The viewpoint that addiction is an untreatable disease can dissuade people who need it from seeking treatment. Those that have an addiction might view that point as a challenge. They are motivated to beat addiction, and through medical supervision and professional treatment, they can achieve sobriety.
When it comes to drug addiction treatment, everyone is different in regards to the best treatment for their specific case. There are many kinds of tried and true therapies and treatment methods available for people in active addiction, but it’s important to realize the same combination doesn’t (and won’t) work for everyone. However, having the correct background knowledge plays a significant role in determining whether a patient can achieve sobriety or not.
As a chronic brain disease, addiction can be identified through compulsive substance use and abuse in spite of the detrimental drawbacks. Knowing what addiction actually is can give some insight into treating it.
The first step to recovery is finding the root of the problem. What compelled someone to follow the path of substance abuse? What triggered it? Understanding what drives someone to abuse drugs or alcohol is critical in treating it.
What are Abuse, Dependence, and Addiction?
When it comes to addiction, there are a handful of terms that people often use interchangeably. But there is a difference between drug abuse, dependence, and addiction.
Though they are all closely related, it’s possible to abuse drugs without being addicted. So what is the difference between these terms?
Abuse refers to harmful or hazardous use of a psychoactive drug or alcohol. Harmful use can be different for each drug. For an illicit drug, some would consider any use at all potentially harmful. Illicit drugs are unregulated, and that makes them unpredictable. Each hit may potentially have harmful additives.
Harmful use of a prescription drug could mean any use beyond what is prescribed. Using someone else’s prescription, getting prescription drugs illegally, and or taking your prescription beyond what’s directed. Legal psychoactive substances like alcohol and nicotine may be abused if they threaten your health or well-being. For instance, binge drinking may be abuse because it can lead to overdose, dependence, or accidents.
Dependence, or chemical dependence, refers to your brain’s reliance on a drug to maintain normal brain chemistry. If you abuse a substance long enough, your brain will start to adapt to its presence, changing your brain chemistry to balance it with the drug in your system. If you stop using the drug, you’ll start to feel withdrawal symptoms, which are a consequence of sudden chemical imbalance. Withdrawal symptoms can be uncomfortable or even deadly, depending on the substance.
Addiction is defined as a complex disease that affects the reward center of the brain. The reward center is designed to encourage you to repeat healthy activities. Addictive substances can trick the reward center into treating drug use as one of these activities. An addicted person may be compelled to use in a similar way that you are compelled to drink water when you’re thirsty.
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders issues related to drug use fall under the category of substance use disorders (SUD). SUDs can be mild, moderate, or severe, depending on specific factors. The DSM-5 identifies substance use disorders based on 11 criteria, which include:
- Dangerous drug use that has put yourself or someone else in harm’s way like drunk driving or experiencing an overdose.
- Social or relationship problems that have been caused by drug use.
- Failing to fulfill responsibilities at work, school, or home because of drug or alcohol use.
- Experiencing withdrawal symptoms after you stop or cut back because of drug dependence.
- Building up a tolerance to the substance that requires you to use more to achieve the same effects.
- Increasing the amount of time you use or the size of the dose you use.
- Trying and failing to stop or cut back on drug use.
- Spending a lot of time using each week or each day.
- Experiencing physical or psychological issues because of drug use.
- Losing interest or giving up normal activities like hobbies to use.
- Experiencing cravings to use a drug or alcohol.
The severity depends on the number of these factors that apply to an individual. Someone who occasionally binge drinks may qualify for number one and not much else. They abuse drugs and might have a mild substance use issue, but they haven’t developed a dependence or addiction. Someone who qualifies for many of these may have a severe substance use disorder, which means they’ve become addicted.
Causes of Addiction
The reason why people do drugs despite the negative side effects seems simple: happiness. Substances such as alcohol and illegal narcotics produce effects which can make people feel good or happy. Pleasure is the motivation for everyone, whether it is working at a job to get paid or buying yourself new things to simply eating a bowl of ice cream.
The sensation of pleasure is caused by the release of dopamine into the brain, which rewards the person with feelings of happiness.
Because of this, the brain begins to seek other dopamine-releasing activities. The brain begins to associate certain activities or substances with happiness, and, eventually, habits form.
In a normal-functioning brain, the dopamine released into the brain is reabsorbed and dopamine levels in the brain return to normal. Yet, when abusing a drug, the chemical function of the brain changes to accommodate the unnaturally high levels of dopamine that are released.
