Addiction is not voluntary. It does not go away when you take a pill. Rather, it is a chronic, progressive, and complex disease of the brain that only worsens when left untreated. The American Psychiatric Association (APA) states that addiction is marked by the compulsive use of a substance despite harmful consequences. Also, people with an active addiction display an intense focus on using their substance of choice.
There is no cure for addiction. However, it is a highly treatable condition. Therapies and treatments can effectively address addiction. Scores of people have battled drug or alcohol addiction and won. Many of them have done so by seeking out professional treatment, which allowed them to lead normal and productive lives.
However, many people do not get the help they need.
In 2017, about 13 percent of the people who needed treatment for a substance use disorder received it. For people with heroin-related opioid use disorders, almost 55 percent received some sort of treatment, which proves that a multitude of people did not get the help they need.
The tragic and unfortunate truth is that those who do not get the proper treatment will suffer, ultimately sacrificing their lives in the process.
For generations, there have been societal stigmas against drug and alcohol treatment. However, those perceptions are being tossed aside thanks to the raging, indiscriminate scourge known as the opioid epidemic, considered the worst drug crisis in U.S. history.
Because we live in a time where people are more likely to die from an accidental overdose than a car accident, the perception around drug treatment has changed considerably. It is rightly being recognized as a safe and effective way to help addicted persons realize lasting recovery.
Essentially, professional treatment can be an enduring solution to the relentless and pervasive scourge of substance addiction.
Poet William Cowper’s quote, “Pleasure is a labour, too, and tires as much,” could explain why people engage in substance abuse. Yet, it can also speak to the subsequent turmoil they experience with that pursuit.
Simply put, people abuse substances because they want to experience happiness. It’s the same as when we participate in other bliss-inducing activities like exercising, playing video games, or enjoying a delicious meal.
All those activities release dopamine, a neurotransmitter that plays a major role in reward-motivated behavior.
Drugs and alcohol tend to release excessive and unusual amounts of dopamine, causing users to experience profound euphoria and feelings of well-being. When the brain experiences a surge in dopamine, it goes through a rewiring process. People under the influence of a substance will seek out more dopamine-triggering activities.
As the brain adjusts to this new “reality,” they can’t experience the same amount of joy as before when they were engaged in previous hobbies and activities. Rather, they become fixated on using their substance of choice because of the abnormal amounts of dopamine it releases.
The brain is effectively rewired by this point. When addicted persons are not using their preferred substance, they tend to experience agitation and irritability. Their brains have been hardwired to want to only indulge in using.
Thus, addiction has set in.
Several factors, however, can lead one down the road to addiction.
Of all the factors that influence addiction, biology or, more precisely, the genes that people are born with, account for half of a person’s risk for substance addiction, says the National Institute on Drug Abuse (NIDA). What’s more, gender, ethnicity, and the presence of other mental health disorders may also heighten the risk of addiction.
Environment, especially the one at home that you grow up in, can greatly influence whether you develop a drug or alcohol addiction. Environmental factors include childhood trauma (especially physical, sexual, or verbal abuse), family members and friends (especially those with substance abuse issues), and early exposure to drugs.
Other factors can determine whether a person develops a drug or alcohol addiction.
The Mayo Clinic lists the following factors that can play a role:
Family history: Genetic predisposition can play a huge role in why members of the same family can succumb to addiction. If you have a blood relative with a drug or alcohol addiction, you are at risk for developing an addiction.
Mental health disorders: Mental health conditions like depression, anxiety, post-traumatic stress disorder (PTSD), and attention-deficit hyperactivity disorder (ADHD) can contribute to the development of a substance use disorder. How? As the Mayo Clinic states, using drugs or alcohol can help you to cope with the painful feelings those disorders induce.
Peer pressure: Peer pressure can strongly influence your decision to abuse substances. This is a compelling factor for young people who engage in drug or alcohol use.
Lack of family involvement/neglect: Like childhood trauma, familial neglect can also compel you to use drugs or alcohol.
Early use: Use at an early age can cause lasting changes in a young and developing brain, which can also greatly increase the likelihood of addiction.
Use of a highly addictive drug: Highly addictive drugs like cocaine, heroin, and prescription opioid painkillers have an unparalleled ability to quickly induce addiction. When you smoke or inject a drug, the potential for addiction spikes considerably. Use of milder, less addictive drugs can also lead you toward abuse and dependency or worse.
Every substance of abuse exerts its own unique effects, depending on their properties. That’s why addiction treatment should be individualized to address a particular substance use disorder. Treatment should never be a cookie-cutter, “one-size-fits-all” process. A recovery program that acts in this matter is not only dangerous, but it can also be detrimental to the client — think treatment dropout and/or relapse.
While various drugs generate varying side effects, many share chemical characteristics and impact the body in the same manner. For instance, alcohol and benzodiazepines work to depress the central nervous system (CNS), while cocaine and Adderall exert an opposite, stimulant effect.
The most addictive substances that are abused are alcohol, opioids, stimulants, and depressants.
