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Addiction Guide

Drug use costs the United States upward of $740 billion annually, according to the National Institute on Drug Abuse (NIDA). These costs are all related to crime, lost work productivity, and health care associated with people who use drugs, alcohol, and/or tobacco. 

Due to the uptick of addiction running rampant throughout our communities, the health community has taken great measures to create and implement new addiction treatment methods.

Addiction is widely recognized as a substance use disorder that is generalized in the mental health disorder category. The Diagnostic and Statistical Manual, Fifth Edition (DSM-V) outlines specific criteria that are used to officially diagnose individuals who have a substance use disorder (SUD).

With the additional research and criteria set in place, it has made the diagnosis of the condition a lot easier, allowing for quicker and more effective treatment. Before the right diagnosis can be made, there must be a clear understanding of the differences between the terms recreational use, dependence, and full-blown addiction. 

Separate areas of the brain are affected by dependence and addiction. They are physiologically different, which means their experiences are unique to one another.

  • Recreational drug use is classified as the use of drugs and alcohol on certain occasions without repetitive use to the point of self-destruction. Physical dependence occurs when the body and brain need just enough of the drug to maintain balance. This affects a different area of the brain than where addiction takes place. The process of overcoming physical dependence can be easier than overcoming an addiction. You will have to manage only the withdrawal symptoms.
  • Addiction is vastly different. The part of the brain known as the reward pathway, where dopamine is synthesized, becomes dependent on the drug. Dopamine is commonly referred to as the “feel-good” chemical that the brain naturally produces. Once it is released into the body, it offers a calm and euphoric feeling in anyone who uses addictive substances. This largely contributes to drug abuse and makes it nearly impossible for someone to stop on his or her own. When making an initial diagnosis, professionals look for symptoms that mimic these behaviors listed above to support their prognosis. These symptoms are the distinguishable differences between a recreational user and a person who has a drug or alcohol addiction.

The criteria set forth by the DSM-V for a proper diagnosis are:

  • Consuming the substance(s) in larger amounts or for longer than you’re meant to
  • Wanting to cut down or stop using the substance, but managing not to
  • Spending a lot of time getting or using substances or recovering from substance use
  • Cravings to use the substance
  • Not managing to do what you should at work, home, or school because of substance use
  • Continuing to use, even when it causes problems in personal, professional relationships
  • Giving up important social, occupational, or recreational activities because of substance use
  • Using substances again and again, even when it puts you in danger
  • Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance
  • Needing more of the substance to get the effects you want (high tolerance)
  • Development of withdrawal symptoms, which can be relieved by taking more of the substance

If you or a loved one is experiencing at least two problems associated with drug abuse as listed above, a mild substance use disorder diagnosis is given. If you have four or five of these qualities, a moderate substance use diagnosis will be given. Meeting six or more is considered a severe substance use disorder. Despite the level given, addiction is serious and has the potential to worsen over time. It is vital to seek professional help to recover from the disease. 

Addiction Risk Factors

It’s difficult to pinpoint any one specific cause for addiction, even in individual people. A wide range of factors can contribute to, cause, or worsen a substance use disorder. Plus, people are all different and present to treatment with different underlying factors that may play a role in their substance use challenges.

The cause of addiction is a subjective and controversial topic, and it remains unclear what actually causes it. However, research tends to point to the fact that addiction isn’t caused by one thing but a host of factors working together. These factors can also be different for each person, which makes it impossible to treat addiction with a one-size-fits-all treatment plan. Still, a few common factors seem to have clear influences on a person’s likelihood to develop a substance use disorder, including environment, biology, development, and co-occurring mental health issues. 

Environmental

Professionals have found strong supporting evidence that there is a correlation between environment and addiction. Individuals experience external issues that are the underlying reasons as they progress through the stages of life. Such factors that could contribute to drug use are recent divorces, money problems, and frequent arguments. These factors can push someone already suffering from substance abuse problems to use. Other factors could be a little more severe such as trauma, abuse, or sexual abuse.

Biological

There is scientific support that addiction, like other mental health issues, has a strong biological component. Researchers conducted twin studies to look at how two people with some of the same genetic markers would develop over time and found that many of them developed substance use disorders at similar rates. 

Even twins with a genetic predisposition to addiction that were separated through their development both seemed to develop substance use problems at the same rate. 

Those who struggle with addiction or a history of addictive behaviors have seen that their mother/father had addiction struggles as well. Children of people in active addiction are eight times more likely than their counterparts to develop a drug habit later in their lives. 

Consuming drugs rewires the brain, and when parents develop habits before conceiving a child, the child is likely to have the same genetic predisposition for substance abuse.

