What Is Addiction?
Addiction is a disease that affects the wiring of the brain, including reward, motivation, memory, and related circuitry.
Drug and alcohol addiction share two basic qualities:
- An individual sometimes uses more than (s)he would like to use.
- An individual continues to use despite negative consequences.
The following criteria are used to diagnose an individual with addiction. An addict struggles with three or more of these behaviors.
- Tolerance. Does the individual use more alcohol or drugs over time?
- Withdrawal. Has the individual experienced physical or emotional withdrawal when he/she stopped using? Has the individual experienced anxiety, irritability, shakes, sweats, nausea, or vomiting? Emotional withdrawal is just as significant as physical withdrawal.
- Limited control. Does the individual sometimes drink or use drugs more than he/she would like? Does the individual sometimes drink to get drunk? Does one drink often lead to more drinks? Does the individual ever regret how much he/she used the day before?
- Negative consequences. Has the individual continued to use, even though there has been negative consequences to mood, self-esteem, health, job, or family?
- Neglected or postponed activities. Has the individual ever put off or reduced social, recreational, work, or household activities because of use?
- Significant time or energy spent. Has the individual spent a significant amount of time obtaining, using, concealing, planning, or recovering from use? Has the individual spent a lot of time thinking about using? Has the individual ever concealed or minimized his/her use or thought of schemes to avoid getting caught?
- Desire to cut down. Has the individual sometimes thought about cutting down or controlling use or made unsuccessful attempts to cut down or control use?
Children Are The Victims
There is a relatively narrow window in which addiction develops: it nearly always originates during adolescence. The prefrontal lobe, the area of the brain where decision-making, judgment and self-control reside is the last to develop, usually in a person’s early twenties. This makes adolescents particularly vulnerable to alcohol and other drugs.
Drugs arrest the development of the prefrontal lobe and target the brain’s reward system, changing brain circuitry and making it difficult for many adolescents to stop using. Ninety percent of those who are currently addicted began using alcohol and other drugs before the age of 18. Learn more
Addiction is a chronic disease, and there is no simple treatment option. Most patients need long-term or repeated care to stop using completely and recover their lives. An effective treatment plan will help the individual stop using drugs, stay drug-free, and live more productively.
Medications can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions.
- Withdrawal. Medications help suppress withdrawal symptoms during detoxification. Detoxification is not in itself "treatment," but rather a step in the process of recovery. Patients who do not receive any further treatment after detoxification usually resume their drug use.
- Relapse prevention. Patients can use medications to help re-establish normal brain function and decrease cravings. Medications are available for treatment of opioid (heroin, prescription pain relievers), tobacco (nicotine), and alcohol addiction. Scientists are developing other medications to treat stimulant (cocaine, methamphetamine) and cannabis (marijuana) addiction. People who use more than one drug, which is very common, need treatment for all of the substances they use.
- Co-occurring conditions. Other medications are available to treat possible mental health conditions, such as depression or anxiety, which may be contributing to the person’s addiction.
Behavioral therapies can help patients change their attitudes and behaviors related to drug use, develop a healthy lifestyle, and continue other forms of treatment, such as medication.
Outpatient behavioral treatment. Outpatient behavioral treatment includes a wide variety of programs for patients who visit a behavioral health counselor regularly. Most of the programs involve individual drug counseling, group drug counseling, or both. These programs typically offer forms of behavioral therapy such as:
- Cognitive-behavioral therapy. Helps patients recognize, avoid, and cope with situations in which they are most likely to use drugs.
- Multidimensional family therapy. Developed for adolescents with drug abuse problems and their families. This type of therapy addresses a range of influences on drug abuse patterns and is designed to improve overall family functioning.
- Motivational interviewing. Makes the most of people's readiness to change their behavior and enter treatment.
- Motivational incentives (contingency management). Uses positive reinforcement to encourage abstinence from drugs.
Treatment can be intensive at first, with patients attending multiple outpatient sessions every week. With time, patients transition to regular outpatient treatment to help sustain their recovery. This regular outpatient treatment meets less frequently and for fewer hours in a given session.
Inpatient or residential treatment. This type of treatment can be very effective, especially for those with severe problems (including co-occurring disorders). Licensed residential treatment facilities offer 24-hour structured and intensive care, including safe housing and medical attention. Residential treatment facilities may use a variety of therapeutic approaches generally aimed at helping the patient live a drug-free, crime-free lifestyle after treatment.
Many people also find it useful to connect with self-help groups (Alcoholics Anonymous, Narcotics Anonymous). There are similar support systems available to friends and family members (Al-Anon or Nar-Anon Family Groups).