The events of October 7 had far-reaching impacts, notably on mental health. A comprehensive study, carried out jointly by Prof. Dana Tzur Bitan from the University of Haifa, the Shalvata Mental Health Center, and Prof. Yuval Neria from Columbia University, investigated the psychological repercussions of the incidents on October 7, affecting 420 Israeli individuals aged 18 and above. The research also explored the strategies that these Israelis have adopted to cope with these effects.
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The study unveiled a notable surge in the consumption of addictive substances following the onset of the war. A portion of the participants, 16%, indicated an uptick in nicotine use, while 10% noted an increase in alcohol consumption, and 5.5% reported a rise in cannabis use. The use of prescription drugs with a potential for addiction also saw a significant rise, with tranquilizer use increasing among 11% of the participants, sleeping pill use among 10%, and painkiller use among 8%.
It's crucial to note that these findings do not necessarily signal the emergence of a chronic or long-term disorder. This increase can be seen as an immediate psychological reaction to the unprecedented and intense events. It's common for most individuals to exhibit a severe psychological response following a traumatic event, but they often employ internal and external coping mechanisms, leading to an improvement in their condition. Nevertheless, it's vital to be cognizant of the potential implications of this increased reliance on substances with addictive potential.
Why are some substances addictive?
Some substances can influence our brains in a way that compels us to keep using them. They can stimulate positive sensations and even trigger brain functions related to reward, motivation, and memory, thereby enhancing the probability of recurrent consumption. In the short run, these substances can also diminish negative emotions like stress, anxiety, and depression. Moderate use of these substances can constitute part of a spectrum of wholesome experiences and adaptive strategies. However, such usage could potentially veer into unhealthy territory when it morphs into unmanageable cravings and detrimental behavior.
What is addiction, anyway, and how is it controlled?
Addiction fundamentally represents a loss of control over the use of substances that alter consciousness, such as alcohol, drugs, and certain prescription medications. This lack of control manifests as intense, and at times unregulated, use, despite an understanding of the potential risks and harm, coupled with a strong desire and craving for the substance. Moreover, a distinguishing characteristic of addiction is the physical, psychological, and functional harm that results from substance use.
Typically, before addiction fully develops, there are incremental processes of forming a dependence on the addictive substance. The first type of dependence is physical, which arises from consistent use and is characterized by the body adapting to the presence of the substance, to the point where it requires it to maintain physical equilibrium. This need is manifested in a strong craving, a powerful desire to use, and a longing for the effects of the substance. When physical dependence forms, the absence of the substance can lead to the development of unpleasant withdrawal symptoms such as irritability, sweating, and trembling.
The second type of dependence is psychological, where we rely solely on the substance and "depend" on it to feel better (or marginally less terrible) mentally. For instance, in these times of uncertainty and anxiety, the use of addictive substances may offer temporary relief from these feelings. However, it's the potent effect of these substances that may lead individuals to abandon other coping mechanisms, both external (like friends, family, mental treatment) and internal (like resilience, faith, optimism), thereby deepening their dependence on them.
What risk factors lead to addiction?
Most of us use addictive substances to some extent, whether it's nicotine, caffeine, alcohol or experimenting with cannabis and other drugs, as well as prescription medications like tranquilizers, painkillers and sleeping pills. Certain individuals have a genetic predisposition and specific personality traits that increase the likelihood of developing an addiction.
In addition, challenging and traumatic life events can trigger emotional distress and a desire to alleviate this discomfort. At such times, when we find our natural resources insufficient to ease the difficult feelings, some people turn to substances for immediate relief.
Over time, most of us manage to reduce our usage and keep it within a normative range. However, individuals experiencing intense trauma and distress, for whom coping mechanisms are inadequate, may develop dependency and addiction.
Symptoms of an addiction:
Daily use: While not a definitive indication of a problem, it certainly suggests a dependency that may develop into addiction.
Increased tolerance to substance and heightened use: If there's an increase in the amount of substance I consume from day to day, and an increase in the amount needed to achieve the desired effect, these are additional signs of developing dependency.
The substance becomes a time and money-consuming operation, often concealed from others: When a person invests significant resources and effort in thinking about the drug, organizing to obtain it, consuming it and recovering from its effects, it means they have fewer available resources for their life, family and daily challenges.
Impaired functioning: This is an important indicator for recognizing addiction. It's important to check whether substance use makes me less present in my daily life, both physically and emotionally, and less capable of performing tasks at work, in studies and at home. If something in me becomes distant and disconnected, it's possible that I've crossed the fine line between normative use and a problem.
We’re aware of the harm; why keep using it then?
The effects of substances on consciousness are strong and fast-acting. Within such a complex, sad and stressful reality, they hold significant power to change how people feel, leading them to cling to use as a coping mechanism.
We seek refuge to navigate the difficult and challenging day-to-day; moreover, the potent impact of substances on the brain makes it hard for us to think rationally and recognize the potential for a problem.
What can we do if we feel like we're losing control?
Firstly, share with someone you trust and don't go through it alone. Sometimes it's possible to muster strength and initiate a reduction or cessation of substance use so that it isn't daily.
It's advisable to seek alternative outlets for emotional needs, such as talking with a friend, going for a walk, listening to music, praying or seeking psychological therapy. There are professionals and support groups available today to help those suffering from addiction.
Additionally, one can attempt to reduce the availability of these substances, remove them from the home, and strive as much as possible to minimize exposure to places where these substances are accessible. It's worth making an effort to ensure that substance use occurs only in social situations and not alone.
In cases of prescription medications, it's important to share any concerns about increasing dosages with the doctor. In some cases, there may be alternative non-addictive medication available.
If you notice that someone close to you is developing concerning patterns of addictive substance or medication use, it's important to express concern and ask if they too are worried, offering help. You might ask, for example, "What can I do to help you reduce or stop using?"
What not to do? Do not blame, criticize, or claim that "if only you wanted to, you could stop." It's important to recognize that facing addiction is a significant challenge, and that people use these substances as a means to cope, not for celebration. For them, it's a delicate balance between the desire to continue using the substance for the relief it provides and the recognition of the harm it causes. A judgmental stance from an observer can push the person away and cause them to become more entrenched in their harmful usage.
- Dr. Daniel Feingold – rehabilitation psychologist, director of the Rehabilitation Psychology Program at Achva Academic College