When considering treatment for a particular addiction, you should understand how each substance impacts the body, particularly how they exert their effects. They all can produce psychological and physiological addiction at different levels. If you can identify the looming signs of addiction early, you can find the right treatment option for you or a loved one.
Alcohol addiction triggers various mental and physical effects. As one of the most toxic addictive substances, alcohol can cause numerous health effects over time. For this reason, early detection of a looming addiction is key.
The following are physical symptoms of an alcohol use disorder:
The mental or psychological effects of alcohol include:
Opioids, more than any other substance, possess the profound ability to hijack the brain, whether they are of the prescription or illicit variety. Most opioids have a sedative effect. They work to slow down the CNS. The most common opioids and opiates of abuse are oxycodone (OxyContin), hydrocodone (Vicodin), heroin, fentanyl, and methadone. The physical symptoms associated with opioids are:
The psychological side effects caused by opioid addiction include:
Stimulants activate the CNS and generate an array of harmful effects.
They spike the blood pressure, body temperature, and heart rate.
That’s only the beginning of what stimulants like cocaine, methamphetamine, and ADHD drugs like Adderall and Ritalin can do.
Like alcohol, stimulants cause physical and behavioral symptoms and exert extremely harmful side effects. What’s more, addiction to stimulants can occur a lot quicker than with other types of drugs.
The following are the physical side effects that come with stimulant addiction:
Stimulant addiction can also produce these psychological side effects:
As their name suggests, depressants slow down or depress the CNS. Alcohol is also a depressant substance, as are opioids. Drugs in the depressant category include benzodiazepine medications (Xanax, Valium, Ativan, and Klonopin), non-benzodiazepine sedative-hypnotics (Ambien, Lunesta, and Sonata), and barbiturates (Luminal, Nembutal, and Mebaral).
The physical effects of sedative medications resemble that of alcohol. They include:
Depressant addiction can also bring about these psychological effects:
The memory loss that occurs with depressant addiction is not the kind where one simply forgets things from the past. Depressant-induced memory loss can have users participate in an action and have no recollection of it the next morning.
What’s more, the activities they engage in can put their lives at risk. People addicted to depressants have reported sleepwalking and sleep-driving. They have also cooked or have engaged in sexual intercourse without being aware of those activities.
Substance abuse can not only enact dangerous effects and symptoms, but it can also lead to overdose and death, particularly with the substances mentioned above. The threats these substances pose make addiction treatment life-saving.
If you suspect that you or a loved one is displaying the signs, symptoms, and effects of addiction, then you must get them into professional treatment immediately.
Again, addiction is progressive, meaning that it only worsens over time. A reputable, professional recovery program can not only help you realize sustained recovery, but it can also decrease your risk of relapse. What’s more, treatment can reduce the likelihood of you or your loved one developing a medical addiction or exacerbating a pre-existing one. A program can also lessen the chances of you participating in criminal activity, which limits your exposure to the criminal justice system and lessens your chances of imprisonment.
Professional treatment is comprised of a continuum of care, which means it encompasses a set of services arranged by levels. The most intense and structured of those services and treatments occur at the start of a recovery program.”
As a client progresses through this continuum, they enroll in treatments that lessen in intensity and comprehensiveness. They are also afforded more freedom.
Once they complete treatment, they can enroll in aftercare to receive continued support for an indefinite period of time to manage their addiction, which is a lifelong condition.
Medical detoxification or “detox” is the first and most critical step in addiction treatment. It is an intensive process that is comprised of 24-hour managed care and supervision. A medical team of doctors, nurses, and support staff oversee a process where the addictive substance is removed from your body (along with associated toxins), and any withdrawal symptoms are medically treated.
Opioids, alcohol, and benzodiazepines require a tapering process, where a client is weaned off those substances to ensure a safe recovery. This process could include using a treatment medication to replace the addictive substance. For example, people who enter detox for opioid addictions are switched to methadone or Suboxone so that they won’t experience debilitating withdrawal effects that could lead to relapse and eventual overdose.
When someone undergoes detox, they become physically and psychologically stabilized. They are also most ready to undergo treatment, which is destined to address their particular needs and get at the root of their addictions.
In terms of safety and effectiveness, medical detox is the best way to start the recovery process. With substances like opioids, alcohol, and benzodiazepines, where withdrawal effects can lead to relapse or be life-threatening in and of themselves, detox is especially valuable.
The worst approach to those particular addictions is attempting to detox on your own, a method that is commonly known as “going cold turkey.”
Going “cold turkey” means abruptly stopping your substance abuse to self-detox, usually without the guidance and supervision of a medical professional. When you attempt to detox on your own, you leave yourself vulnerable to the multitude of withdrawal effects that can occur with certain substances.
This seemingly easy method of denial actually endangers the body because it needs time to adjust from the effects of a substance, which it has become dependent on.
The sudden action of stopping your use can unleash a range of ruinous effects and disturbances, which are commonly known as withdrawal symptoms.
The withdrawal symptoms of alcohol, benzos, and barbiturates, for example, are life-threatening. Effects like seizures, psychosis, and flu-like symptoms (with opioids) can compel people in withdrawal to relapse.
