Addiction is a condition demarcated by repetitive, compulsive behavior that results in either substantial distress to the person or significant impairment in some area of the person’s functioning, such as family relationships, work, or incurring criminal charges or legal action. If addictive behavior is either causing the person distress or disrupting some important area of the person’s life, then it likely meets the criteria for constituting a disorder. Addiction encompasses a wide range of behaviors, though usually addictions are conceptualized as either being substance-related or non-substance related. Non-substance related addictions are also referred to as behavioral addictions.
Truly, just about any substance that affects the neurochemistry of the brain has the capacity to be addictive. Some of the more common substance addictions are alcohol, tobacco (nicotine), and caffeine.
Not only does alcohol intoxication come with a host of potential dangers, but alcohol withdrawal—the physiological effects that occur when a person is addicted to alcohol and then suddenly stops drinking—can be fatal. This is why when a person is detoxing from alcohol it is often necessary to conduct their detox in a medical setting so that they can be properly monitored.
Other substances with high addiction potential include opioids, which include illicit substances like heroin as well as prescriptions opioids such as Percocet and fentanyl. Some individuals develop an addiction to opioids after they are prescribed them following a surgery or some other medical procedure and then progress to using illicit opioids like heroin when they are unable to secure another prescription for opioids. Fentanyl is a particularly potent opioid; it is about 50 times more potent than heroin and, as a result, is implicated in thousands of unintentional overdose deaths yearly. Sometimes drug dealers lace their heroin with fentanyl to heighten its effects; the problem is that users are not always aware of this and thus inadvertently use a drug that is beyond their tolerance, resulting in unintentional overdosing.
Stimulants such as cocaine, amphetamines, and methamphetamine also carry a high addiction potential. Some prescription drugs are amphetamines, like Adderall, which is a medication designed to treat attention-deficit/hyperactivity disorder (ADHD). Other amphetamines, like methamphetamine, are illicitly concocted. Methamphetamine, like other drugs, can be ingested in a number of ways: it can be smoked, snorted, eaten, or injected with a needle, either under the skin or directly into a blood vessel. Injecting a drug directly into a blood vessel usually has the most impact because the substance enters the bloodstream directly and, with just a few heartbeats, is distributed to the brain and other areas of the body.
Cannabis, Sedatives, and Hallucinogens
Other substances with abuse potential include cannabis (marijuana); sedative medications like benzodiazepines, which include medications like Xanax, Klonopin, Ativan, and Valium; phencyclidine (PCP); and hallucinogens like lysergic acid diethylamide (LSD) and psilocybin, which is the psychoactive ingredient in hallucinogenic mushrooms.
There are many behavioral—or non-substance related—addictions. While less research has been conducted on behavioral addictions as opposed to their substance-related counterparts, there is significant anecdotal evidence to support their existence and impact. Behavioral addictions include the following:
A gambling addiction can lead to significant financial strain, as the person continues to gamble despite mounting losses and incurring significant debt. The person may be unable to refrain from gambling or, if they start off gambling sensibly, find that they are unable to refrain from engaging in increasingly irresponsible bets.
Disordered eating can take many different forms.
- A person may intentionally restrict food intake for the purposes of maintaining an inordinately low body weight, which is a condition known as anorexia nervosa. This can be a life-threatening condition. Those with this condition have a compulsive fear of gaining weight. Individuals with this condition will often misperceive their body weight and body size, thinking they are much larger than what they are.
- A person may engage in a cycle of “binging” on large amounts of food during discrete periods of time and then “purging” through self-inducing vomiting or using laxatives or enemas, which is a condition known as bulimia nervosa.
- A person may feel compelled to eat non-food substances, which is a condition known as pica. More common non-food substances seen in cases of pica are paper, cloth, hair, string, wool, soil, paint, chalk, clay, and charcoal.
- Extreme dieting can be a type of disordered eating.
Excessive or extreme exercising can be a type of addiction. The person may exercise far too much, or, when they do exercise, they do so at an inappropriately high intensity. In these cases, the individual may experience body dysmorphia, or the misperception of body shape. For instance, a bodybuilder who has a very well-developed, muscular physique by all objective measures perceives himself or herself as being small, underdeveloped, or “puny.” Steroids and other performance-enhancing substances are sometimes abused in instances of exercise addiction.
A person may feel compelled to shop, go on shopping sprees, or otherwise purchase things that they don’t need and/or can’t afford. The advent of online shopping has likely exacerbated the problem given the ease with which a purchase can be made.
