive substances is most often manifested as follows:
Long-term use of psychoactive substances may lead to kidney damage – dehydration, muscle dysfunction, increase in body temperature impairs the work of the kidneys, which over time can no longer perform its function.
Excessive and prolonged use of alcohol is known to damage the liver. However, long-term use of opiates and steroids affects the liver in the same way as alcohol. The liver is damaged as a result of scars, necrosis and chronic inflammation.
Many psychoactive substances affect the functioning of the heart. The damage is multifaceted, starting with an increase in heart rate and blood pressure, ending with thrombosis and stroke.
Both the consumption of tobacco products as well as marijuana and cocaine cause great damage to the lungs. In addition to direct damage, drugs such as heroin, which cause slowing of breathing, also cause serious lung problems.
- Psychoactive substances also cause short-term harm, which manifests itself in dizziness, headaches, etc. Lowers immunity.
Behavioral effects that may develop as a result of psychoactive substances are as follows:
- The addicted person takes more and longer doses of the medication than he or she has been prescribed
- An addicted person is unable to stop using a psychoactive substance despite having a strong desire to quit
- Has a strong desire to use and obtain a substance
- Cannot complete tasks/work due to substance abuse
- Continues to worsen interpersonal relationships despite substance use
- In the face of substance use, termination of service and social ties
- Continues to use the substance even though he knows and realizes how the drug harms his physical and mental health
Consumption of psychoactive substances, in addition to harm to health and deteriorating quality of life, negatively affects the social and economic situation of people. Even the purchase of alcohol and tobacco in low-income countries is associated with high costs, which greatly impoverish the already poor. Treating damaged health is even more expensive for people and the state as well.
The rates of psychoactive substance use in Georgia are quite alarming. For example, the minimum age for tasting alcohol is 10 years. The study found that 1.6% of the general population due to alcohol abuse need to seek appropriate medical services. 31% of the population in Georgia is a tobacco user. The minimum age for first use of tobacco is 7 years for men and 9 years for women. 15.9% of respondents say they have smoked marijuana at least once in their lives, the minimum age for its use is 9 years for men and 12 years for women. Involvement in gambling was mentioned at least once in a lifetime by 31.3% of respondents. It should also be noted that, according to the NCDC, the number of smokers has decreased by 3% in the last three years, and tobacco use has stopped by 10%, which is largely due to the introduction of new legislation.
Consumption of psychoactive substances and the fight against various addictions remain a challenge in the world to this day. Experience working with addictions in Western countries has been accumulated, which, to some extent, is shared by Georgia at the legislative level. (For example, banning the use of tobacco products in public places, banning smoking in the presence of a child in taxis and cars) Addiction services have also emerged. A number of countries have better rates than Georgia, for example, according to Poland in 2018, the number of smokers is 26%, in the UK in 2020, millions of people quit smoking. However, the consumption of psychoactive substances by adults remains a challenge in the world to this day. In 2019, 8.4% of the population in EU countries aged 15 and over reported consuming alcohol on a daily basis. Raising awareness of addictions, including harm information, availability of addiction services, flexible legislative policy – these are the set of mechanisms that work effectively in different countries of the world and to which we should aim.
Why we use psychoactive substances
People have been consuming psychoactive substances since ancient times. For how long has the problem of psychoactive substance abuse exist, in parallel, there is the question – why? Why do people consume drugs? There is no single answer to this question. Various fields and currents of science offer hypotheses and coping mechanisms. However, before expanding on these hypotheses, I would like to point out that we need to distinguish between two different issues:
- Why does a person start consuming / tasting a psychoactive substance?
- Why do you continue to use the substance?
The answer to the second question is in the nature of addiction. As I mentioned at the beginning, psychoactive substances are characterized by both physical and psychological dependence on it. We often hear from people – “Alcohol puts me in a good mood, I get tired”, “I love cigarettes, I like its taste”, “I want and I smoke, when I no longer want to, I quit smoking”.