In many cases, when someone goes back to substance abuse, their tolerance threshold has been lowered considerably. This means they can go back to using their usual, previous dose, and experience overdose, which can be fatal.
This phenomenon is particularly true with opioid addiction. Of the more than 700,000 drug overdose deaths that have occurred in the U.S. between 1999 and 2017, nearly 400,000 of them involved an opioid, according to the U.S. Centers for Disease Control and Prevention.
The array of negative outcomes that come from a “cold turkey” detox reveals why medical detox is the best way to initially treat an addiction.
However, as NIDA asserts in its “Principles of Effective Treatment,” medical detox alone is not enough to stem the tide of long-term drug use.
That’s where inpatient treatment comes in.
Inpatient treatment programs are reserved for severe cases of addiction and polysubstance abuse (the simultaneous use of two or more substances).
These programs allow patients a temporary stay at the facility where they will receive treatment.
This type of program offers comprehensive, full-time therapy and care in a structured environment. This setting is optimal for the recovery journey. While medical detox is technically an inpatient service, typical detoxification lasts anywhere between three to seven days.
However, a true inpatient treatment program lasts between 30 to 90 days or more. To maximize the effectiveness of a residential program, clients are urged to remain in treatment for at least 90 days, according to NIDA.
The idea is that for severe, life-threatening addictions, clients need to devote most of their time to recovery. Inpatient treatment promotes that setting.
Residential treatment is a form of inpatient treatment. Here, patients are viewed as residents and join a recovery community where they will be exposed to individual and group therapy, along with evidence-based behavioral therapies designed to address the mental and emotional impacts of addiction. Clients are also given time to pursue recreational activities and pursuits but under supervised care.
Because clients will be part of a community that includes other people in recovery, they can draw on the support and inspiration they need from their peers to transition back into everyday life. Or, if they need to, they can enter outpatient treatment, which still allows them access to therapy and care but on a part-time basis — a step down from inpatient services.
After detox, clients can enter outpatient treatment, especially if their addiction is considered mild. They can also enter an outpatient program after an inpatient or residential treatment process. Outpatient programs are ideal for clients who have solid support networks and structured home environments. They also show no imminent threat of relapse or potential for cultivating another addiction.
In a standard outpatient program, patients are required to attend therapy and counseling services at scheduled times, but they can return home or some other independent living arrangement after treatment is done for the day.
Most outpatient programs provide services on a part-time basis, which gives clients the opportunity to get therapy and attend to their daily responsibilities and obligations.
Outpatient programs can range in intensity, from partial hospitalization and intensive outpatient to a standard program.
A partial hospitalization program or PHP offers the most intensive outpatient setting. It consists of sessions that occur three to five times a week that generally last up to six hours per meeting. A PHP, which is also intended to treat severe cases of addiction, is like detox in that patients are under steady surveillance and care. However, with PHP, a client can still return home.
Intensive outpatient treatment (IOP) is similar to inpatient care. Clients in an IOP program meet with physicians and therapists three to five days a week for three-hour sessions. However, the IOP schedule allows patients the time to attend to their responsibilities outside of treatment. What’s more, outpatient is intended to work around the client’s schedule so that they can still go to work or school.
Clients with addiction need support long after treatment is over. Why? Because addiction is a chronic condition that requires long-term care and management. In addition, the threat of relapse is ever-present in the form of triggers, which can occur from within or without (an old haunt, past associates, etc.)
According to NIDA, relapse from substance abuse disorders occurs at a rate of between 40 and 60 percent. Thus, aftercare provides a vital function in offering clients access to supportive recovery communities like 12-step programs. In aftercare, clients take part in group therapy and participate in social outings with fellow members.
The value of aftercare programs is that they can serve as a hedge against relapse. Aftercare communities provide members with connection, support, mentorship, and inspiration.
American Psychiatric Association. (n.d.). What Is Addiction? from https://www.psychiatry.org/patients-families/addiction/what-is-addiction
American Society of Addiction Medicine (ASAM). (2018, July 20). What are the ASAM Levels of Care? from https://www.asamcontinuum.org/knowledgebase/what-are-the-asam-levels-of-care/
Mayo Clinic. (2017, October 26). Drug addiction (substance use disorder). from https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112
National Institute on Drug Abuse. (n.d.). 7: Duration of treatment. from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/6-duration-treatment
National Institute on Drug Abuse. (n.d.). Understanding Drug Use and Addiction. from https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction
National Safety Council. (n.d.). For the First Time, We're More Likely to Die From Accidental Opioid Overdose Than Motor Vehicle Crash. from https://www.nsc.org/in-the-newsroom/for-the-first-time-were-more-likely-to-die-from-accidental-opioid-overdose-than-motor-vehicle-crash
U.S. Centers for Disease Control and Prevention. (2018, December 19). Opioid Overdose. from https://www.cdc.gov/drugoverdose/epidemic/index.html
Whitehouse.gov. (n.d.). Ending America's Opioid Crisis. from https://www.whitehouse.gov/opioids/