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Understanding Addiction


Addiction means an uncontrolled use of a substance or gambling, despite the harm it is causing in someone’s life.  

Not everyone who gambles or uses drugs and/or alcohol experiences an addiction.

The harms experienced from substance use or gambling vary from person to person.

They can be mild to severe and occur along a ‘continuum’

sliding scale from 1 to 4 with colours fading from green to orange to indicate level of addiction
  1. No gambling or substance use:  Some people never gamble or do drugs
  2. Casual or non-problematic use:  Most people gamble or try substances recreationally without harm
  3. Harmful involvement:  People are experiencing some difficulties in their personal, work and/or social relationships.
  4. Addiction or substance use dependence:  Unable to stop gambling or drugs/alcohol despite negative health and social harms

Signs of Addiction

According to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders), three of the following criteria must be met to define an addiction:

  • Increased tolerance (needing more to experience the same ‘high’ or ‘rush’)
  • Withdrawal when not engaged (physical symptoms such as sweating, vomiting or pain)
  • Partaking more than you wanted/expected (spending more than you can afford)
  • You wish to decrease use but are unable (loss of control)
  • You spend a lot of time and energy on the substance/activity (driving to multiple doctors to get prescriptions, spending excessive hours in a casino regularly, chain smoking, planning your day around a hangover or crash)
  • You neglect or give up important social, occupational or recreational activities due to this substance/activity, or
  • You continue with the substance or activity despite knowing that it is causing you problems or making problems worse.

Why can’t they just stop using drugs or gambling?

Biological factors

With continued use of alcohol, drugs or problem gambling, a physical dependence occurs. This is when the body adapts to having that drug or ‘high’ in the system. 

Since the body becomes so used to having the drugs or gambling stimulating the system, overtime the brain of the person who is addicted stops producing the natural chemicals it needs to function. 

If a person just ‘stops’ the substance use or gambling, the body and brain is shocked by this change and this results in uncomfortable or painful reactions, such as shaking, headaches, anxiety and nausea. 

Psychological factors

Psychological factors are an important aspect of addiction.  When someone decreases or stops using the substance/activity it can lead to anxiety or depression. 

Often, the substance or activity has been used to cope with stress, anxiety, sadness or some other emotional void – stopping the use returns the user to the original feelings that led them to the drug or activity in the first place. Read more about concurrent disorders.

Spiritual factors

Spirituality can be explained as having to do with making meaning of our life. It is the essence of our survival and that which keeps us committed to working through the struggles and pain we encounter in life. 

Those with addictions have often lost their connection to feeling a sense of fulfillment and have often lost fulfilling relationships with others. A person may look to distract themselves from, or numb themselves to, such feelings. 

As the dependence negatively affects one’s relationships and connection to society the spiritual dread deepens, driving the person further into the addiction.

Social factors

An extremely important consideration for addiction and substance use dependence are the social determinants of health. 

Many people in our society experience discrimination and violence, are socially excluded because of the way they look or don’t have the same privileges and access to housing, money and jobs.

Substance use and addiction are complex issues, and what we hope people understand is that there are a number of reasons why someone might experience harms from addiction.

Addiction and mental health counsellors are specially trained to understand these complexities and the difficulties in the lives of people experiencing addiction and mental illness. 


Treatment options for addiction include self-help, individual or group counselling, medication and withdrawal management.

Everyone’s support and treatment needs are different.

Addiction Services Central Ontario (ASCO) believes in a holistic view of what causes someone to become problematically involved with gambling or substances. 

A holistic approach means placing the person at the centre of their recovery and recognizing that they are more than the addictive behaviour. 

Holistic approaches to addiction recovery include biological, psychological, social and spiritual elements that are important in recovery and gaining back control of your life.

In treatment, addiction is not viewed as a problem within the individual alone, but rather within the context of a total system of relationships—including one’s body, mind, family and society. 

Harm Reduction

Harm reduction uses different strategies—from reducing the harm from gambling and substance use to stopping their use entirely. 

