Treatment of addiction

Question

Substance addiction e.g. heroin is treated by gradually decreasing doses of a less potent substance other than heroin (if I am correct).

Is this rule can be applied to any other addiction e.g pornography or it is only for substance addiction ?

Answer 1

Heroin is a special case of substance addiction, because of the tremendous withdrawal side effects. In general, substance addiction recovery doesn't require a gradual approach. In fact, from what I know about OCD, which has some similarities, I suspect that a gradual approach would be more difficult to succeed with.

https://www.addiction.com/addiction-a-to-z/porn-addiction/porn-addiction-treatment/ states that recovery from a pornography addiction will generally involve

counseling such as cognitive behavioral therapy (CBT), coupled with group therapy, 12-step and other social support groups and perhaps alternative therapies such as art therapy, equine therapy (working with horses), EMDR (eye movement desensitization and reprocessing) and the like.

I have done some reading about exposure treatments for OCD, skin picking and hair pulling, and I have helped my son with his home exercises for OCD (with guidance from his therapist). Another term for exposure treatments is Exposure and Response Prevention. I wrote up an overview about our experience with it here.

I see some overlap between pornography addiction and OCD. One of the OCD symptoms my son has had is an electronics addiction. At school he was given a Chromebook to carry around all day and use in all his classes. It was connected to the internet. He started spending his school day surfing the internet, and started failing classes.

The internet is often used for viewing pornography.

One of the things that makes it so difficult to get this under control is that frequently one uses the computer for other things as well, and it's a slippery slope to go from writing a necessary email to surfing pornography sites.

If you want to read more about this, I recommend the articles by Fred Penzel: http://www.wsps.info/index.php?option=com_content&view=category&id=36:ocd-and-related-subjects-by-frederick-penzel-phd&layout=default

Answer 2

Most (proposed) behavioral addictions aren't that well studied (or accepted in the DSM). Gambling is the exception, so you may want to look at how that is treated. Also, there are no accepted standards for what is porn addiction vs. normal use. And since you ask about depression in a different question: increase in porn use can be a symptom of depression or bipolar [hypo]mania.

Answer 3

1. Detoxification (the process by which the body rids itself of a drug)

2. Behavioral counseling

3. Medication (for opioid, tobacco, or alcohol addiction)

4. Evaluation and treatment for co-occurring mental health issues such as depression and anxiety

5. Long-term follow-up to prevent relapse

A range of care with a tailored treatment program and follow-up options can be crucial to success. Treatment should include both medical and mental health services as needed. Follow-up care may include community- or family-based recovery support systems.

https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction