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January 16, 2021
Addiction is not a sign of weakness, a character flaw, or a moral failure. It is a common condition that affects millions of people of all ages, backgrounds, and socioeconomic groups. And while there is no one cause of addiction, there is hope—it can be treated effectively.
Addiction is a chronic disease that changes both brain structure and function, currently affecting the lives of nearly 10% of adults in the United States.
Addiction swaps the everyday desires of the brain with those of the drug you are addicted to. You no longer enjoy what other people do as the brain changes. The changes start with recognition of pleasure and end with a drive toward compulsive behavior to fulfill that desire. Sometimes, when you try quitting, the addiction weakens your ability to manage impulses.
Addiction exerts a long and powerful influence on the brain. This influence manifests in three ways:
With drug and alcohol addiction, substances hijack the brain’s reward system. This could lead to developing a physical dependence on substances.
Some people develop unpleasant and sometimes dangerous physical symptoms when they stop or decrease substance use. These changes result in a weakened ability to control impulses despite the negative consequences.
Substance misuse can lead to serious physical, emotional, and social problems. For example, continued use of drugs or alcohol can lead to job loss, broken relationships, and other failures. These problems often increase stress and anxiety.
Learn more about how family plays an important role in addiction intervention and recovery
Stress, anxiety, trauma, and depression can also result in the development of substance use disorders, which can create new challenges for your mental health.
Studies show that many of those struggling with other mental illnesses also struggle with addiction to drugs and alcohol. Many individuals with a substance use disorder (SUD) also have other mental health symptoms or disorders. This is known as having a dual diagnosis.
The following have been known to co-occur with addiction:
It is possible for people of all ages, backgrounds, and socioeconomic groups to develop addictions to alcohol or drugs. Although some groups are more vulnerable than others, there are several factors that contribute to the onset of addiction.
Research suggests that genes contribute to the risk of developing both a substance use disorder and a mental illness. Environmental factors, such as stress or trauma, can cause genetic changes. We also know that some genes are passed down in families. These changes may contribute to the development of a substance use disorder or other mental illnesses.
Research shows that some mental illnesses increase risk for addiction disorders.
For instance, someone struggling with mental illness may get into drugs in an attempt to feel better. Though it may seem to alleviate immediate pain, the use of drugs and alcohol often has devastating, long-term effects. Continued drug use causes the brain to increase the rewarding effects, sometimes resulting in the development of other addictions.
People who struggle with an anxiety or mood disorder, such as depression or bipolar disorder, are twice as likely to also use drugs or alcohol. Those with attention-deficit hyperactivity disorder (ADHD), antisocial personality disorder and conduct disorder, psychotic disorders—such as schizophrenia and schizoaffective disorder—or OCD are also more likely to misuse substances.
While serving in a high-stress, high-responsibility role as a corrections officer, Wayne developed a serious problem with alcohol, and he knew he needed help to overcome it. Learn more about his path to mental wellness.
There is no single cause of addiction. However, a few factors can contribute to whether you may start using or misusing substances.
Your friends may encourage you to join them in using drugs. Many people succumb to peer pressure for fear of losing friends or a desire to fit in.
People may start using drugs or alcohol when they are available at school or home. In some cases, parents introduce their children to drugs. Children raised in a family where others are using drugs or alcohol may be at a higher risk to start using.
Financial problems, a bad breakup, or the death of a close friend or relative are some of the situations that can push you to seek relief or escape with drugs or alcohol.
Also, people exposed to high levels of stress (for example, a first responder or a member of the armed services) are susceptible to addiction. Research has found that 60-80% of people with PTSD also have substance use issues. People who experience PTSD may use drugs and alcohol to cope with stress or to relieve symptoms such as anxiety, depression, and irritability.
Experiences during childhood can lead to physical and emotional difficulties, including addiction. Physical, sexual, or verbal abuse; neglect; witnessing violence; and parental separation or divorce are factors that can impact your use of substances.
People with substance use disorders can experience both a physical dependence on the substance and a psychological dependence. While some of these signs may appear almost immediately, depending on the substance, some are gradual and will appear over time.
Not all of these symptoms will present themselves when someone is struggling with an addiction. Any of these signs, though, may indicate consistent substance use.
Some of the physical signs of addiction:
Some of the psychological signs of addiction:
If a friend or loved one also exhibits any of these, they could be signs that individual is struggling and needs assistance:
If you or someone you know shows these signs and symptoms, it may be a sign of a substance use disorder—and the need for help from a doctor or counselor.
The good news is that it’s possible to receive both effective and safe treatment for addiction. Both medication and therapy have been very successful in treating substance use disorders.
Treatment not only helps manage addictive behaviors but also helps minimize the chance of relapsing in the future. It’s also never too late to seek treatment—individualized care plans are created for each patient, ensuring that your exact needs are met. No two patients are alike.
