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Addiction Guide

Addiction is a health problem that can affect anyone. It’s not bound to any region, age, race, or socioeconomic status. In the United States, addiction is a growing issue that leads to a wide range of consequences like health problems, homelessness, and rising overdose rates. According to the U.S. Centers for Disease Control and Prevention (CDC), there were 70,237 overdose deaths in the United States in 2017 alone.

Because of this serious public health issue, researchers, clinicians, and politicians are looking for new solutions to stem the growth of addiction and overdose rates. If you or a loved one is struggling with addiction, it’s important to understand what it is and how it can be effectively treated.

Addiction is a chronic disease that starts when a drug alters the way your brain perceives drugs or alcohol. It’s often characterized by powerful compulsions to use, even despite serious consequences. In many cases, these compulsions are very difficult to resist, and they’re more than just a bad habit.

If you have a loved one that has developed an addiction, you might be wondering why they can’t just stop using. Unfortunately, addiction is more complicated than that. Your brain might treat drugs or alcohol like it treats food and water. You have compulsions so powerful that ignoring them is like trying to ignore thirst.

Addiction relapse rates are similar to those with other chronic illnesses. Substance use disorders see relapses between 40 and 60 percent, while diseases like asthma and hypertension have rates of 50 to 70 percent. Because addiction can come with significant relapse prevention rates, it’s important to seek treatment that gives you the highest chance for long-term freedom from active addiction.

Though addiction is chronic, it is a treatable disease. Learn more about addiction, how it works, and how it can be treated.

What Is Addiction?

Addiction is a disease that affects the reward center of the brain, causing powerful compulsions to use drugs or alcohol. It’s often identified by continuous use despite encountering dangerous consequences that might make other people stop. Consequences can include strained relationships, job loss, medical issues, or psychological issues like depression. Addiction is officially characterized as a severe substance use disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM describes substance use in three tiers of severity: severe, moderate, and mild.

A mild substance use disorder might be characterized by problematic substance use like self-medication or binge drinking, without causing chemical dependency or compulsive use. Mild substance use disorders are common among college students that binge drink on the weekends but still maintain their social and scholastic responsibilities through the week. It’s still dangerous because of the inherent liabilities of binging, like alcohol poisoning. Plus, frequent drug use can lead to chemical dependency.

A moderate substance use disorder can include chemical dependence, which is when you feel physical and psychological discomfort when you try to stop using. Dependence is caused when your brain gets used to the chemical effects of the drug and adapts it into normal brain chemistry.

When you stop using, your brain chemistry can become unbalanced, which causes uncomfortable and even dangerous withdrawal symptoms.

What Causes Addiction?

Addiction can happen to anyone. It’s a disease that crosses socioeconomic, racial, and geographical boundaries. However, not everyone who uses drugs at some point in their lives becomes addicted. So what causes some people to become addicted while others use drugs without ever developing a severe substance use disorder.

The causes of addiction can be difficult to pinpoint. Addiction is a complicated disease, and each person is unique. People who develop severe substance use disorders can have a range of underlying causes and consequences that can lead to or worsen addiction.

Even in individual cases, it’s difficult to identify one likely cause definitively. Instead, addiction is thought to be caused by a variety of factors that work together to for the problem. These factors can be grouped into three major categories: biology, environment, and development. 

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Biological

Genes can influence both physical diseases and psychological disorders. Studies have shown that genetics may play a significant role in a person’s risk and likelihood to develop a substance use disorder. Other factors like your gender, ethnicity, and the presence of other mental disorders with genetic components can impact your experience with substance abuse. Researchers have looked at family addiction rates, addiction among twins, and addiction in adopted children and have estimated that a person’s heredity makes up more than 50 percent of their risk for substance use disorder.

Co-occurring mental health disorders, such as depression, anxiety, trauma, and psychosis, can play a significant role in the development of a substance use disorder.