A person may be addicted to sexual activity and engaging in sexual acts with others. This can result in a host of problematic things, ranging from marital strain to contracting sexually transmitted infections. Excessive pornography viewing falls within this category as well.
Social Media Usage
With the proliferation of social media in the past 15 years or so has come the propensity for addictive social media usage. A person may spend inordinate amounts of time on social media sites checking for updates, posting updates, and posting pictures.
Like social media, online video gaming has surged in the past 15 years. This has opened the door to a whole new set of addictive behavior. A person with a video gaming addiction may spend hours upon hours playing video games—even at the expense of work, interacting with family, eating, or even maintaining basic personal hygiene.
Technically called kleptomania, this condition is characterized by a compulsive need to steal items that are not needed for personal use or monetary value. Not surprisingly, this disorder is associated with a significantly elevated risk of incurring criminal charges and legal hardships.
Technically referred to as pyromania, this condition is delineated by repeated, purposeful fire setting. Those with this condition often feel a sense of tension or arousal before setting the fire and a great deal of pleasure or relief after setting the fire. In this condition, fires are set because of the compulsive need to do so and not for financial gain, anger, or to conceal criminal activity.
Compulsive hoarding is when a person has problems discarding possessions—regardless of their value—that then results in clutter and congestion to the detriment of the living environment. A person may, for example, hoard to the point that they can only navigate through their home using very narrow walkways that are surrounded by piles of junk. Hoarding may pose a physically hazardous situation.
Some individuals engage in compulsive hair pulling. Technically called trichotillomania, this condition is demarcated by a persistent urge to pull hair followed by a sense of relief or satisfaction once the hair has been pulled. Hair can be pulled from various places, e.g., the head, eyelashes, or eyebrows. Some individuals with trichotillomania compulsively eat the hair that they pull, which can result in the formation of human hairballs in their intestinal tract.
Signs of Addiction
Just like there are various types of addictions, there are a wide array of behaviors and other indicators that may signal the presence of an addiction. These signs of addiction will vary based on the person and the type of addiction. Complicating matters, those with addiction typically put forth sizable effort in concealing their addictive behaviors to avoid detection or to minimize the impact of their problematic behavior. Signs of addiction can include the following:
- Tolerance. Most often seen in instances of substance addiction, tolerance is when more of a substance is needed to achieve intoxication. For instance, a person who drinks habitually may need to consume an excessive number of alcoholic beverages to become intoxicated.
- Withdrawal. Like tolerance, withdrawal is most often conceptualized as a hallmark sign of substance addiction. Withdrawal refers to the unpleasant physical and psychological effects that occur when a person suddenly stops using a substance that has been used habitually. The specific signs and symptoms of withdrawal will vary based on the substance. For instance, caffeine withdrawal is relatively mild and is associated with headache, fatigue, and difficulties concentrating. In contrast, alcohol withdrawal can be severe and associated with nausea, vomiting, seizures, and even psychotic symptomatology like hallucinations.
- Inability to Stop. Those with an addiction typically evidence a reduced ability or inability to reduce or stop engaging in the problematic behavior—even when they might understand the need to do so and voice an intent to do so.
- Inordinate Amount of Time Devotion. Those with an addiction often spend inordinate amounts of time thinking about, planning, engaging in, and/or recovering from their addictive behaviors. For instance, someone with a video gaming addiction may spend many hours each evening playing video games at the expense of addressing other responsibilities, such as childcare. A person addicted to alcohol may experience problems at work because of frequent hangovers. A person with a shopping addiction may accrue significant debt because of overspending.
- Impairment in Important Areas of Functioning. A hallmark sign that a particular behavior has gone from being questionable to problematic is when that behavior begins to pose substantial problems to some important area of the person’s functioning. If the person’s behavior is resulting in trouble at work, criminal charges, or experiencing significant strain with significant others, then those—alone or collectively—would be a sign of an underlying addiction.
- Feeling Powerless to Control Addictive Behavior. Those with addictions will sometimes report feeling powerless to control their behavior. Similarly, they may evidence signs of underlying psychological symptomatology, such as depression and anxiety.