To diagnose addiction, a licensed treater will ask you about the nature of your substance use and learn how substance use is affecting your life. They may ask about other factors, such as your personal and family history as well as identifying any coexisting mental health issues. Honesty and family involvement in this process are crucial to receiving an accurate diagnosis.
Treatment for addiction and co-occurring disorders may include a combination of medications, family therapy, cognitive behavior therapy (CBT), dialectical behavior therapy (DBT), exposure and response prevention therapy, and group therapy approaches.
Before embarking on any treatment journey, it is important to contact your health care providers to seek help that is best suited for your condition or a loved one.
Treatments vary depending on the type of disorder. Here are some of the more common treatment and support options.
This form of short-term treatment is for people who are physically dependent on drugs or alcohol.
Detox may be necessary for people withdrawing from alcohol, benzodiazepines, and barbiturates, as the withdrawal symptoms can sometimes be fatal without medical supervision. Medical professionals monitor patients to ensure a safe and comfortable withdrawal.
This type of treatment involves a 14- to 30-day stay at a treatment center like McLean. This type of treatment can be incredibly helpful for people who prefer to be in a structured, drug-free environment, removed from temptations or triggers.
Dual diagnosis programs specialize in helping people who struggle with both addiction and other mental health issues. Treatment may involve group, individual, and family therapy, and medication management.
Outpatient and partial hospital (day) programs offer less structure because patients do not live at the facility. Patients return home each day after treatment is complete.
Treatment may consist of medication, talk therapy, or both. Sessions can occur one or more times per week. Those who are in stable recovery may attend therapy less frequently.
12-step fellowship programs, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), offer meetings in a supportive and encouraging environment. They are free to join and widely available. Other programs, such as SMART Recovery, also provide tools for recovery and social support.
In addition to medications and therapy, successful recovery involves rebuilding a meaningful life. This process can be slow and challenging as you rebuild family and social relationships and begin to expand your role in your community. Unfortunately, the process can be difficult for those struggling with homelessness, financial instability, lack of social supports, or limited education.
Moreover, the recovery process can involve investing in new interests and provide meaning to your life. A successful recovery from addiction can include understanding that your problems usually are temporary. Recovery also involves acknowledging that life is not always supposed to be pleasurable.
An important step in recovery is having personal agency. There are many ways to heal by just being part of better things. By diversifying interests and goals, identifying and working through drawbacks, and remembering life has its highs and lows, recovery can be longer-lasting.
Individuals are encouraged to focus on positive behaviors like:
Whether practicing these behaviors alone or with loved ones, positivity can be a powerful—and successful—component of the recovery process.
Let us help you or a loved one. Call us today at 877.263.3510, and we’ll help you find the treatment option that’s right for you.
Addiction is fueled by a loss of control over the use of a substance as the brain goes through a series of changes, starting with the recognition of pleasure and ending with a drive toward compulsive behavior.
Whether it is a psychoactive drug, sexual experience, or any other form of pleasure, the brain perceives them all in the same way. It stimulates dopamine release from the brain’s pleasure center.
The difference comes in the speed, intensity, and reliability with which the brain releases dopamine. Typically, drugs of abuse stimulate a high dopamine surge. That’s why they will always be so addictive. The high levels create an alternative route to the brain’s reward system, which causes dopamine to flood the brain—and ultimately intensifies addiction.
Until recently, scientists thought the only cause of addiction was pleasure. But recent studies show that dopamine affects the brain’s learning process and the ability to retain things in memory.
Dopamine takes over the control of the brain’s reward learning process when it interacts with glutamate—like dopamine, another neurotransmitter. This learning process is essential to encouraging necessary body activities, like eating and sex, that are needed for survival.
Again, since the brain’s reward circuit includes the parts that boost motivation, dopamine does the same—but with an overload of motivation.
Continued consumption of the drugs causes the brain to stimulate the body into a deep desire to consume more drugs.
With time, the brain gets used to the substances, which translates to less pleasure. Naturally, we know pleasure comes after some hard work. But these drugs overwhelm the brain, and in turn, the brain either releases less dopamine or gets rid of its receptors.
That means that dopamine’s effect on the reward center reduces significantly. So, even if you were addicted, you no longer experience the pleasure you were used to. And that can drive someone to consume even more quantities to reach the dopamine “high” levels that can cause significant pleasure.
Most substances only provide fleeting relief. For instance, if you have pain or stress, taking opioids could result in temporary painlessness. If you are experiencing negative moods, anxiety, or sadness, taking stimulants like cocaine also provides short-term fulfillment.
Despite short-term respite, the long-term effects of an addiction are quite detrimental. But even so, the intense urge for that relief can cause you to ignore the risk.
