Addiction is more than a bottle of booze or a line of a narcotic. Officials at the UA’s Campus Health Service say that although alcohol tends to be what most students come in for, consultations for students with other addictions do come up — a representation of a campus trend that reflects a national issue.

Of the 16 million Americans suffering from compulsive sexual behavior, 60 percent suffered abuse during childhood, according to the Society for the Advancement of Sexual Health. Around 2 million Americans are compulsive gamblers, while another 4 to 8 million have gambling problems that are less severe, according to the National Council on Problem Gambling. In addition, at least 1 in 20 Americans is a problem shopper, according to a study by Stanford University. Problem shopping, as well as gambling or sex addiction, tend to trigger the pleasure centers in the brain the same way substances do.

Counselors at UA’s Counseling and Psychological Services (CAPS) see students struggling with the beginnings of addiction every day.

CAPS employees see students who deal with more than just an alcohol or drug addiction, according to Debra Cox-Howard, a substance abuse professional counselor at CAPS. These students are addicted to things like food, the Internet, shopping, spending, gambling, a relationship and sex. She said the trend is national, not just campus-wide, but it doesn’t get the recognition of more publicized addictions.

“My first publication I ever wrote was (about) ‘other’ addictions because alcohol and drugs, they get the spotlight,” said Ernestina Buck, an adjunct assistant professor of disability and psycho-educational studies. “But the person who’s overeating, undereating, who is porn-addicted, who’s gambling, they don’t get the focus and they get lost.”

According to a 2011 study by the Research Institute on Addictions, compulsive gambling saw an uptick in frequency during the teen years, reaching a high level in the respondents’ 20s and 30s.

Another study by the nonprofit Henry J. Kaiser Family Foundation showed that children and teens can spend up to eight hours a day on the Internet with the growing availability of social networking sites and smartphones. Those eight hours can actually equal 11 hours of time spent when multitasking is taken into account.

How addictions form

“Any kind of addiction is on a continuum, so you’ve got use, abuse and dependence,” said Lynn Reyes, alcohol and other drug prevention specialist at the UA’s Campus Health Service. “It’s really not going to matter how old you are, but if you are dependent in your 20s or your 40s, dependence is dependence.”

Most times in college students, dependence hasn’t formed yet. It varies between use and abuse. There’s a difference between abuse and addiction. Drug abusers tend to neglect responsibilities or take more risks. In what is usually referred to as addiction — when someone has become dependent on a behavior — the person loses control over its use, participating despite negative effects on their life.

“Environment is a key factor,” Reyes said of forming addictions.

Everyday habits get normalized because of the person’s environment, influenced by their friends or social group.

“If the thinking is that this is normal college behavior, that I need to do this to fully experience college, the belief will lead to maintaining that behavior, and when you see other people doing it, that kind of norms it,” Reyes said.

But Reyes said many people see a distorted reality of what others are doing around them, which might skew how people engage with substances and each other. “There’s a difference between the actual norm and the perceived norm.”

Genetics and age are also important. Genes account for between 40 and 60 percent of personal vulnerability to addiction, especially during adolescence, according to the National Institute on Drug Abuse.

“There’s different genes that have different effects on a person and their dependency traits,” Buck said.

And all of this has a tremendous effect on the brain.

How addiction affects the body, brain

Addictions develop over time, typically beginning during the development of the prefrontal cortex in the brain, which regulates pleasure and continues to change into the late teens and early 20s.

“The brain is basically hijacked by the addictive process, and there are neurochemical changes that happen when a person crosses that line into addiction,” Buck said.

Addiction dramatically affects the brain, including the limbic system and prefrontal cortex, both of which hold pleasure centers in the brain:

• Addiction activates the pleasure centers through neuron signals. Neurons in the reward pathway, connect among other things the limbic system and prefrontal cortex, release neurotransmitters.

• Those same neurons send electrical signals across small spaces in the brain called synapses to each other down their axons, a tendril that springs off of a neuron.

• Dopamine is released into the synapse, crosses to the next neuron and binds to receptors, providing jolts of pleasure more intense than natural rewards such as eating when hungry or feeling rested after sleeping.

The dopamine allows the addictive substance, whether natural or one part of an addiction, to soothe the survival center of the brain. The addictive substance then increases the amount of dopamine, heightening the feeling of pleasure.

Every time an addict uses, it carves a deeper pathway for the neurons to follow. As these pathways deepen, within the span of addiction, the body believes everyday functioning is dependent on the addictive substance.

“The brain has been programmed to identify survival with that drug or activity,” Buck said.

How addiction manifests itself

Once the brain has made the connection between the addictive substance and survival, a person has become dependent. Dependency has a few hallmark symptoms, according to Buck.

One is a higher-than-average tolerance for a substance, and it takes more of a substance each time an addict uses it to achieve the same pleasurable result.

The second is withdrawal, during which a person has predictable physical symptoms. They can manifest themselves as moodiness, anxiety, sleeplessness or irritability with non-chemical addictions.

“And those symptoms can last a long time, especially if the dependency isn’t treated,” Buck said.

Treatment for college students

No two people have the same path to recovery, no matter what the addiction.

It’s not a moral issue or about willpower, and it’s not about hitting rock bottom. It’s about understanding the addiction, any addiction. And this flies in the face of those who think non-chemical addictions aren’t necessarily real or aren’t as addictive as alcohol or illicit drugs.

“Because treatment is more than detox, it can include psychological, social interventions, lifestyle interventions such as nutrition and finding healthy replacements for the activity or substance,” Buck said.

That is why Buck has her students who want to become drug counselors add a benign habit, like drinking an extra cup of water a day or exercising at a certain time every morning, to help them understand how quickly a habit can become addictive.

Future paths of addiction

“In the recovery process, part of what happens is developing new associations of safety for the brain so that when stress is triggered, the person has developed healthy and safe avenues for the brain to associate with safety,” Buck said.

There are special ways to treat addicts, things that also work with college students, according to Cox-Howard.

One treatment method uses motivational interviews, which are created to recognize the differences between readiness levels of people entering treatment. The goal-directed interviewing spurs motivation within the client to change their behavior. These interviews identify the addict’s own weaknesses in order to tackle them.

Another is cognitive behavioral treatment, which would treat addiction through either one-on-one or group treatment methods.

Some of this is through cognitive remodeling, where Socratic questioning methods help addicts re-evaluate how they perceive their addition.

Other parts deal with exposure therapy, where addicts are introduced to a behavior they will have to confront, such as shopping or sex, with physician support to begin to deal with its place in their life.

But with more data about how pervasive non-chemical addictions are among youth, Reyes said, will come clarification on the severity of non-chemical addiction. Addiction counselors hope that more understanding of youth non-chemical addiction will show whether a lack of reporting these addictions is equivalent to a lack of occurrence of them among students.

“I think Internet addiction, the social media addiction is still developing because the technology changed. Even the (World Wide Web) was only developed in the 1990s,” Reyes said. “So will the (social) media stuff be bigger than, say, sex addiction or gambling or other stuff? I don’t know. Certainly there’s potential. We have to wait and see.”