The extreme surge of dopamine is too much for the brain to absorb, so the dopamine is not recycled normally. As the excess dopamine lingers, the brain begins to produce less of it and begins to depend on the dopamine that is produced from drug use instead of naturally. Activities that were once fun and enjoyable, soon become dull and boring when compared to using drugs.
It’s essential to understand what addiction is and how it works. It is even more critical to know the specific roots of your addiction. At what point do drugs begin to take over someone’s life, and what makes someone more susceptible to addiction than others?
While it is true that there are almost countless factors contributing to whether someone becomes addicted to a drug, the two main factors that have the most influence on someone who potentially could develop a substance abuse disorder are environmental and biological factors.
Depending on the environment that someone is in, the probability of that person developing an addiction or dependency can vary from nearly impossible to almost guaranteed. The term “environmental factor” as relating to addiction refers to the different outside forces that a person is exposed to that may influence their risk of developing an addiction.
Family – A person with a potential substance or alcohol abuse disorder may come from a family in which one or both parents may use substances to deal with stressors. This can influence children to think that doing the same is okay.
School, work, friends — These environmental factors can sway someone’s likelihood of developing an addiction. Especially during adolescence, the people that surround an individual during school and work can easily influence them. Failure at work or school and even a lack of friends can influence put an individual at risk for addiction.
Currently, experts are studying models that contribute to some factors of addiction development to biology. These models assert that brain development and functionality and genetics can play a vital role in determining whether someone is at a higher or lower risk of addiction.
Although no genes have been specifically identified as “addiction probability” genes, there is no doubt that some genes can indirectly influence a person’s susceptibility. Take a look at alcohol addiction, for example. There is not a gene that puts someone at a higher risk of developing alcoholism. However, there are genes that we know of that can substantially reduce the effects of a hangover and can boost the enjoyable effects of alcohol.
A risk factor is simply something that correlates with the addiction rate. Regarding the development of drug addiction, there are a few risk factors that are worth considering:
Many mental health disorders directly correlate with the likelihood of developing an addiction. Depression, ADHD, ADD, PTSD, and personality disorders are common among those with a substance or alcohol use disorder.
Stimulants, opioids, and benzodiazepines are generally more addictive than other substances. Even though addiction is not guaranteed, the type of drug heavily influences whether or not a person becomes addicted.
The lack of a parental figure, difficulty in family communication, and even a lack of motivation to engage in family bonding can increase someone’s likelihood of developing an addiction.
Signs of Addiction
While some substances may share common signs of addiction, it is important to remember that every case is different. By treating every addiction individually, one can put themselves at great risk.
All drugs are different, and the plethora of illicit substances that can be abused grows every day. Because of this, learning the noticeable signs of addiction for each type of drug can be the difference between a successful and failed recovery. For example, an individual with alcohol use disorder and someone addicted to Xanax may show similar long-term abuse signs, but there will be signs unique to each substance.
The most commonly abused substances are alcohol, stimulants, depressants, and opioids, and each of them shows different signs of long-term abuse and addiction.
Because the signs of alcohol addiction can include physical and mental symptoms, early detection of an alcohol use disorder can be much easier to observe than other substance use addictions. The physical symptoms of alcohol addiction can include:
- Slurred speech or problems with coordination
The psychological side effects of alcohol addiction can include:
- Restlessness and agitation
- Loss of interest in previous hobbies or activities
In the case of stimulant abuse disorders, the signs can be physical or behavioral. However, the physical side effects of stimulant addiction are unique and are usually more severe when compared to other substances. Stimulants, even when used short-term use, have extremely severe withdrawal symptoms and can easily alter the chemical functionality of the brain. The physical symptoms of stimulant addiction may include:
- Extreme exhaustion
- Severe weight loss
- Short, shallow breathing
- Seizure/loss of muscle control
The psychological symptoms of stimulant addiction are:
- Severe anxiety
- Suicidal thoughts
When it comes to depressant abuse and addiction, the physical and behavioral symptoms are quite noticeable. Depressants have sedative properties, and they slow down a person’s central nervous system function. This results in noticeable behavioral and physical side effects. The physical symptoms of depressant addiction are:
- Shallow breathing
The psychological symptoms of depressant addiction include:
- Low attention span/difficulty concentrating
- Poor decision making
- Memory loss
The memory loss aspect of depressant addiction is in reference to the affected person’s actions, which they will not remember later on. It is almost identical to sleepwalking in that the user will randomly become conscious in the middle or after a bizarre action.
