People with a substance use disorder have disturbed thinking, behavior and body functions. Changes in the brain’s wiring are what cause people to have intense cravings for the drug and make it hard to stop using the drug. Brain imaging studies show changes in the areas of the brain that relate to judgment, decision making, learning, memory and behavior control (APA, 2013).
People can develop an addiction to:
- PCP, LSD and other hallucinogens
- Inhalants, such as, paint thinners and glue
- Opioid pain killers, such as codeine and oxycodone, heroin
- Sedatives, hypnotics and anxiolytics (medicines for anxiety such as tranquilizers)
- Cocaine, methamphetamine and other stimulants
These substances can cause harmful changes in how the brain functions. These changes can last long after the immediate effects of the drug — the intoxication. Intoxication is the intense pleasure, calm, increased senses or a high caused by the drug. Intoxication symptoms are different for each substance.
Over time people with substance use disorder build up a tolerance, meaning they need larger amounts to feel the effects.
According to the National Institute on Drug Abuse, people begin taking drugs for a variety of reasons, including:
- to feel good – feeling of pleasure, “high”
- to feel better – e.g., relieve stress
- to do better – improve performance
- curiosity and peer pressure
People with addictive disorders may be aware of their problem, but be unable to stop it even if they want to. The addiction may cause health problems as well as problems at work and with family members and friends. The misuse of drugs and alcohol is the leading cause of preventable illnesses and premature death.
Symptoms of substance use disorder are grouped into four categories:
- Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use
- Social problems: substance use causes failure to complete major tasks at work, school or home; social, work or leisure activities are given up or cut back because of substance use
- Risky use: substance is used in risky settings; continued use despite known problems
- Drug effects: tolerance (need for larger amounts to get effect); withdrawal symptoms (different for each substance)
Many people experience both mental illness and addiction. The mental illness may be present before the addiction. Or the addiction may trigger or make a mental disorder worse.
The National Council on Alcoholism and Drug Dependence (NCADD) the abuse of alochol and drugs is a serious issue that should not be ignored or minimized. If untreated use and abuse can develop into serious dependence.
Symptoms associated with alcohol abuse:
- Temporary blackouts or memory loss.
- Recurrent arguments or fights with family members or friends as well as irritability, depression, or mood swings.
- Continuing use of alcohol to relax, to cheer up, to sleep, to deal with problems, or to feel “normal.”
- Headache, anxiety, insomnia, nausea, or other unpleasant symptoms when one stops drinking.
- Flushed skin and broken capillaries on the face; a husky voice; trembling hands; bloody or black/tarry stools or vomiting blood; chronic diarrhea.
- Drinking alone, in the mornings, or in secret.
Signs of addiction include the following:
- Loss of Control: Drinking or drugging more than a person wants to, for longer than they intended, or despite telling themselves that they wouldn’t do it this time.
- Neglecting Other Activities: Spending less time on activities that used to be important (hanging out with family and friends, exercising, pursuing hobbies or other interests) because of the use of alcohol or drugs; drop in attendance and performance at work or school.
- Risk Taking: More likely to take serious risks in order to obtain one’s drug of choice.
- Relationship Issues: People struggling with addiction are known to act out against those closest to them, particularly if someone is attempting to address their substance problems; complaints from co-workers, supervisors, teachers or classmates.
- Secrecy: Going out of one’s way to hide the amount of drugs or alcohol consumed or one’s activities when drinking or drugging; unexplained injuries or accidents.
- Changing Appearance: Serious changes or deterioration in hygiene or physical appearance – lack of showering, slovenly appearance, unclean clothes.
- Family History: A family history of addiction can dramatically increase one’s predisposition to substance abuse.
- Tolerance: Over time, a person’s body adapts to a substance to the point that they need more and more of it in order to have the same reaction.
- Withdrawal: As the effect of the alcohol or drugs wear off the person may experience symptoms such as: anxiety or jumpiness; shakiness or trembling; sweating, nausea and vomiting, insomnia, depression, irritability, fatigue or loss of appetite and headaches.
- Continued Use Despite Negative Consequences: Even though it is causing problems (on the job, in relationships, for one’s health), a person continues drinking and drugging.
People can recover from addiction. Effective treatments are available.
The first step on the road to recovery is recognition of the problem. The recovery process can be hindered when a person denies having a problem and lacks understanding about substance misuse and addiction. The intervention of concerned friends and family often prompts treatment.