In fact, the use of psychoactive substances is neither a love story nor has anything to do with romance. Unfortunately, desire alone is not enough to overcome addiction, and in practice, “when I want to, I will give up” very rarely happens. All illusory thoughts that exist about a psychoactive substance originate from addiction. Physiological dependence is “the process by which an organism becomes accustomed to and dependent on a given substance as a result of its chronic use.” As a result of physiological addiction changes in brain function, addiction affects perception, memory and behavior. Psychological dependence is a “behavioral tendency that drives a person to use drugs.” Clearly, when addicted, it is superfluous to talk about your own choice and love of the object of addiction. Physical and psychological attitudes change a person’s thoughts/attitudes towards an object and also change the behavior accordingly. When an addicted person is unable to take a substance, he experiences strong discomfort and tries by all means to obtain it.
To return to the question – why does a person become addicted? Why does he start tasting the substance? There are different theories.
I will single out a few factors:
Biological: One of the hypotheses as to why drugs are consumed is based on the fact that people inherit a substance addiction attitude. Studies on families and identical twins have shown that sometimes, several members of one family become addicted to a substance, although this theory does not rule out a strong environmental factor and its impact on the individual.
Psychological: Behavioral psychology treats behavior as a reaction to a stimulus. Almost all behaviors are taught, and learning is based on what the person receives as a result of the behavior – reward or punishment. In other words, if the intake of a particular substance was followed by the satisfaction of certain needs, it is likely to increase the likelihood of a recurrence of the behavior.
Cognitive psychology, which studies cognitive processes (perception, sensation, thinking, memory, etc.), says that human thoughts/cognitions are related to oneself and the world, including dependence on psychoactive substances. For example, the pattern of thinking – “Cigarettes will make you more confident and I will have many friends”, may lead to tobacco addiction.
Personality psychology links substance abuse to a person’s personality traits. Eysenck (Eysenck, 1997) believed that psychoticism, neuroticism, and extraversion were associated with the development of addiction. Psychoticism is characterized by aggression, egocentrism, impulsivity. Neuroticism is characterized by moodiness, anxiety, and irritability. Extraversion involves positive emotions, socialization. Some studies have confirmed the correlation between these personality traits and attitudes, although we can not say that extroverts are uniquely prone to develop this or that attitude. There is also a theory that a person who avoids existing existence, responsibility and gravity, can not find meaning, seeks “relief” in various substances.
There is no definite answer to the question – why a person starts consuming psychoactive substances. In a particular case, experimentation, environmental and societal influences, availability or other factor(s) may be crucial. Also, we can not say with certainty that an impulsive and egocentric, or anxious person has a uniquely high predisposition to drug use.
The question – why does a person continue to take psychoactive substances even though they sometimes realizes its harmful effects, the answer is in the nature of addiction. Continues to consume as it depends on the object of addiction psychologically and in some cases, even physically. Physical dependence manifests itself in the form of withdrawal syndrome. For example, after quitting smoking, sometimes a person feels irritability, dizziness, weakness, coughing, etc. If the physical manifestation of withdrawal syndrome in the case of cigarettes lasts a maximum of 5 days, in the case of alcohol and drugs it is much more difficult and necessarily requires the supervision of specialists
Addiction coping mechanisms
Cognitive-behavioral psychology is considered to be one of the most effective ways to overcome and treat addiction today. This approach is based on the assumption that a person’s beliefs and thoughts have a great influence on his behavior, therefore, to change the harmful behavior, we need to change the harmful thoughts/beliefs that cause it. For example, in the case of tobacco dependence, the most optimal treatment is to use a combination of psychotherapy and pharmacotherapy. Pharmacotherapy sometimes doubles the chances of overcoming addiction. In case of drug and alcohol dependence, there are several treatment options: detoxification, replacement therapy (methadone and buprenorphine), psycho-social rehabilitation. In the case of treatment with psychoactive substances, the duration of the rehabilitation itself is important, which increases the chances of remission. Addiction is characterized by relapses, which can manifest as severe stress, depression, or anxiety, so long-term rehabilitation is crucial.
To overcome addiction, group psychotherapy is often used, where people have the opportunity to share their own experiences. Also, sharing someone else’s experience provides additional reflection and helps in the healing process. After being released from addiction, people often involve themselves in the process of helping others, which is beneficial for the former addict and for the patients as well.
To overcome the addiction, it is necessary to go through consistent stages. The treatment is multi-layered and complex depending on the object of dependence and the severity of the addiction.