According to the 2014 National Survey on Drug Use and Health, 7.9 million people in the U.S. had a mental health disorder and a substance use disorder at the same time. A significant number of people who come through addiction treatment programs are treated for other mental health issues at the same time.

For that reason, people who are diagnosed with mental health problems may be predisposed to substance use disorders. 

Environmental

Your environment can shape multiple aspects of your life, including the way you interact with drugs and alcohol. Your environment can determine your exposure to drugs, which is crucial, especially at a young age. Environmental influences can come from a variety of sources, including your own home.

For instance, if your parents or siblings use drugs, you are more likely to have some exposure to drugs or alcohol at an early age. Studies show that limiting substance exposure among adolescents can help to prevent substance use disorders later in life.

Environmental influences can also come from your peers, community, and your school or workplace. For adolescents, the development of addiction can depend on risk factors and protective factors. Risk factors are elements in a person’s life that can push them toward alcohol use and abuse, while protective factors can prevent it.

Risk factors for children and teens include early aggressive behavior, lack of parental guidance, early exposure to drugs or alcohol, high drug availability, and low socioeconomic status. Protective factors can include self-control, parental monitoring and supervision, academic competence, low-drug availability, anti-drug policies, and a strong sense of community.    

Developmental

Developmental factors refer to behaviors, strengths, and weaknesses you pick up over time as a result of inborn and outside influences. Your development is where biological and environmental factors meet. As your body and brain develop, you may respond to challenges, events, and other facets of life differently from other people. Some things impact you deeply while other things are forgotten without making much of an impact.

Your development can also influence how you respond to drugs and alcohol, and how you deal with stress and other issues throughout your life. People who struggle with substance use disorder often learn to turn to drugs and alcohol to cope with stress. For that reason, much of addiction treatment has to do with learning healthy coping responses to deal with stress.

How Addiction Affects the Brain

All addictive psychoactive substances affect the brain by altering the chemical process to achieve their effects. Many substances indirectly affect the brain by interacting with your brain’s neurotransmitters, chemical messengers that carry messages between nerve cells. Some drugs, like opioids, mimic the brain’s own neurotransmitters and can cause similar effects. Drugs often directly or indirectly affect “feel-good chemicals” in the brain. These chemicals are tied to mood, reward, and generally, facilitate positive physical or psychological feelings. This is what causes drugs to produce euphoric highs.

Feel-good chemicals include dopamine, endorphins, serotonin, and oxytocin. Drug use can lead to addiction when they trick your reward center into treating drugs like normal healthy activities like eating and drinking. The reward center is designed to take notice of stimuli that cause a release of these feel-good chemicals and encourage you to repeat them. Since drug use can manipulate those chemicals in a powerful way, the reward center may encourage you to use drugs repeatedly.

The reward center is also more likely to develop an addiction when drugs are used as a coping mechanism. Your brain is designed to seek positive feelings and avoid negative ones. When your brain learns that drugs can cause positive feelings, your reward center may cause powerful cravings as a coping response to stress, mental health problems, or other negative emotional states.

Not all drugs affect the brain in the same way, though. Here’s a breakdown of the most common addictive drug categories affect the brain:

Stimulants

Central nervous system stimulants affect the brain by increasing excitability through your nervous system. Most stimulants affect dopamine and, to a lesser degree, serotonin. Cocaine, like many stimulants, is a dopamine reuptake inhibitor. Reuptake is a process where excessive chemicals are removed from your brain chemistry and recycled. Inhibitors allow certain chemicals to remain in the brain to be picked up by more receptors, creating more intense effects. Meth inhibits the reuptake of dopamine, but it also increases the amount of the chemical that’s released, causing an intense, short-lived high.

Opioids

Opioids can bind to their own receptors in the brain because they’re very similar to a naturally occurring chemical in your brain called endorphins. These chemicals are designed to control your body’s pain response. Opioids are more powerful than your naturally produced endorphins, and they cause more intense effects, including euphoria. As a medication, opioids are useful in treating moderate-to-severe pain. 