Utility of Forensic Psychological Consultation
In instances when an addiction is suspected, obtaining a consult with a forensic psychological expert would likely be prudent and helpful. The expert will be positioned to examine the data and offer opinions on various relevant issues, such as whether the person’s behavior is pathological and reflective of an addiction; the impact and potential ramifications of the addictive behavior; the extent to which an important capacity might be impaired; and, perhaps most importantly, if treatment—and what kind of treatment—is indicated. The person with an addiction may be actively incentivized to conceal or minimize their behavior, and those close to the person with the suspected addiction may lack the objectivity, knowledge, or expertise to properly identify and diagnose the problem. An expert might be called upon to analyze the data from a more peripheral position and offer mostly consultation, or the expert might be called upon to complete an in-depth, comprehensive evaluation of the individual to offer more specific opinions. An expert will be positioned to assist with identifying problematic behavior, which is important to know regardless of who’s representing who. Encouragingly, there are several empirically validated treatments available for addictions, which is cause for optimism when considering potential outcomes involving cases of problematic behavior.
Representing the Addicted Person
The first step in representing an addicted person is to identify whether there is an addiction and, if so, the type of addiction. In family law, addiction is very often the underlying reason for the marriage termination and/or conflict with children in a post-decree matter. Relying on mental health professionals and other third parties is key to identifying the addiction. Too often we hear from opposing counsel of our client’s addiction as reported by the estranged spouse, which then prompts inquiry to the client. Have you had any criminal issues due to the alleged addiction? Have you had any work-related issues with respect to the alleged addiction. Depending on the addiction, obtain releases to talk to third parties, family, friends, and professionals with whom the client may be working. Then talk to those people. Gather as much information as you can about the alleged addiction. If it turns out your client is likely addicted, get that client help. Courts can be very forgiving if a person admits the addiction and then voluntarily seeks the help needed to overcome the addiction. Obvious examples are substance abuse addictions. Inpatient rehabilitation facilities or intense outpatient treatment is a must. Convince the client that getting help to overcome the addiction will most likely help with their case and their relationships with children, family, friends, co-workers, and often the estranged spouse.
If the client refuses to get adequate help for the addiction, there are some safeguards the family law community has as options. For clients with an addiction to alcohol, there are a number of alcohol monitoring systems that can be utilized. Soberlink is a very popular product that allows a client can test to identify alcohol consumption before a parenting time visit and during parenting time visits. The results can be instantaneous, and the results can be sent to the guardian ad litem, spouses, and others for some peace of mind that the children are safe. If the addiction is a non-substance abuse addiction, helping can be more difficult. Encouragement of intense therapy, support groups, and/or inpatient and outpatient treatment programs is suggested. There are those instances when a client simply refuses to get help with their addiction. In those situations, as an advocate we do the best we can. We counsel the client in writing of the concerns if the addiction is not addressed and improved. Consider asking the court to appoint a guardian of the addicted person especially if the addicted person is not making competent decisions likely due to the addiction. In some instances, terminating that client is the best option. Be very mindful of getting paid from your addicted client. Very often the addictions are expensive, and the addicted person may choose to pay for their addiction rather than their attorney.
Representing the Non-Addicted Spouse
The majority of non-addicted spouses want their spouse to get help. As mentioned, often the addiction is the underlying cause of the marriage termination, or problems with children and the addicted spouse. Support your non-addicted client through the family law process. Encourage the non-addicted spouse to also seek support groups such as AL-anon and Alateen. Counseling is another suggestion for the non-addicted spouse. There are many times when you have to be very critical of the addicted spouse to effectively represent the non-addicted client. Trying to avoid doing that is wise, but if the addicted spouse doesn’t fix their problem, you may have no other choice. I regularly counsel my non-addicted clients that it can be very difficult to settle the family law matter with an addicted person involved. Addictive behavior can cause so many ups and downs, and when you think you may be close to resolution, the addicted person switches his or her mind on the agreement.
Effects on Finances, Children, and Relationships in General
Addiction has huge effects on finances, children, and relationships in general. Understandably, addiction can cause others to feel uncomfortable around the addicted person. There is usually lack of trust of the addicted person because often the addiction is so overwhelming that it takes over the addicted person’s life. That can lead to individuals stealing from friends and family just to keep up with the addiction. Similarly, the overwhelming effects and damage caused by addiction usually have a detrimental effect on relationships with children. Unfortunately, addiction can often be hereditary in nature. Learning that fact can be scary for a child who does not like the addictive behavior and does not want to behave in the same manner. Addiction can be absolutely devastating on a family’s financial circumstances. The addicted person’s judgment can be so clouded, they often spend too much money on their addiction, mismanage their finances, and in many instances, destroy their family.
In conclusion, dealing with addiction in any family law matter is scary and makes the family feel like they are on a roller coaster. As legal counsel, be sure you identify whether there is an addiction issue as soon as possible. Then develop a strategy on how to deal with the addiction in the family law matter.