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Humans have used psychoactive substances for thousands of years for a variety of social, religious, and medicinal purposes. For as long as civilization has had drugs and alcohol, it has also had cases of substance abuse. While the nature of substance abuse and addiction has been widely debated over the centuries, it is only as recently as the 20th century that addiction has begun to be rigorously studied. Addiction is still widely misunderstood, but experts now understand that substance abuse and addiction are not moral failings, but health disorders that require proper treatment.
It is a common misconception that illegal drugs are the only drugs that can be abused. In fact, both prescription drugs and so-called “street drugs” are both frequently abused to a dangerous extent. Pharmaceutical medications that are used in off-label ways by prescription-holders or sold on the streets are often just as life-threatening as drugs with no medically recognized purpose.
Used to treat pain, prescription opioids are often prescribed for pain or following an injury. The United States is currently suffering from an opioid epidemic as a consequence of the wide availability of these medications.
The most commonly abused substance, alcohol is a central nervous system depressant active ingredient in drinks such as beer, wine, and distilled spirits. Alcohol abuse is the third leading cause of death in the United States.
Marijuana refers to the dried leaves, flowers, stems, and seeds from the Cannabis sativa or Cannabis indica plant. While marijuana has medically recognized uses, it is also a highly abused substance because of its calming effects.
Cocaine and crack cocaine are stimulants that make people feel more confident and energetic for short periods of time. They are highly addictive and can cause life-threatening damage to the cardiovascular system.
A common street opioid, heroin can be smoked, snorted, and injected. This highly addictive analgesic drug derived from morphine, often used illicitly as a narcotic producing euphoria. It can take over a person’s life very quickly.
Fentanyl is a pain-relieving narcotic that is similar to morphine, but much more intense. Due to its potency, it is commonly abused and mixed with heroin to increase the users high. Fentanyl overdose deaths are on the rise in recent years.
Benzodiazepines are a class of psychoactive medications used to treat a scope of conditions, including anxiety and sleep deprivation. They are one of the most generally endorsed prescriptions in the United States.
Closely related to amphetamine, “crystal meth,” as it is often known can do irreversible physical and neurological damage. User’s experience a stimulated euphoria, much more intense and longer lasting than other stimulants.
Addiction is referred to as “substance use disorder” by practicing psychiatrists. The disorder is characterized by a person’s inability to control their own consumption of drugs or alcohol. In most cases, individuals suffering from substance use disorder report suffering from moderate to severe consequences as a direct result of their drug use. These consequences can include problems with relationships with family members, friends, or other loved ones. Many people suffer from difficulties at work, ranging from merely failing to advance to being fired completely. Financial problems are not uncommon among individuals with substance use disorder, due to impulsivity brought on by intoxicated states and drug-seeking behavior. Others suffer criminal consequences. Over both the short and the long term, individuals engaging in substance abuse are prone to a wide variety of health problems, including fatal conditions such as drug overdose.
Psychiatrists actually understand that most cases of substance use disorder fall on a wide spectrum of severity. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the guidebook used by practicing psychiatrists to diagnose patients with mental health conditions, defines substance use disorder by eleven symptoms. If an individual suffers from 2-3, they are considered to have a mild case of substance use disorder. 4-5 symptoms is indicative of a moderate case. The presence of 6 symptoms or more is usually a sign of a severe case requiring immediate emergency care. The eleven symptoms listed in the DSM-5 are as follows:
Understanding that there is often a fine line between recreational drug use and addiction is crucial. Due to stereotypes and depictions of addicts on television and in films, many people mistakenly believe that addicts are exclusively people who have lost everything. In fact, not all addicts are homeless, though many are. Many people suffer from addiction while holding down jobs, providing for their families, and generally making ends meet. Functional addicts and alcoholics are common, though sadly they are often the last to seek help and get treatment because they fail to recognize or admit the existence of their substance use disorder. When it comes to diagnosing an individual with substance use disorder, their appearance and social standing are not factors. Rather, addiction is defined by the distress and consequences they are forced to reckon with as a result of their continued substance abuse.
Substance use disorder causes a wide range of physical, social, and psychological harm to individuals suffering from it, as well as collateral damage to people affected by their actions. These harms tend to grow and compound over time. As such, it is often helpful to divide the effects of addiction into the categories of short-term and long-term consequences.
Sometimes it can be difficult to differentiate between recreational drinking or drug use and substance abuse, in part because binge drinking and drug use are relatively accepted on a cultural level. Many people also find that they adapt to their addictions. By structuring their lives around their addictions, individuals can appear to be functioning normally. However, the fact that they have allowed drugs and alcohol to determine the day-to-day structure of their lives indicates a level of powerlessness. Even the most apparently functional addicts usually exhibit symptoms of their substance use disorder through the cracks of their facade. Common symptoms of substance abuse and substance use disorder include:
Ultimately, close friends and family members can usually get a strong intuitive sense that something is wrong. If a loved one appears to be behaving differently or seems to be compulsively abusing substances, chances are they are suffering from substance use disorder to some extent. It is a good idea to reach out. Many people with addictions live in a state of denial, and talking with concerned and supportive loved ones can help them begin to recognize their problem.
