How much do you know about substance use disorders?
- Why are some chemicals addicting and others not?
- How do drugs and alcohol affect the brain?
- Why is it so hard to quit?
Not sure? Keep reading! Below you’ll find a list of FAQ related to addiction.
The basics: what is an addiction?
Addiction…Some people feel the word “addiction” is pejorative. That’s why we tend to say “substance use disorder” to describe the illness. However, I’ll be using the words addiction, chemical dependency, drug problem, substance abuse, substance use disorder, and other terms interchangeably to avoid using the same word over and over. I mean no disrespect.
Back to the question. Addiction is a chronic illness. It’s marked by drug use that’s difficult for the user to control. Consequences of drugging and drinking are enormous, but still the individual can’t stop. Repeated drug use leads to changes in the brain, making the person crave the drug, and interferes with the ability to resist these urges. The drug use becomes harmful. Sometimes an individual with a drug or alcohol problem will let go of all responsibilities just to use. Often they’ll even lie, steal, threaten, prostitute, or become assaultive just to get more drugs. These brain changes can last a long time, which is why people often relapse after being clean for an extended period. It’s common for a person to relapse multiple times before reaching for recovery.
Why are some chemicals addicting and others not?
Compared to non-addicting chemicals, drugs of abuse tend to
- cause an unusually pleasurable experience (few people abuse a drug that makes them miserable)
- grant this pleasurable experience immediately after the drugs are taken (no one abuses chemicals that take six days to take effect)
- make the person want to use again in the future (through multiple processes, including withdrawal symptoms and cravings to use).
What substances are typically abused?
There are three groups: (1) illegal substances like methamphetamine, cocaine, phencyclidine, heroin, Flakka, and others, (2) legal substances you buy at the store, like alcohol, tobacco, or (in some places) marijuana, and (3) prescription and over-the-counter medications like Adderall or OxyContin that become drugs of abuse when taken excessively or to get high. This article focuses on chemical substance abuse, although gambling, hoarding, hair-pulling, and other behaviors can be considered addiction if out of control.
Why do people get hooked on drugs and alcohol in the first place?
Most addicts don’t start using drugs because they want to be addicts. Here are some of the reasons why they end up getting hooked.
1–Genetic. Addiction runs in families. A person is more likely to abuse drugs or alcohol if their parents abused them, even if they were adopted out and raised in a different environment. There’s a biological, very unfair side to addiction. This means that some people have more of a tendency to become addicts than others.
2-Despair. Some people start using drugs to battle against worry, sadness, anger, fear, or pain. This is called “self-medicating.” Drugs can be effective for a short time, but the effect wears off, and then the person feels worse than they did before. The bad feeling can prompt them to use more and more, leading to tolerance, withdrawal, and addiction.
3-Prescription. Often enough, people start taking drugs innocently, having received a prescription of Oxycontin or Adderall from their doctor. They start by taking an extra pill from time to time. The dose escalates, they need more and more, and soon the person gets sick every time they try to stop.
4-Experimentation. College student might experiment with cocaine or get drunk on the weekends with their friends, not meaning to make it a daily thing. The addict doesn’t know that they are the one who’ll get hooked potentially for the rest of their life.
5-The high. Drugs and alcohol make you feel good. They take away boredom. They give a person something to look forward to. The problem is that the good feeling doesn’t last. Most drugs have a withdrawal syndrome, or the addict misses the high when it isn’t around. Life becomes boring without it. The person then uses the drug just to avoid feeling bad.
What’s the difference between a habit and an addiction?
“Habit” and “addiction” aren’t clinical terms.
Habit – Habit is occasional use. It’s generally understood that a person with a substance use disorder can’t use in moderation. That is, addiction is all or nothing. On the other hand, a person with a habit can choose to stop at any time and do so successfully. There is no psychological or physical component driving their use, and they don’t have physical withdrawal when they stop using. Also, the use of the drug or alcohol doesn’t interfere with their life. An example might be someone who drinks 2 beers every weekend. Typically that is not a substance use disorder.
Addiction-This is when a person isn’t able to control their drug use. They can’t stop using even when they want to. There is a strong psychological or physical force driving them to keep using: addiction is often associated with dependence on the drug or tolerance to its effect. The user needs higher and higher amounts to receive the same effect, and they often experience withdrawal when they stop. In addiction, the use of the drug or alcohol also leads to serious problems with health and/or at home, work, school, and socially.