Here are some ways to help you overcome addiction:
Decision Making – Overcoming any addiction begins with making a decision that is preceded by a desire to overcome the addiction. Decision making itself plays a role of one of the strongest motivators in the process of surrender and rehabilitation. The stronger the decision, the greater the chance of achieving the goal.
Motivation – Work on your self-confidence before taking concrete steps. Remember the successful and accomplished goals of the past when you did your best to achieve them even though you thought it was impossible. Writing down your own motivators is important. Strong motivation can be your own health, well-being of family members, etc. However, the more specific we are about motivation, the better. For example, “I will be able to exercise better”, “I will sleep fully and peacefully”, “I will not be bothered by pain”, etc.
Addiction Planning – Planning is one of the most important stages and involves finding information about your addiction (how it affects your physical and mental health, what kind of harm it does in particular), setting a specific date (for example in case of smoking cessation) and developing specific remedies or triggers. (This may include a variety of exercises, breathing exercises, meditation, walking, etc.)
Visualization – Imagine and see yourself as an addicted person. How do you behave in a particular situation? How do you feel? A necessary condition is to imagine yourself as happy/free. Practice similar visualizations often.
Identify Misleading Thoughts – For years you have used the object of addiction as a coping mechanism. In fact, it is not a coping mechanism and a positive attitude towards it is only in our imagination, which is reinforced by both external factors (such as the established notion that cigarettes/alcohol/other substances help us deal with stress) as well as habitual levels. Find reliable information, observe yourself, and other dependent people. Illusory thoughts are replaced by information based on facts.
Choosing a date and stopping using a psychoactive substance on a scheduled date – for some, overcoming addiction is relatively easy, while for others it is very difficult. The situation is complicated by past experiences and failed attempts. It is important not to cling to past failures and try again and again, because each time we have more experience, we are more informed and firm. Get help from professional and close people. If it is possible to quit smoking on your own, in the case of a heavy drug it is necessary to involve specialists in the relevant field.
Be vigilant during rehabilitation – After stopping substance use, you may be reminded of negative thoughts and triggers. The trigger can be of different types: stress, anxiety, socialization, stressful situations, specific people, etc. Identify the thoughts about the desire first and block them immediately. Do not allow them to be impacted. Replace them with positive thoughts. There are plenty of benefits to taking as a result of quitting addiction. You can write them down and always remember them when a trigger or negative thought bothers you.
Getting help and support from specialists and relatives – it is often necessary to involve specialists in overcoming addiction and this requires the mobilization of financial and other resources. It is also important to support people close to you. Often our loved ones do not understand and do not know how to help us and think that the phrases “Quit smoking!” Or “Stop drinking!” Help an addicted person. If our family member is dependent, we can support them by saying things like, “I know it’s hard, but I’m there for you,” “You can count on me,” and “I can help you as much as I can.” Sometimes even simple listening makes life easier for a person. Talk honestly with people you trust about attitudes and emotions, and tell them what kind of support would be helpful to you at a particular moment.
Addiction can be overcome, but it requires some work. Release from a psychoactive substance is not a one-time act, but rather a process in which a person goes through each stage sequentially and repeatedly until the goal is achieved.
Prevention The English word “prevention” comes and translates as problem prevention. Distinguish between universal (primary), targeted (secondary) and selective (selective) prevention.
Primary or universal prevention means prevention for the general population, communities, etc. For example, teaching about psychoactive substances in school, parenting activities so that the child does not start using drugs. From the age of 10-12, it is possible to talk to children about the harms and risks of substances, and before that, as a result of proper educational work, drug resistance should be established. Secondary or targeted prevention involves identifying and intervening in problems related to the use of psychoactive substances. It involves identifying the causes of addiction and working on them. Selective prevention involves selecting and working with high-risk groups of drug addicts. Prevention should involve the family as well as the school, the community and the state. Each of these rings creates a significant unity in the form of prevention.
Prevention is the most important stage, because the psychoactive substances tested in adolescence often contribute to the formation of addiction in adulthood and often remain addicted to this or that substance for the rest of their lives. Due to the complexity of the addiction, the ways to solve the problem are also multifaceted. Prevention involves the development of specific skills, values and beliefs in children, as well as raising the qualification of teachers in terms of addictions. Reducing the availability of psychoactive substances/products and introducing and cultivating a healthy lifestyle in schools.
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