Most cases of substance use disorder begin innocuously enough. People begin using drugs and alcohol for many reasons: to relax, to make social interaction easier, to increase focus, and to celebrate important occasions. Ultimately, people use substances because it makes them feel good. Many people find that they are drawn to this good feeling again and again. While wanting to take drugs or drink alcohol does not mean one is suffering from addiction, certain populations may find it difficult to resist cravings. They may be drawn to the good feelings substances provide as a way to gain control over chaotic mental states, alleviate suffering in their day to day life, or they may simply be predisposed toward compulsive behavior. Vulnerable populations include:
Individuals with addicts in their families.
Research has shown that there is a genetic component to substance use disorder.
People with underlying mental health conditions, such as depression, anxiety, or bipolar disorder.
Many individuals suffering from mental illness, especially untreated mental illness, turn to substance abuse as a form of self-medication.
Those who began using drugs and alcohol at an early age.
When the brain is still undeveloped, people make decisions far more impulsively, which can lead to substance abuse. Drug and alcohol use has also been found to harm the development of immature brains.
Individuals who were exposed to abuse or suffer from post-traumatic stress disorder.
People who suffer from trauma have higher rates of addiction than the rest of the population. Substance abuse can be a way of gaining control, distracting oneself from painful memories, and coping with pain.
Growing up in poverty.
When the brain is Individuals and families who are worse off financially have a higher likelihood of being exposed to drugs, have access to fewer resources to cope with addiction, and often have limited prospects and opportunities. Research shows that people who do not have a strong sense of a future to look forward to are more likely to make decisions based on present-moment cravings.
Using drugs and alcohol releases endorphins and dopamine in the brain that reinforce those behaviors. Over time, substance use alters chemical pathways in the brain and causes permanent changes in areas of the brain associated with motivation and decision making. This can make drug use more automatic and difficult to control. Over time, the brain adapts to the effects of the substances and requires greater quantities for users to achieve the desired effects. As dosages increase, so too does the severity of withdrawal symptoms. Physical dependence begins when individuals find themselves uncontrollably seeking substances to avoid the effects of withdrawal.
Substance use disorder usually followers physical dependence. While individuals with a physical dependence on substances are free to stop using at any time, people with substance use disorder find that they are unable to quit despite a desire to do so. Many find that addictions fill a deep emotional hole in their lives. Substance use disorder can also be diagnosed when an individual begins to experience severe negative consequences as a result of their substance abuse. While the nature of these consequences differs dramatically from person to person, people suffering from addiction all share a similar helplessness to stop using despite clear evidence that they are harming themselves.
Mental illness and addiction are strongly connected. Not only are people with substance use disorders more likely to develop mental health conditions such as depression and anxiety, but people with those conditions are also predisposed to developing addictions. Drugs and alcohol can provide powerful but temporary relief from many psychological and emotional ailments, including grief, depression, anxiety, lack of focus, and rage. Unfortunately, the relief is generally short-lived, and many people find that over time “self-medication” has a tendency to make underlying conditions worse. Thus, many individuals with mental illnesses engaging in substance abuse find themselves in a vicious cycle, in which every attempt to escape their misery only further entrenches them in addiction and mental illness.
Individuals who have one or more comorbid conditions are referred to as dual-diagnosis. These individuals require specialized care at a treatment facility that has the resources to treat a person’s substance use disorder as well as their other mental health conditions. If addiction is treated exclusively, even at a high quality treatment center, there is a high likelihood that the person will relapse down the road as a result of triggers arising from their other conditions. Similarly, treating mental illness without addressing substance abuse is rarely successful, as substance abuse inevitably leads to severe psychological distress. Formal treatment programs with psychiatric resources, such as partial hospitalization programs (PHPs), are ideal for these dual diagnosis individuals.
As a disorder that primarily affects an individual’s ability to make decisions, addiction can only be treated with outside help. A wide variety of formal treatment programs exist to deal with addiction at all levels of severity. For individuals with a strong physical dependence on substances, enrolling in a medical detox program is usually the best course of action. Following that, it is important to treat addiction more specifically, either in an inpatient program where clients live on the premises and receive 24 hour care, or at an outpatient facility, which they can attend for a limited time each week. In both kinds of treatments centers, individuals can expect to be exposed to a wide range of treatment modalities, from psychiatric care and medication management to cognitive-behavioral therapy. Many treatment facilities encourage involvement in support groups and 12-step programs both during and after formal treatment as a support for long-term sobriety.
Substance use disorder cannot be cured. However, it is possible for individuals to get relief from the obsessive desire to abuse substances as long as they continue to receive treatment. For most people, the nature of this treatment will change over time as they develop more stability in sobriety. Physical abstinence is only the beginning of a long but rewarding process. Treatment centers and support groups offer individuals a chance to build social support systems, develop coping strategies, and learn applicable life skills that allow them to make a new beginning. By seeking help, even the most intractable cases of addiction are solvable. Long term sobriety is accessible to anyone who reaches out.
is a boutique outpatient treatment program catering to mental health, dual-diagnosis and substance abuse addiction.