Development

Your development is how you learn, grow, and create habits that shape how you interact with the world around you. Development can help you build up defenses against substance use problems, or it can make you vulnerable to them. Development is where your biology and environment meet to shape you as you grow. This is more prominent at critical stages, which may be why early exposure to drugs makes it more likely to develop an addiction later in life. Development is also a significant factor among people whose brains are still developing. In particular, teens are still developing decision-making skills, judgment, and self-control.

Psychological

A major contributor to addiction is mental illness. The question it has been related to is which came first, the chicken or the egg? Does substance use create depression? Or does depression drive substance abuse? While those questions have not been answered, there is an undeniable correlation between psychological problems and substance use. Drug consumption is used as a way to cope and “numb” these otherwise uncomfortable feelings someone experiences. It can be traced to eating disorders, bipolar disorder, and depression.

Risk Factors Can Point to the Root Cause

It is clear that both sides of the spectrum have meaningful arguments to the topic of addiction, but there are the select few who assert that the evolution of addiction is influenced by both biological and environmental factors. The experience of traumatic events and genetic predisposition are large pieces in this puzzle of coming to a finite conclusion. With that said, looking at addiction isn’t as much the “why” as it is choosing the correct method of treatment that gets to the root of its cause. 

Signs of Addiction

There are tell-tale warning signs that can help you recognize addiction in either yourself or others. Before someone enters treatment, the proper diagnosis must be made to recognize the problem. Without this bit of information, it’s possible a person could be placed somewhere that won’t adequately treat the problem.

Addiction signs and symptoms vary from one person to another, and such as a mental health disorder the way in which it appears is as unique as the person it is affecting. Symptoms will also vary with the types of drugs being consumed, though there are symptoms associated across the stage with common drugs that will help narrow down the search.

Each category presents similar yet different symptoms because not all drugs affect the brain and body in the same fashion. Below are the main categories of abused drugs, and the signs and symptoms that signal that dependence on them are underway. 

Alcohol

  • Drinking to forget about problems
  • Drinking outside of social settings; regularly drinking alone
  • Lying to justify drinking habits
  • Irritability when not having a drink
  • Losing memories or time frames when drinking; blacking out
  • Decrease in performance at work or school
  • Continuing use despite legal, social, or medical consequences
  • Mood swings; changes in personality
  • DUIs or arrests linked to alcohol use
  • Engaging in risky behaviors (driving a motor vehicle when intoxicated)
  • Isolation

Stimulants

  • Strong urges to use stimulants
  • Constant thoughts of using stimulants
  • Doing “whatever it takes” to obtain stimulants
  • Isolation
  • Consumption in doses higher than prescribed
  • Experiencing withdrawal within 24-48 hours of stopping the drug
  • Taking stimulants to avoid withdrawal
  • Hiding stimulant use from family or friends
  • Feeling unable to stop drug use despite attempts to quit
  • Unable to function without the drug
  • Mixing stimulants with drugs, alcohol
  • Using the drug despite negative consequences
  • Anxiety
  • Depression
  • Delusions
  • Hallucinations
  • Paranoia
  • Suicidal thoughts

Depressants

  • Depression
  • Tremors
  • Dysphoria
  • Loss of appetite
  • Memory problems
  • Muscle spasms
  • Nausea
  • Dizziness
  • Motor impairment
  • Feeling lightheaded
  • Sensitivity to light, sound, and touch
  • Numbness sensations
  • Hallucinations
  • Smell sensitivity
  • Muscle pain
  • Mood swings
  • Drowsiness

Opioids

  • Change in weight
  • Withdrawing from social activities/obligations
  • Mood swings
  • Aggression
  • Irritability
  • Fatigue
  • Depression
  • Changes in social circles
  • Insomnia
  • Financial difficulties
  • Lying and/or stealing
  • Nausea or vomiting
  • Red eyes
  • Pinned pupils
  • Sweating
  • Cravings for opioids
  • Experiencing withdrawal symptoms
  • Unable to stop taking opioids even when faced with negative consequences

Opioid addiction symptoms are typically similar across the board, but it’s good to remember that they don’t affect everyone the same. Being vigilant of the changes in demeanor is important in identifying symptoms of addiction before they spiral out of control.

Something else to note is the rise in opioid overdoses that have overtaken the United States. There is nothing more precious than time to treat an addiction, and the faster these warning signs are identified, the more valuable time there is to help save someone. If you find yourself in the tight grips of addiction or suspect a loved one needs help, don’t delay in reaching out for help.