Even if you hardly experience pleasure from drugs, the memory created from past use compels the desire to recreate that pleasure. This compulsion causes part of your brain—the hippocampus and amygdala—to start developing thoughts about getting the drug again, which grows into intense desire when encountering an environment with those drugs.
This desire to relapse even after years of sobriety, especially when you encounter tempting environments, results from this conditional learning.
When entering treatment, it’s possible for a person to experience withdrawal. Withdrawal is the process of quitting a substance and can vary in severity.
Physical and psychological dependencies can also appear during withdrawal. Your body gets used to drugs and alcohol such that if you don’t use them for a while, physical symptoms begin to show up. You have to take the drugs to maintain your “normal” self. Psychological dependence stems from the mind. You believe you cannot survive without using—for example, it’s impossible to be social or fun without drinking alcohol.
When you have a psychological dependence on drugs or alcohol, you may also come to believe that you need to use the substance all the time. You believe you cannot survive without drugs.
Physical dependence relates to when your body has become used to having drugs, and therefore you need to take drugs to even feel normal. For example, if you have an addiction to a depressant like alcohol, you may feel restless, agitated, or have tremors when you do not drink. Some substances, like opioids, can cause sweating or nausea during withdrawal. Withdrawal from cocaine and marijuana often produces emotional symptoms, ranging from irritability to depression.
Withdrawal symptoms can be mild or severe, depending on:
Sometimes withdrawal may be fatal—especially if you are in a critical condition. It’s strongly encouraged to reach out to your health care providers if you are considering withdrawing or seeking treatment for addiction.
When going through withdrawal, it’s possible for a variety of responses to occur.
Symptoms vary from one individual to another—depending on the level of addiction and the type of drug. The symptoms are simply how you’d feel when you no longer use them. Withdrawing from cocaine, for instance, will make you feel depressed, agitated, and tired.
Since the brain is used to the drugs, it will always long to have that “normal” state. Sometimes the cravings will be too strong to the point that you have to use them. Therefore, to effectively manage the cravings, you must engage yourself in constructive activities like reading, exercising, learning new skills, and other active engagements.
Even though you will quit within a short period, the effects will, of course, last longer, depending on the factors we mentioned earlier.
Withdrawal involves four main steps:
Tolerance is a state where the body’s reaction to the drug goes down as you continue using it. That means, to achieve the same effect as before, you have to consume larger quantities of the drug. Note that tolerance doesn’t imply extreme addiction—it is the body becoming less sensitive to the substance.
Simply put, it involves stopping the consumption of drugs or alcohol.
Acute withdrawal occurs in the first couple of days after withdrawal, and it applies to alcohol as well as prescription and illicit drugs. As mentioned earlier, all effects are different. That means the length within which these symptoms happen is also different.
As the name suggests, this is the stage that comes right after acute withdrawal. It’s also called protracted withdrawal, and it involves a series of severe, persistent symptoms that last even after the addiction is over. However, this is a crucial stage that all people with substance use disorders go through in their early stages of withdrawal. The brain is usually in the reorientation process to recover from the changes it underwent during the active addiction stage.
To better understand the condition, it’s important to know what addiction is—and what it isn’t.
In the 1930s, when researchers first began to investigate what caused addictive behavior, they believed that people who developed addictions were morally flawed or lacking in willpower. “Addicts” were punished. Or they were encouraged to muster the strength to break their habits.
Over the years, we have learned much more, and today, we recognize addiction as a chronic disease that changes both brain structure and function. With addiction, the brain goes through a series of changes—beginning with recognition of pleasure and ending with a drive toward compulsive behavior. These advances in science have improved diagnoses and treatment of substance use disorders (SUDs).
Many have fought back against the notion that people with addiction are deliberately and maliciously engaging in substance misuse. In truth, those with addiction disorders have an illness.
Misconceptions, stigma, and hurtful language often discourage those who need help from reaching out. As our understanding of SUDs improves, the myths and misconceptions will go away. As a result, more and more individuals will seek treatment.
Several safe, effective, and inexpensive treatments are available for addiction. Treatments vary depending on the type of substance use disorder.
Effective medications are available for alcohol use disorder, opioid use disorder, and nicotine use disorder. Often, psychosocial treatments are combined with medication. Treatment can be beneficial at any point in an addiction and can be tailored to a person’s needs.
Charles talks about early life trauma, addiction, and acceptance in this emotional episode of McLean’s podcast, “Mindful Things”
According to the Substance Abuse and Mental Health Services Administration’s survey in 2018, about 20.3 million individuals struggled with SUDs between 2017 and 2018. Another study from 2014 shows that 7.9 million people in the U.S. developed SUD and other mental illness simultaneously. Half of that population were men, even though the gender difference has been reducing since then.