The signs of an addiction to opioids range from physical to behavioral, and knowing what they are can aid in the early detection of addiction. The physical symptoms of depressant addiction are:
- Weakened immune system
- Gastric problems (ranging in severity from constipation to bowel perforation)
- Shallow breathing
- Liver damage (prevalent in cases that combine opioids with acetaminophen)
The psychological signs of opioid addiction are:
- Mood swings
- Social isolation
Drug addiction treatment is meant to help people not only end their addiction but also prevent future relapse and addiction. Relapse prevention in the future is an aspect of treatment that is commonly overlooked even though it is just as important as any other stage of treatment.
The National Institute on Drug Abuse (NIDA) clearly states, in a research-based guide, that drug addiction is a chronic disorder characterized by occasional relapses. For this reason, addiction treatment is a long-term process that involves multiple interventions and constant attention and care.
While all cases of addiction are viewed as unique, drug addiction treatment generally follows a certain path: medical detoxification, a treatment program (outpatient, inpatient, residential), and aftercare.
As the first and arguably the most important step in drug treatment, medical detoxification eliminates any toxins or leftover residue from previous abuse before continuing treatment. Detox is usually short, only lasting for around five to seven days, and is the starting point of treatment. Because it is the first stepping stone on the path to sobriety, it is consequently the most difficult for a majority of people that seek treatment.
The overall success of a person’s addiction treatment depends largely on the success of medical detox, so ensuring that you receive the proper help and support you need during it is essential. For this reason, medical supervision is almost always suggested before engaging in detox. Treatment centers provide 24/7 support for patients in detox, and the patient’s withdrawal symptoms can be much easier to spot and combat.
Despite the apparent benefits of engaging in professional medical detox, many people struggling with substance use disorders disregard or forget the more-than-likely withdrawal symptoms and attempt to self-detox at home by going “cold turkey.”
Going “cold turkey” refers to the immediate cessation of substance intake or abuse in an attempt at self-detoxing. By engaging in “cold turkey” detox, an individual can avoid the minor inconvenience of seeking professionally-supervised medical detox at a treatment center. Not only are success rates in cold turkey detox alarmingly low, but withdrawal symptoms are much more intense and harder to treat.
As evidenced by low success rates and severe withdrawal symptoms, there is no doubt that quitting cold turkey is dangerous. When it comes to almost any physically addictive drug, the act of quitting cold turkey is not only uncomfortable but also can be counterproductive in treating addiction. The sudden lack of an addictive substance in someone’s body can produce side effects that can cause death, so it is crucial that you seek professional detox.
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Outpatient treatment programs are forms of treatment that involve a patient partaking in therapy at a recovery center, but have a stable environment to live in and thus don’t have to live on-site during treatment. Programs that are common as outpatient treatment include partial hospitalization, intensive outpatient programs (IOP), and a variety of others.
Intensive outpatient treatment is similar to inpatient treatment in the way that the patients are serviced and accommodated. Patients that participate in IOP meet about three to five days a week, for three hours a day. Intensive outpatient programs are generally tailored around work obligations or schedules to accommodate the patient best.
Most effective in treating people that have a stable living environment outside of treatment, IOP is generally the first level of treatment after detox.
The next step up from IOP includes partial hospitalization. Meeting from three to five days a week for four to six hours a day, partial hospitalization is more suited toward patients that require constant medical surveillance and care. Think of it as a slightly less intensive detox, but without living on-site for treatment. It is meant generally for severe addictions, but also for those who can handle the responsibility of living off-site.
Although medical detoxification technically counts as an inpatient program, the use of the term “inpatient treatment” seldom refers to detox and more commonly applies to post-detox treatment that involves a patient staying on-site during recovery. As a long-term approach to treatment, inpatient programs are some of the most effective ways to treat addiction.
Regarding the subject of inpatient programs, there are two main types of treatment options. The first is called residential and is meant for less severe addictions. The second, more intensive and urgent treatment option is called intensive inpatient treatment.
Residential treatment is a common and unique method of treatment that explores the psychological reason for addiction rather than the physical reason.
In residential treatment, the resident will have access to 24-hour living support and supervision, and the patient must only participate in five hours of treatment per week. The main point of residential treatment is to explore the long-term psychological aspects of addiction and to find the underlying causes of addiction.
