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What Is Addiction?
Addiction is a chronic medical disorder defined by the compulsive seeking of drugs, alcohol, or activity despite negative consequences. Everyone’s introduction to addiction is different, but what’s common across all substance use and behavioral disorders is that continued use will lead to long-lasting changes in the brain.
While an individual may make the conscious decision to try a drug or an activity for the first time, this feeling of choice will slowly deteriorate as their body and mind changes with the influence of the substance. This is why addiction has impacted the lives of so many, and yet there is still the misconception that addiction is a matter of willpower. Many factors play into who is more at risk of developing a substance use disorder (SUD) and what treatment methods will work that go way beyond “choice.”
Addiction Affects The Brain
When someone uses a drug or engages in an addictive activity, the brain’s reward system becomes flooded with dopamine. Dopamine is the neurotransmitter in the brain that gives people the feeling of pleasure. It is also present in the regions of the brain that regulate movement, emotion, cognition, motivation, and reinforcement of rewarding behaviors.
The increase of dopamine in the brain due to substance abuse causes the neurons to reduce the number of dopamine receptors. This decrease in neurons leads to an individual needing to continue using substances to bring dopamine levels back to “normal,” thus reinforcing drug use behavior. Those with a drug or alcohol addiction or a behavioral addiction may struggle to find enjoyment from pleasurable activities, like spending time with friends, while sober.
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Risk factors are characteristics that make an individual more susceptible to substance use disorders. These include developmental factors, genetics, and environmental factors. One of the most significant risk factors is when someone starts using alcohol or drugs. The earlier an individual begins using substances, the greater their chances of developing an addiction, and the more severe their disorder is likely to be. Early use can also make young people more prone to mental health disorders when they get older. Additionally, environmental factors like access to drugs, trauma, lack of parental involvement during adolescence, and peer pressure can increase addiction risk.
Research estimates that genetics account for 40 to 60% of a person’s likelihood of developing an addiction. Like in any other chronic disorder, like heart disease or type 2 diabetes, genes influence the numbers and types of receptors in people’s brains, how quickly their bodies metabolize drugs, and how well they respond to different medications.
A dual diagnosis is when individuals have both a drug or alcohol addiction and a co-occurring mental or behavioral condition. 45% of people with addiction have a co-occurring mental health disorder.
Physical Dependence And Addiction
While “dependence” and “addiction” are two terms that are often linked, they are not interchangeable. Addiction is characterized by the inability to stop using a substance or engaging in an activity, failure to meet work, social, or family obligations, and, sometimes, tolerance and withdrawal. Physical dependence occurs when the body adapts to a particular substance and needs it for continued function.
When a physical dependence forms, more of the drug is required to reach the desired effect. This is known as tolerance. If drug use ceases abruptly, the body will experience drug-specific physical or mental symptoms known as withdrawal. Dependence doesn’t constitute addiction because it can be formed without misusing substances, like taking prescribed medication as directed. Likewise, an individual can be addicted to a substance without being physically dependent on it.
Diagnosing An Addiction
Like identifying any other illness, diagnosing a substance use disorder requires a thorough evaluation from a medical professional. This can include an assessment by a psychiatrist, a psychologist, or a licensed alcohol and drug counselor. The signs that point to addiction are not always clear to see, so it’s best to get a professional evaluation. From there, deciding the next best steps for treatment becomes more attainable. One of the best aids in recognizing addiction is the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. The DSM-5 presents a list of criteria that helps identify if someone has a SUD and to what severity.
The DSM-5 list of criteria includes:
Lack of control
An individual uses a substance in more significant amounts or over a longer time than intended. Lack of control is one of the cardinal features of addiction. An individual with an addiction will have difficulty refraining from substances even if they have intentions to stop or reduce.
Desire to limit use
An individual wants to cut down or stop using substances, but they cannot do so. They may repeatedly attempt to reduce or refrain from drugs without success.
The actions required to get, use, or recover from substance abuse take up a significant amount of time.
Those with an addiction will experience intense urges or desires to use their specific substance. These cravings can upend any planned schedule for the day because these thoughts are reoccurring and distracting.
Prioritizing substance use
Substance use takes priority over significant obligations like work responsibilities, relationships, or school. Individuals with an addiction will be unable to manage commitments due to use.
An individual will continue to abuse a substance, even when it causes problems in relationships.
Loss of interest
An individual will give up important activities or hobbies because of substance abuse.
Individuals will continue to use a substance, even when it may put them in danger. Dangerous circumstances could include drunk driving, sharing drug paraphernalia, or the activities they partake in to obtain the substances.
Physical or psychological problems worsen
An individual will continue to use, even when physical or psychological problems may be worse or made worse by use. The condition of an individual’s life may be deteriorating, so they decide that continuing use will have no worse effect on where they are in the moment. This disregard can make a dire situation worse.
As the brain and body adapt to the continued use of substances, more significant amounts of the substance are needed to achieve the desired effects for an individual.
Withdrawal symptoms can be physical or emotional. These include anxiety, confusion, heart palpitations, or insomnia. However, extreme alcohol withdrawal can lead to delirium tremens. This is potentially fatal because they can cause seizures.
Warning Signs Of Addiction
Multiple signs may indicate that someone is developing or has an addiction, but it’s important to remember that everyone is different. Everyone will display various symptoms, and some may even try to conceal the severity of their condition.