Addiction Treatment

The only method of treatment available for addiction is addiction treatment. Because addiction is a chronic disease that will continue to progress if left untreated, delaying the treatment process will diminish the users’ quality of life and bring them closer to death. There is no single cure for addiction, but because of the advances in modern medicine, there have been more in-depth methods available to help treat the disorder.

Alcohol or drug rehab is the most common method of addiction treatment in which a client will go through the entire continuum of care. Their quest for sobriety can be achieved through one of these treatment programs, but the actual addiction therapies that will be input during one of these treatments will vary. The process as a whole is generally the same.

When referring to the full continuum of care, it means to complete each level of the addiction treatment in a specifically designed curriculum. Clients will start at a higher level of care with more advanced supervision and slowly work their way into lower levels of care that require less monitoring. This will allow the clients to earn more responsibilities. This is one of the most effective methods for treating this illness. It is designed for the specific stages of the treatment process to begin building a foundation for the road to recovery.

In the beginning stages of recovery, more medical intervention is necessary, and as the client begins transitioning further from abusing their drug of choice, they will require less hands-on attention from the medical team. It is highly recommended that to achieve their desired sobriety, a client should not rush through the process. Staying long enough in rehab leads to a desirable outcome.

Medical Detox

This is the first stage in the master plan of care. This is often known as the most difficult stage due to the imminent withdrawal the client will experience. The purpose of detox is to provide medical stabilization and bring the client through the withdrawal process safely. All drugs possess symptoms related to terminating use, but some can be worse than others.

Drugs such as alcohol and benzodiazepines present dangerous withdrawal symptoms such as seizures, and this, in result, could cause physical injury leading potentially to death. This is why at-home detox risky business, and detoxing on your own is not recommended.

Other than the possible deadly side effects, the success rate is diminished immensely when attempting to detox outside of a professional facility. The overwhelming side effects attributed to quitting “cold-turkey” can prove to be too much and cause the user to immediately go back to using. In a protected environment, it will be harder to obtain the drug, and there will be medication to help alleviate symptoms of withdrawal.

There will be a complete medical assessment by a team of doctors, nurses, and medical support staff to ensure clients receive exactly what they need to be comfortable. The severity of the addiction, the drug of choice, and overall physical and mental health will be taken into account while creating a personalized detox plan.

Progress will be monitored thoroughly during this period to ensure safety, comfort, and effectiveness of the treatment. Upon the completion of this process, the client will be stabilized enough to begin the next level of addiction treatment.

Inpatient

Inpatient treatment, also known as residential treatment, follows medical detox. During this stage, a client will be required to live onsite at a facility and undergo intense addiction therapy for an extended period. Depending on the client’s recovery plan, this can vary from 30-90 days. 

While attending inpatient rehab, a client will have a full-time schedule of various addiction treatments and therapies. It’s advisable to look into the program before entry to ensure the facility offers the right therapies the client needs. These will vary from center to center, and the client must make sure what clients need is offered. 

During inpatient treatment, the client will learn coping mechanisms and how to identify their personal triggers. Additionally, the person will learn life skills and relapse prevention techniques that will be useful long after leaving treatment. This is a lifelong journey, and with that, the client requires attention to the details to avoid the possibility of relapse.

Inpatient treatment is designed to identify and work through the underlying factors of addiction away from the external environment. This is one of the most important portions of the continuum of care and the difference between relapse and recovery. 

Outpatient (OP)

Outpatient programs are characterized as the next phase in the continuum of addiction treatment care. There are two different levels of outpatient treatment–outpatient and intensive outpatient (IOP), with each being as important as the other in furthering recovery. This will continue to address any physical and psychological issues being experienced as the progression of treatment carries on.

Intensive Outpatient (IOP)

Intensive Outpatient is a program that typically follows inpatient or residential treatment. The level of care differs vastly from inpatient due mostly in part that clients aren’t living at the facility. They are required to find alternative housing and means of arriving at therapy sessions throughout the program.

A majority of those who opt into this treatment live in sober living or halfway houses to maintain the structure received throughout the program. Early recovery is a peculiar time as the person is still adjusting to sobriety; relapse occurs most commonly in the first few months, but this is a useful means of support. 

Returning home is an option as well, but regardless of living arrangements, complete abstinence is required from drugs and alcohol during IOP. These sessions will use similar intensive therapy techniques that are seen in inpatient/residential treatment, but they will occur throughout the week for several hours at a time for support. Random drug tests are a requirement during off-hours.

Freedom is better associated with this portion due to the added responsibility the client will have instead of inpatient treatment. Many recovering users return to work and family obligations. This will last anywhere from six to eight weeks before moving on to the next phase.