Intensive Inpatient Treatment
Similar to the 24-hour living support that is offered in residential treatment, intensive inpatient treatment provides 24-hour medical supervision and care, but is more tailored towards severe addictions. With access to support groups and therapeutic sessions, a patient in an intensive inpatient program will live comfortably on-site and be treated with the utmost care and attention.
As mentioned before, addiction requires long-term care and attention even after inpatient or outpatient treatment. Aftercare should follow immediately after a treatment program and works best right after a short, intensive treatment such as partial hospitalization or intensive inpatient treatment.
Some outpatient treatment programs have been used and proven successful in aftercare and relapse prevention. After suffering from the common withdrawal symptoms associated with drug addiction treatment, the chances of relapse increase exponentially. To stay sober, aftercare is necessary and can significantly reduce the chances of future relapse and addiction.
Common Withdrawal Symptoms
There are many withdrawal symptoms linked to drugs and alcohol, and even though every case is different, there are a few common withdrawal symptoms that are apparent through the various addiction treatment programs. These symptoms can include, but are not limited to:
- Change in appetite
Unique to alcohol withdrawal symptoms are Delirium tremens, or DTs for short. DTs are a collection of amplified withdrawal symptoms that can be associated with loss of muscle control, spasms, shivering, sweating, vivid hallucinations, extreme body temperatures, and sometimes-fatal seizures.
Neglecting withdrawal symptoms can easily lead to relapse, but what exactly does it mean to relapse, and how can you prevent it?
Relapse occurs when someone uses a substance after a long period of abstinence. Many people view relapse as becoming addicted again. While it may contribute to the development of becoming addicted again, relapse also means a slip-up (quick, short interval) or a binge (heavy use in a short amount of time).
Many times, someone in recovery who relapses can quickly get back on the right path. Treatment center staff refers to relapse as a chance to learn and/or readjust the recovery plan rather than a failure.
The beginning stages of treatment are the most difficult, and relapse is most common in the beginning, accounting for 66 percent to 80 percent of relapses. Because of this, early detection plays a significant role in relapse prevention. Once an addiction is detected and identified, it is imperative that a patient devise a relapse prevention plan as soon as possible.
Causes of Relapse
Below is a list of helpful tips for anyone struggling with addiction. Relapse happens, and sometimes it can seem like an impossible roadblock to overcome. There are a few simple but extremely effective tips worth considering when you are in treatment and at risk of relapse:
Mental or emotional health problems such as anxiety, depression, and any negative emotions are often high-risk triggers for relapse. In some cases, even boredom can push someone to relapse.
A factor that might trigger intense cravings and commonly leads to relapse is seeing or being around the substance that you went to treatment for.
Although many reasons for relapsing have negative connotations, many positive situations, and celebratory events like parties and concerts can encourage relapse. It is best to avoid these events altogether or to bring a trusted friend who can advise against your possibly addiction-inducing decision.
When it comes to avoiding relapse, it is crucial to seek professional help when noticing the early signs and causes of relapse before it happens.
If You Or Someone You Know Suffers From Addiction
Here at Arete Recovery, we know how difficult it can be to treat addiction. That’s why we want to extend our hands to you and help you or anyone you may know that suffers from substance addiction.
Our team of licensed medical experts is willing and ready to lead you down the path to sobriety. As soon as you step foot in our treatment center, our doctors, nurses, and therapists create a treatment plan that works for you.
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Ramo, D., Brown, S. Classes of substance abuse relapse situations: A comparison of adolescents and adults. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031179/
National Institute on Drug Abuse. (June, 2017). Understanding Drug Use and Addiction. from https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction
Harvard Health Publishing, (November ,2014).Substance Abuse (Depressants or Sedative-Hypnotic Drugs). Harvard Health Publishing. from https://www.health.harvard.edu/diseases-and-conditions/substance-abuse-depressants-or-sedative-hypnotic-drugs
Psychology Today, (n,d).Dopamine. Psychology Today. from https://www.psychologytoday.com/us/basics/dopamine
Substance Abuse and Mental Health Services Administration. (2016, June). Substance Use Disorders. from https://www.ncbi.nlm.nih.gov/books/NBK519702/
World Health Organization. (2017, October 05). Substance abuse. from https://www.who.int/topics/substance_abuse/en/