Depressants

Depressants like alcohol or prescription sleep aids work to suppress excitability in the nervous system. They usually affect a natural chemical called gamma-Aminobutyric acid (GABA), which is responsible for controlling excitability in the nervous system. Depressants bind to GABA receptors and increase the effectiveness of the neurochemical. This can cause intoxication, sedation, and hypnosis.

Addiction Treatment

Addiction treatment is a process that addresses medical, psychological, social, legal, and financial problems that may cause or contribute to a substance use problem. Addiction treatment should be personalized for your individual needs to be effective. When you first enter addiction treatment, you’ll go through an assessment process that’s designed to determine your specific needs and to create a treatment plan that’s tailored to you. 

Detox

Addiction treatment often starts with medical detox, which involves 24-hour medically managed services. As the highest level of care in addiction treatment, detox involves treatment from medical professionals that specialize in treating withdrawal and addiction.

Drug withdrawal symptoms vary widely depending on the drug you were using. For instance, opioids cause intense flu-like symptoms, stimulants cause extreme fatigue and depression, and depressants can cause seizures and potentially life-threatening complications.

Detox can help ease uncomfortable symptoms and avoid or treat potentially dangerous ones. Medical detox is also able to help people with other medical conditions that need to be addressed alongside withdrawal.

The Levels of Care

After detox, you may move through additional levels of care based on your specific needs.

According to the National Institute on Drug Abuse (NIDA), detox is an important part of addiction treatment, but it’s not enough to effectively treat severe substance use disorders. 

National Institute on Drug Abuse

If you still have medical or psychological needs that require high-level care after detox, you might need to go through an inpatient or residential treatment program with 24-hour medical monitoring. If you can live on your own, you may move on to intensive outpatient treatment or outpatient treatment, which is when you attend treatment during the day and live at home. 

Relapse Prevention

Through treatment, you will go through a variety of therapies with the goal of addressing underlying issues like mental health problems, social disorders, and even financial issues. You may go through individual therapy, group therapy, or family therapy. You may also go through behavioral therapies that are designed to advance your readiness to change, increase your self-efficacy, and develop coping skills. Relapse prevention is an important part of treatment, and it centers around developing strategies to deal with stress, triggers, and cravings. 

Start Recovery Today 

If you or someone you know is struggling with a substance use disorder, it’s important to learn more about addiction and how it can be treated. Addiction is a complex and progressive disease that may get worse over time if it’s not treated. Seeking help with a substance use problem early on can help prevent it from escalating into a severe substance use disorder. It can also help you to avoid some of the most costly consequences of addiction like health problems, broken relationships, and financial ruin. Learn more about addiction and how it can be treated to start on your road to sobriety today.

Sources

Breuning, L. G. (2012). Meet Your Happy Chemicals – psychologytoday.com. from https://www.psychologytoday.com/files/attachments/59029/happy-chemicals.pdf

Centers for Disease Control and Prevention. (2019, June 27). Drug Overdose Deaths | Drug Overdose | CDC Injury Center. from https://www.cdc.gov/drugoverdose/data/statedeaths.html

Dick, D. M. (2008, November 2). The Genetics of Alcohol and Other Drug Dependence. from https://pubs.niaaa.nih.gov/publications/arh312/111-118.pdf

National Institute on Drug Abuse. (2016, February). 8: Medical detoxification. from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification

National Institute on Drug Abuse. (2018, July). Treatment and Recovery.National Institute on Drug Abuse. (2018, July). Treatment and Recovery. from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery

Odgers, C. L., Caspi, A., Nagin, D. S., Piquero, A. R., Slutske, W. S., Milne, B. J., … Moffitt, T. E. (2008, October). Is it important to prevent early exposure to drugs and alcohol among adolescents? from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3664402/

Substance Abuse and Mental Health Services Administration. (2015, September). Behavioral Health Trends in the United States: Results … from https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf

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