Substance use disorder is a common mental condition that affects millions of people. In 2011, SAMHSA reported that an estimated 22.1 million persons, or 8.9% of the U.S. population aged 12 or older, would meet the diagnostic criteria for SUD.
SAMHSA broke down the percentage of users who will develop dependence on particular drugs:
Alcohol is one of the most popular—and most misused—substances in America. Statistics from the 2018 U.S. National Survey on Drug Use and Health (NSDUH) found that 139.8 million Americans over age 12 drank during the past month. Of that group, 67.1 million were binge drinkers, while 16.6 million drank too much over the last month. Also, about 14.8 million of that group struggled with an alcohol-related disorder.
SAMHSA researched Americans above 12 years old on the use of tobacco and discovered that 27.4% of the American population (69.6 million) used tobacco within the last 30 days of their survey. While tobacco consumption is dropping, NSDUH’s 2018 statistics on tobacco consumption report that 58.8 million Americans were current cigarette smokers.
The CDC’s report in the National Youth Tobacco Survey of 2018 recorded a 78% and 49% rise in e-cigarette smoking amongst high school and middle school students.
Other 2018 NSDUH statistics show the prevalence of heroin and opioid use in the U.S. According to the study, about 808,000 Americans used heroin between 2017 and 2018, and about 2 million Americans struggled with an opioid-related disorder.
About 15% of Americans (43.5 million) above 12 years old smoked marijuana in 2017, according to NSDUH’s 2018 statistics. The report also indicates that 4.4 million of those who used the drug struggled with at least one SUD. Marijuana has short-term side effects like hallucinations and short reaction time. Long-term side effects include impaired judgment and memory loss.
Use of other drugs is on the rise, according to NSDUH. In 2018 alone, about 1.9 million Americans consumed methamphetamine, out of which 1.1 million turned out to have the drug’s related disorder, the group reported. Since 2011, methamphetamine use has quadrupled.
Also, NSDUH found that approximately 5.5 million Americans admitted to using cocaine during 2018. A 2018 CDC report stated that cocaine consumption increased by almost a third between 2016 and 2017.
Sign up now for our webinar series supporting mental health and wellness.
Looking for even more information about substance addiction? You may find these resources helpful.
Learn more about addiction and what you can do if you or a loved one is displaying signs of a substance use disorder.
These organizations may also have useful information:
AA is an international organization of people who have had a drinking problem. They offer self-help groups, educational resources, and support for those who struggle with alcohol addiction and the path to recovery.
American Academy of Addiction Psychiatry
An academic society organization, AAAP has an interest in preventing and treating substance use disorders and co-occurring mental illnesses.
Learn to Cope
This nonprofit support network offers education, resources, peer support, and hope for parents and family members coping with a loved one addicted to opiates or other drugs.
Massachusetts Substance Use Helpline
Provides free and anonymous information and referral for alcohol and other drug abuse problems and related concerns. The helpline is committed to linking consumers with comprehensive, accurate, and current information about treatment and prevention services throughout Massachusetts.
National Institute on Alcohol Abuse and Alcoholism
Part of the National Institutes of Health, NIAAA supports and conducts research on the impact of alcohol use on human health and well-being.
National Institute on Drug Abuse
NIDA supports scientific research on drug use and its consequences. NIDA is part of the National Institutes of Health.
Partnership to End Drug Addiction
Partners with families, professionals, and other organizations to end addiction in the United States. They take a public health approach, rooted in science and compassion.
This abstinence-oriented, nonprofit organization for people with addictive problems offers self-empowering, free mutual support meetings focused on ideas and techniques to help an individual change their life from one that is self-destructive and unhappy to one that is constructive and satisfying.
Substance Abuse and Mental Health Services Administration
SAMHSA, an agency within the U.S. Department of Health and Human Services, leads public health efforts to advance the behavioral health of the nation. SAMHSA works to reduce the impact of substance addiction and mental illness on America’s communities.
A comprehensive list of available 12-step programs as well as the tools to identify the most appropriate. This site has in-depth information about 12-step programs, how they work, and how to find one near you.
The Complete Family Guide to Addiction: Everything You Need to Know Now to Help Your Loved One and Yourself
by Thomas F. Harrison and Hilary S. Connery
(Guildford Press, 2019)
Treating Women With Substance Use Disorders: The Women’s Recovery Group Manual
by Shelly F. Greenfield
(Guilford Press, 2016)
Brain-Robbers: How Alcohol, Cocaine, Nicotine, and Opiates Have Changed Human History
By Frances R. Frankenburg, MD
Women & Addiction: A Comprehensive Handbook
by Kathleen T. Brady, Sudie E. Back, and Shelly F. Greenfield, editors
(Guilford Press, 2009)
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