A harm reduction approach to the treatment of addiction places the wants and needs of the client at the centre of their care and respects their choice to cut back and reduce negative consequences or quit substances entirely.

ASCO uses a harm reduction approach in addiction treatment.

Learn more about our programs

Concurrent Disorders

A concurrent disorder is when a person experiences a mental health concern and a co-occurring addiction issue. 

There is a strong link between addiction and mental health concerns.

For example, a person with depression may drink alcohol as a way to feel better, since the effects of alcohol might temporarily lift their mood. 

Drinking as a way to cope with depression may lead to harms such as impaired driving or relationship issues. These harms can contribute to feelings of shame and sadness, which may make depression worse.

The symptoms and signs for a concurrent disorder are different from person to person, depending on the particular addiction and mental health issue.

It is important for people experiencing substance use or gambling addiction to pay attention to co-occuring mental health concerns and seek help. Especially if they are experiencing thoughts of suicide or self-harm.

Learn more about our  concurrent disorders program.


While addiction and mental illness have been getting more attention in traditional media, social media and corporate campaigns, people who are affected by their substance use and mental illness still experience discrimination because of stigma.

Stigma are negative stereotypes that are harmful and stop people from seeking help or talking about their addiction or mental illness. For example, people with addiction and mental illness are often portrayed in media as criminals, violent, lacking morals or weak in character.

Stigma can create barriers to everyday living. Employment opportunities, family acceptance and even medical care can be obstacles when you carry the stigma of addiction and mental illness. 

People suffering from an addiction and mental illness can experience even more challenges from stigma when they are also discriminated against because of their gender, race or socioeconomic status. 

What are the effects of Stigma?

Stigma is so prevalent in society that the individual may even begin to believe these negative stereotypes about themselves. 

These negative thoughts can also lead to further substance abuse to cope with feelings of worthlessness or shame.

At ASCO, we understand that substance abuse and problem gambling are the result of biological, psychological, spiritual and societal challenges as a result of personal circumstances and support systems.

When working with clients, we honour the dignity, worth and resolve of those who seek treatment and offer a safe and supportive environment to all our clients.


Trauma is any event or situation experienced by someone that leaves a lasting impact on mental, physical, social or emotional wellbeing because it was either physically, psychologically or emotionally harmful.  

Experiencing trauma can have long-lasting effects and can impact a person’s well-being and ability to cope. The effects of trauma can be experienced days, weeks, months or even years after the traumatic events took place.

Whether someone realizes it or not, addiction is often a response to past trauma. 

The resulting trauma can follow the victim into adulthood, causing long-term physical and psychological distress, such as:

  • Anxiety
  • Depression
  • Low self-worth
  • Chronic health problems and sleep disorders
  • Difficulty with intimacy and relationships
  • Substance abuse and self-destructive behaviour

For some people, memories of trauma intrude into their daily lives, sometimes overwhelming them to the point where they have difficulty paying attention to the present. 

The person may:

  • Relieve traumatic memories
  • Have nightmares
  • Experience flashbacks
  • Become upset when reminded of the event, possibly experiencing physical symptoms like sweating an increased heart rate and muscle tension
  • Avoidance and
  • Numbing Symptoms

People with avoidance and numbing symptoms try to shut off memories of the trauma and will avoid talking about or putting themselves in situations that will remind them of the trauma.

They may withdraw from friends and family to avoid situations that will remind them of or force them to face traumatic memories. They may turn to alcohol, drugs or gambling to help become numb to their memories.

Trauma-informed care

At Addiction Services Central Ontario (ASCO), we have a trauma-informed approach to treatment. 

This approach recognizes that anyone can have a history of trauma, and that a person’s addiction may represent their efforts to cope with overwhelming feelings of distress. 

Our trauma-informed approach to care includes screening clients for trauma and counselling techniques that recognize and support clients who have experienced trauma. 

This approach emphasizes ASCO’s commitment to a physically and emotionally safe, respectful and accepting environment for clients and their families. 

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