Psychiatrist Prof. Dr. Nevzat Tarhan noted that in addiction, the individual becomes a slave to the substance they are addicted to, and the substance controls the person, emphasizing that addiction is a disease with relapse potential. Tarhan noted that the easiest way for the brain to learn is to take a substance readily available and turn to it, stating, “If a person learns stress management after treatment, they know what to do when a craving for the substance arises. The person needs to be able to manage the crisis moment. Because they cannot manage the crisis, they start using the substance again. That is why substance addiction is considered a chronic disease,” he said. Tarhan also noted that a misguided search for meaning is effective in the development of addiction, stating, “We can observe a lack of search for meaning in some addicted patients,” and thus emphasized the importance of a meaningful life philosophy.
Üsküdar Üniversitesi Founding Rector, Psychiatrist Prof. Dr. Nevzat Tarhan, made evaluations regarding addiction and its treatment.
In Addiction, the Substance Controls You
Prof. Dr. Nevzat Tarhan stated that the English equivalent of “bağımlılık” is “addiction,” adding, “The Turkish equivalent of ‘addiction’ is not 'bağımlılık' but ‘tutsaklık’ (captivity). You become a slave to the substance. Not by your own free will, the substance takes precedence in your life. The substance controls you. This means you have become addicted and captive. Captivity is the most severe form. After that, there is ‘dependence,’ which is a weaker form of addiction. It is in the nature of physiological addiction, psychological addiction.”
Addiction is a Disease with Relapse Potential
Prof. Dr. Nevzat Tarhan noted that addiction is generally a treatable brain disease, saying, “It doesn’t fully heal, but it gets better. After experiencing the disease, if a person adapts their living conditions, it may never relapse again. But it is always a disease with relapse potential. The attack subsides, and the person recovers from addiction. For example, a person recovers from addiction once. Their parents divorce, and they are sad. They stay with their father. The father engages in guilt-inducing, judgmental conversations and emotional blackmail. The child is saddened by this. While walking, the father comes to mind. They immediately take the substance they had quit. Why? Because our brain produces serotonin under stress. Serotonin decreases, and when it decreases, the person seeks to increase serotonin through self-medication, a behavior of self-comfort and self-treatment,” he explained.
Crisis Management Should Be Taught in Addiction Treatment
Prof. Dr. Nevzat Tarhan noted that the easiest way for the brain to learn is to take a substance readily available and turn to it, stating, “If a person learns stress management after treatment, they know what to do when a craving for the substance arises in such situations. Therefore, they need to have received psychoeducation in addiction treatment. The person needs to be able to manage the crisis moment, which is what we do at the hospital. Because they cannot manage the crisis, they start using the substance again. That is why substance addiction is considered a chronic disease. A person becomes diabetic. After learning they are diabetic, they pay attention to what they eat, drink, and do. Diabetes is no longer a problem in their life. Smart people adjust their lives accordingly. Those who quit substances also receive treatment in hospitals.”
Post-Treatment Follow-up is Important
Prof. Dr. Nevzat Tarhan noted that substance cessation treatment is easily achieved through various methods but emphasized the importance of post-treatment follow-up. Prof. Dr. Nevzat Tarhan said, “Today, there are digital follow-up systems. When a patient doesn't come for a check-up, a message is sent to their phone. The patient is also ready. It’s a kind of intervention. Expert help is immediately sought. We have patented a hospital management system. We will implement this. Currently, we are performing this follow-up without an application on smartphones.”
Uncontrolled Attempts to Quit Occur…
Prof. Dr. Nevzat Tarhan noted that addiction treatment is a team effort, stating, “The physician and psychologist are members of the team. Addiction negatively affects a person’s entire life. Tolerance develops. There is an uncontrollable urge to overuse. When a person does not take the substance, withdrawal symptoms begin. Dangerous and harmful use emerges. A person drives even though they know that driving under the influence of alcohol is dangerous. Most claim not to be alcoholic. A person has suffered stomach bleeding but continues to drink alcohol. Uncontrolled attempts to quit occur. It becomes central to life. They start sleeping and waking with it. They abandon all normal life and social activities. The person experiences problems due to this.”
Addiction is a Family Disease
Prof. Dr. Nevzat Tarhan noted that not only the individual but also their family is affected by addiction, and for this reason, addiction is called a ‘family disease,’ stating, “In addiction, not only the individual falls ill, but all close relationships are disrupted. Their spouse, children, and close circle are affected.”
Common in Those with Childhood Trauma…
Prof. Dr. Nevzat Tarhan noted that addiction is very common in those with childhood trauma, stating, “We now routinely apply the childhood trauma scale in every addiction case. In all of them, there are certainly physical neglect and physical abuse, emotional neglect and abuse, and sexual traumas. If a person places the trauma within a logical framework and resolves it, the substance-seeking behavior also decreases. Traumas disrupt the brain's network and remain like dormant volcanoes. Under stress, they become active. Whatever a person's weak point is, they turn to substances. Therefore, childhood traumas are very important,” he warned.