Some general physical, behavioral, and psychological warning signs to be aware of include:
- Deterioration of physical appearance and personal grooming habits.
- Rapid weight loss or weight gain.
- Neglecting commitments or responsibilities at home, work, or school.
- Unexplained absences.
- Change in friends, hobbies, and hangout spots.
- Considerable financial fluctuations.
- Lapses in concentration or memory.
- Sudden mood swings, increased irritability.
- Unusual lack of motivation.
- Engaging in secretive or suspicious behaviors.
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Understanding Drug Addiction
Many mistakenly coincide drug addiction with a lack of moral principles or willpower, but the truth is not that simple. An addiction may begin with the initial decision to try a drug, but the idea of choice is quickly taken away as the brain and body adapt to the substance. Some people with a mild addiction can recover with little to no treatment, but those with a more severe case of addiction will require treatment due to its chronic nature.
Multiple factors like culture, environment and family history can shape who is at risk of addiction. Not everyone who tries a substance will become addicted. So, distributing blame as to why only some people develop a substance use disorder takes away from the mission of directing individuals to quality care and recovery.
Common Types of Drugs
Drugs are categorized into several groups based on chemical similarities, how they impact the body and mind, and even legal definitions. Understanding what type of drug is being used by someone with an addiction is critical in determining what kind of treatment is needed and how the individual became addicted in the first place.
A list of common drugs include:
- Illicit Drugs
- Sleeping Pills
Combining more than one drug at a time is known as polydrug use. This act of mixing substances carries additional risks and can be extremely dangerous due to the range of unpredictable side effects. Using one substance will already have a drastic impact on the body, so adding another substance will add even more strain on the body and brain function.
The effects of polydrug use can depend on the amount of a substance and the frequency of use, how an individual’s body responds to substances, and the type of substances combined. For example, if someone were to combine two stimulants, like Cocaine and Ecstasy, some possible side effects could be anxiety or panic attacks, heart problems, or psychosis. Now, if a stimulant and a depressant are combined, like alcohol and Adderall, the side effects can be even more alarming. These effects include heart problems, possible kidney failure, or respiratory infections.
Alcohol addiction, also known as an alcohol use disorder (AUD), is defined by a craving for alcohol and the inability to stop drinking despite adverse consequences. The prolonged abuse of alcohol results in chemical changes in the brain; therefore, it’s crucial to treat an AUD in its earliest stages if possible. The severity of the disease, how often someone drinks, and the alcohol they consume varies from person to person. Some people drink all day heavily, while others drink heavily within a couple of hours or binge drink and then stay sober for a while.
An individual doesn’t have to meet specific criteria to consider treatment. Someone who is not diagnosed with an AUD but may struggle with alcohol consumption can still reach out for help. Like any other addiction, many factors contribute to someone’s likelihood of developing an AUD, but there is no single cause.
Signs Of Alcoholism
Unlike the use of some other drugs, like Heroin or Meth, the use of alcohol can fly under the radar as a widely accepted part of everyday life. Drinking is so common in American culture, often linked to celebrations and social events, that it can be hard to see the difference between casual alcohol use and a real problem.
Some warning signs of alcoholism include:
- Establishing a high tolerance for alcohol, or lack of “hangover” symptoms.
- Drinking at inappropriate times.
- Needing alcohol to feel better or “normal.”
- Neglecting personal, social, and professional obligations.
- Participating only in activities that involve drinking.
- Increasing quantity or frequency of use.
This is by no means an exhaustive list, and everyone will present symptoms differently, but discovering these warning signs early on may help an individual avoid more severe health consequences.
For many individuals, the first step on the road to recovery is realizing that they may have a problem with substance abuse. Acknowledging an issue is a scary first step, but this opens the door to many possible treatment options. Because addiction is a chronic condition, the option of refraining or reducing drug use simply by willpower or with little to no help from outside sources is unlikely. Most individuals need long-term or repeated care to stop using entirely and improve their lives. Attending treatment facilities, specialized therapies, or support groups is effective in helping people achieve their goals.
Types Of Treatment
There is no approach to recovery that will suit everyone’s needs and expectations, but thankfully, the recovery journey is adaptive to an individual’s specific needs.
· Inpatient Rehab
Those in inpatient rehab are required to stay in the facility for the duration of their time in treatment. Inpatient rehab uses structured programs and the support of staff and medical professionals to help individuals focus on recovering. Individuals are removed from addiction sources, triggers, and aggravators and are supervised 24/7. The length of program varies but may last 30, 60, or 90 days.
· Outpatient Rehab
Outpatient programs offer many of the same treatments and therapies as inpatient rehab while allowing an individual to stay at home. While individuals can still work or go to school, not having individuals remain onsite for treatment can run the risk of encountering triggers. Thus, outpatient treatment is suited for those with a mild SUD, or it can serve as a “step down” program after inpatient treatment.
Different forms of therapy and support groups are also used in collaboration with these rehab treatment options. This combination of recovery options provides individuals with a full scope of coping skills, medical attention, and continued care.
Looking For Help
It is a universal truth that you or a loved one is deserving of help for any form of addiction or substance abuse. The road to recovery can be intimidating but know that there are options for everyone, and you do not need to travel alone. Contact a treatment provider today to discuss available treatment options for you or a loved one.