A health professional can conduct a formal assessment of symptoms to see if a substance use disorder exists. Even if the problem seems severe, most people with a substance use disorder can benefit from treatment. Unfortunately, many people who could benefit from treatment don’t receive help.
Because substance misuse affects many aspects of a person’s life, multiple types of treatment are often required. For most, a combination of medication and individual or group therapy is most effective. Treatment approaches that address an individual’s situation and any co-occurring medical, psychiatric and social problems can lead to sustained recovery.
Medications are used to control drug cravings and relieve severe symptoms of withdrawal. Therapy can help addicted individuals understand their behavior and motivations, develop higher self-esteem and cope with stress. Other treatment methods may include:
- Therapeutic communities (highly controlled, drug-free environments)
- Outpatient programs
Many people find self-help groups for individuals (Alcoholics Anonymous, Narcotics Anonymous) as well as their family members (Al-Anon or Nar-Anon Family Groups) useful.
Drug addiction is preventable. Drug education and prevention efforts aimed at children and adolescents and involving families, schools, communities and media can be effective in reducing drug misuse.
|Risk and Protective Factors for Drug Misuse and Addiction|
|Aggressive behavior in childhood/Good self-control||Lack of parental supervision/Parental monitoring and support|
|Poor social skills/Positive relationships||Drug experimentation/Academic competence|
|Availability of drugs at school/School anti-drug policies||Community poverty/Neighborhood pride|
These 13 principles of effective drug addiction treatment were developed based on three decades of scientific research. Research shows that treatment can help drug-addicted individuals stop drug use, avoid relapse and successfully recover their lives.
- Addiction is a complex, but treatable, disease that affects brain function and behavior.
- No single treatment is appropriate for everyone.
- Treatment needs to be readily available.
- Effective treatment attends to multiple needs of the individual, not just his or her drug abuse.
- Remaining in treatment for an adequate period of time is critical.
- Counseling— individual and/or group —and other behavioral therapies are the most commonly used forms of drug abuse treatment.
- Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.
- An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure it meets his or her changing needs.
- Many drug-addicted individuals also have other mental disorders.
- Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse.
- Treatment does not need to be voluntary to be effective.
- Drug use during treatment must be monitored continuously, as lapses during treatment do occur.
- Treatment programs should assess patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases, as well as provide targeted risk-reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases.
Source: National Institute on Drug Abuse. These principles are detailed in NIDA’s Principles of Drug Addiction Treatment: A Research-Based Guide.
How to Help a Friend or Family Member
Some suggestions to get started:
- Learn all you can about alcohol and drug misuse and addiction.
- Speak up and offer your support: talk to the person about your concerns, and offer your help and support, including your willingness to go with them and get help. Like other chronic diseases, the earlier addiction is treated, the better.
- Express love and concern: don’t wait for your loved one to “hit bottom.” You may be met with excuses, denial or anger. Be prepared to respond with specific examples of behavior that has you worried.
- Don’t expect the person to stop without help: you have heard it before – promises to cut down, stop – but, it doesn’t work. Treatment, support, and new coping skills are needed to overcome addiction to alcohol and drugs.
- Support recovery as an ongoing process: once your friend or family member is receiving treatment, or going to meetings, remain involved. Continue to show that you are concerned about his/her successful long-term recovery.
Some things you don’t want to do:
- Don’t preach: Don’t lecture, threaten, bribe, preach or moralize.
- Don’t be a martyr: Avoid emotional appeals that may only increase feelings of guilt and the compulsion to drink or use other drugs.
- Don’t cover up, lie or make excuses for his/her behavior.
- Don’t assume their responsibilities: taking over their responsibilities protects them from the consequences of their behavior.
- Don’t argue when using: avoid arguing with the person when they are using alcohol or drugs; at that point he/she can’t have a rational conversation.
- Don’t feel guilty or responsible for their behavior; it’s not your fault.
- Don’t join them: don’t try to keep up with them by drinking or using.
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- National Institute on Drug Abuse: Drugs, Brains, and Behavior – The Science of Addiction
- National Council on Alcoholism and Drug Dependence
- National Center on Addiction and Substance Abuse at Columbia University
- Alcoholics Anonymous
- Narcotics Anonymous
Adapted from: National Council on Alcoholism and Drug Dependence
American Psychiactric Association,https://www.psychiatry.org
American Psychological Association, https://www.APA.org
National Institute on Drug Abuse (NIDA) https://www.drugabuse.gov/