Substance Can Be Seen as a Shelter in Chronic Depression
Prof. Dr. Nevzat Tarhan noted that after childhood traumas, those with chronic depression are prone to substance use, stating, “These are unhappy, pessimistic, and gloomy individuals with moderate depression who cannot achieve happiness. Because these individuals are constantly under stress, they see the substance as a shelter or a safe haven. They deceive themselves with the substance. It is a false tranquilizer. It gives a false bribe to the brain and provides temporary relief. Of course, the effect of the substance becomes even worse.”
A Purpose in Life is Necessary
Prof. Dr. Nevzat Tarhan noted that a misguided search for meaning is also effective in the development of addiction, stating, “It is important for a person to have a purpose in life. We can observe a lack of search for meaning in some addicted patients. Not having a reason to live means not having meaning to live in life. It means not having planned goals for the future. Anomie, or normlessness, is the disease of this era. Ultimately, a person’s life philosophy is important in addiction.”
Addiction Damages the Brain
Prof. Dr. Nevzat Tarhan reminded that addiction damages many organs, including the liver, heart, stomach, and intestines, stating, “The brain suffers the most damage. Memory impairments occur in the brain. According to the damaged areas in the brain, early dementia occurs in individuals who have used substances for a long time because the brain shrinks. Alcohol and all toxic substances that lead to addiction are cell poisons. They poison brain cells. They pump all necessary chemicals in the brain into the blood, providing temporary relief like doping. A person feels bad for three weeks after using the substance. They lack the strength to even lift their hand.”
If a Person Loses Control, Addiction Can Be Diagnosed
Prof. Dr. Nevzat Tarhan noted that the biggest symptom of addiction is loss of control, stating, “If a person experiences loss of control, a diagnosis is made. If a person loses control over their life and with regard to the substance, addiction has begun. Factors such as a person using a substance longer than planned, neglecting their family, and their life spiraling out of control should be considered. The frontal lobe of the brain is the decision-making and control region. It is the brain's command center. In addicted individuals, the chemistry of this region is disrupted.”
Neuromodulation Treatments Are Applied in Addiction
Prof. Dr. Nevzat Tarhan noted that many methods are applied in the treatment of addiction, stating, “Clinical treatments lasting two or three weeks can be applied. Sometimes drug therapy is not enough; in some individuals, we apply deep brain stimulation treatment, called deep TMS, related to addiction. In deep brain stimulation treatment, stimulations are applied to the region of the person's brain where cravings for the substance arise. For these individuals, only drug therapy and detoxification are not sufficient in treatment. Treatments that modulate the brain, called neuromodulation therapy, are applied.
Internal Control is Impaired in Addiction
Prof. Dr. Nevzat Tarhan noted that a person’s internal control is impaired in addiction, stating, “There are two types of control in an individual: internal and external control. Internal control is the ability of a person to be the captain of their own ship. If someone cannot be their own captain, they are given an assistant captain. This approach also exists in addiction treatment. The rudder is not suddenly taken away; an assistant captain is given first. Therapy and treatments are applied to the patient. The patient is cleansed. After treatment, they become able to control themselves. The patient is informed about the possible consequences they would face if they were to start using the substance again during this process. Awareness is created in the person.”
Prof. Dr. Nevzat Tarhan also pointed out the importance of family support in addiction treatment, stating, “Here
The approach of families and social support are very important. There are social workers in clinics. The social worker conducts follow-up after treatment. They call the patient. If this is not done, addiction can relapse.”
Loose and Inconsistent Discipline Harms
Prof. Dr. Nevzat Tarhan noted that the parenting style of mothers and fathers is also important in the development of addiction, stating, “There are particularly parental attitude errors. There is a lot of love, loose discipline, or inconsistent discipline. The child has not learned a life with rules, has not learned a sense of responsibility. They have learned freedom but not responsibility. When they live irresponsibly, they don’t know where to stop. Attention deficit and hyperactivity constitute a risk group in addiction,” he warned.
Addiction is Increasing in Turkey
Prof. Dr. Nevzat Tarhan drew attention to the importance of protection efforts to prevent addiction, stating, “Primary prevention involves working, secondary prevention involves taking measures to eliminate risks, and tertiary prevention is to prevent relapse. Unfortunately, tertiary prevention is weak in Turkey. Unless these are done, addiction is rapidly increasing graphically. It is increasing in Turkey, and it is increasing worldwide, but in Turkey, it is increasing more than the world average,” he warned.