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Partial Hospitalization (PHP)

A partial hospitalization program (PHP) is another level of outpatient care. While it is similar to IOP, it also requires clients to seek housing and transportation to several hour-long sessions per week.

One of the main differences between PHP and IOP is PHP is where the therapy sessions occur. PHP will take place in a hospital or hospital-like setting. This is useful for clients who need additional ongoing medical care.

PHP has a similar structure to IOP in that consistent attendance is a requirement as well as continued sobriety. Group and individual therapies are conducted to continue providing ongoing clinical attention.

Aftercare

Upon completion of the program, it’s necessary to note that the journey to recovery doesn’t magically end. Throughout the rest of the client’s life, recovery will be a lifelong journey. In the beginning, it may seem to be a daunting task, but there are various aftercare options to assist in recovery.

Many facilities offer an alumni program, which is something clients should look into before attending a treatment center. Alumni programs schedule activities and outings with past clients to encourage them to build meaningful and sober relationships in recovery. Alumni connections also allow people to seek refuge and have a point of contact if they are ever struggling with sobriety.

There are other options available if the facility does not offer aftercare programs but is equipped for your needs. These are 12-step programs or SMART Recovery®. These are separate entities that each approach recovery in a way that allows recovering clients to connect with networks of sober support. 

Withdrawal

Withdrawal is one of the main reasons substance users cannot escape their addiction because they are sick. This condition is defined as the physical dependence of a substance to function properly after long-term abuse of a prescription or illicit substance.

Withdrawals are a series of different symptoms the brain and body will undergo as a result of halting substance use. Anytime a substance is being used and is being removed, the body must go through an adjustment period to return to normal functions. Not only is this uncomfortable, but it could be dangerous.

As mentioned previously, different substances will equate to different types of withdrawal symptoms with some being worse than others. A host of factors can change the course of withdrawals for either you or a loved one. 

Among them are health and medical history, the substance consumed, frequency of use, and how long a substance(s) have been used. These will dictate the severity of symptoms and make detox especially important. Taking control of this process is the key to success.

Relapse

Relapse, or the return to using addictive substances after a period of abstinence, is a part of addiction recovery. NIDA reports that relapse happens to 40 percent to 60 percent of people in recovery, a rate that’s common other chronic illnesses, such as asthma, diabetes, and hypertension. If you or your loved one experiences a relapse, don’t feel bad or blame yourself. It does not mean your treatment didn’t work. 

Instead, it means another form of treatment may be a better fit, or the one you received must be adjusted to be effective. Addiction is highly difficult to overcome, but it is not impossible. Respond to a relapse with these steps.

  • Seek help immediately.
  • Look at what went wrong and curb that behavior in the future.
  • Seek out more relapse prevention therapy to utilize more coping skills.
  • Reach out to others recovering.
  • Be honest.
  • If someone feels they are about to relapse, take measures to avoid falling back into the cycle of addiction.
  • Approach relapse as a learning experience as opposed to a mistake; this is just another opportunity to grow.

Find Quality Addiction Treatment

Addiction is a chronic disease that affects the brain in a way that can make it incredibly difficult to get over on your own. Addiction is also progressive, and it often gets worse while it’s left untreated. Mild substance use disorders can become moderate and even severe problems over time. 

As drug abuse leads to dependence and addiction, maintaining your substance use problems starts to take over your life. You may be able to hide it or manage it at first, but addictions often get out of control and start to take over different parts of your life. Severe substance use disorders often affect multiple parts of your life, including your health, finances, and relationships with family and friends. 

To avoid some of these serious consequences, it’s important to seek help as soon as you realize you might have a problem. However, even if you’ve struggled with a substance use problem for a long time, there is help available that can lead you to lasting recovery. If you or someone you know is struggling with a substance use disorder, learn more about addiction treatment to start your road to recovery today.

Sources

American Psychiatric Association. (2017, January). What Is Addiction? Retrieved from https://www.psychiatry.org/patients-families/addiction/what-is-addiction

American Society of Addiction Medicine. (n.d.). American Society of Addiction Medicine. Retrieved from https://www.asam.org/resources/the-asam-criteria/about

Bevilacqua, L., & Goldman, D. (2009, April). Genes and addictions. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2715956/

National Institute on Drug Abuse. Retrieved from https://www.drugabuse.gov/sites/default/files/1922-the-neurobiology-of-drug-addiction.pdf

National Institute on Drug Abuse (January 2018) Treatment Approaches for Drug Addiction. Retrieved from https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction

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