There’s no fine line between the two. Often a habit develops into an addiction.
What are the signs and symptoms of someone with a drug problem?
People with an addiction might:
- Use or need more drugs than expected to get the effect they want
- Be unable to cut down or stop, even if they want to
- Can’t stop, even if it’s clearly a problem or becomes dangerous
- Spend a lot of time devoted to the drug (hours a day getting, using, and recovering from use)
- Have intense cravings to use
- Give up or be unable to manage important non-drug-related activities because of substance use (like work, home, and school activities)
- Continue using despite social, work, and recreational problems
- Continue using despite health problems
- Withdraw from the drug when they stop
People with substance use disorders often act differently than before. They lose interest in normal activities, change friends, spend a lot of time alone, get moody, sleep strange hours, miss crucial appointments, and have problems with family relationships. They might get into trouble with the law over drug use or criminal acts. At times they’ll appear altered by drugs, either energetic and speedy or slowed down.
Why is it so hard to get over drugs?
Stopping drugs is a little like trying to lose weight. The doctor says you need to stop munching on those chocolates and cookies, eat smaller portions, avoid all your favorite foods, and go to the gym every day. It’s easy to hear but difficult to do. Even if you lose a few pounds, it doesn’t take much to slip up and gain the weight right back. In a small way, recovery from drugs is similar. It’s a day-to-day struggle.
But it’s tougher than that. Most addicts have been using for years, and the drug is their major coping skill, a substitution for family and friends. They don’t know how to live without it. To stay sober and clean, they must tolerate unwanted emotion, and they have no practice. Free of drugs, they must find new ways to deal with the woes life throws in their direction. Yet abstinence from drugs brings on all sorts of new challenges: dealing with the grief and lost dreams, the guilt over what they’ve done to others, the conflicted relationships with their family, the need to wipe clean the past and replace all using friends and hangouts, and the temptation to escape it by relapsing. Many individuals with chemical dependency say it’s harder to quit than keep using.
How does addiction affect the brain?
Drugs affect the brain’s reward system by overwhelming it with a chemical called dopamine. Dopamine intensifies pleasure and motivates the addict to keep using. As the person continues to use the drug over time, the body starts to make less dopamine and reduces the high. This means the user needs to use more of the drug to get the same high. Eventually they take so much that they get sick every time they stop.
Long-term use of drugs might also cause problems with:
- Learning (ability to process new information)
- Memory (ability to access facts and memories)
- Judgment (insight, decision-making)
- Mood (depression, anxiety, irritability)
- Behaviors (criminal, irrational, impulsive)
- Perception changes (hallucinations, paranoia)
Addicts who’ve been doing drugs for a long time can have changes in their personality. They might lack empathy or do nasty things. The long-term effects and changes in personality can last for months after they stop using. Some substances, like methamphetamine and inhalants, can cause permanent changes.
Can drug addiction be treated?
Substance use disorder can’t be cured, but it is treatable. While people who have recovered from an addiction are at risk for relapse for years and maybe for the rest of their lives, many people do stay clean and sober in the long-run. A person with an addiction can go on to live an amazing life.
Research shows that the best treatment for addiction is all-encompassing. It must be tailored to each individual and target co-occurring medical, psychiatric, and social problems, just as it targets recovery from drugs. There are medications that can help with opiate and alcohol problems, but learning coping skills and making life changes is key. The addict needs to rewrite their life story. This is a long journey.
Most people with addiction can’t navigate the course on their own. To be successful, to become sober and clean for the long term, they need help, as well as the support of friends and family. And for many, 12-Step programming is a life-saver.
Where can someone with a drug or alcohol problem find help?
If you or someone you care about has an addiction, it’s important you look for help. There are many recovery resources available. Consider joining a community support group like a twelve-step program, contacting your local mental health care facility or hospital, or calling 1-800-662-HELP (4357). State facilities often have free services available for the treatment of substance abuse. Check online to learn more about residential rehabs and other resources in your area. The Salvation Army often has a free program. Also, talk to your doctor about medications that can be helpful for addiction. The important thing is that you don’t give up.
For help if you or a loved one feels suicidal, call 1-800-273-TALK (8255). You can also visit the SAMHSA website.
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