Drug Addiction and Treatment Awareness

“What is drug abuse?” The term “drug” according to the American Heritage Dictionary: Fourth Edition is either “a medicine used in treating a disease” or “a narcotic or hallucinogen.” The term “abuse” has many definitions but the most relevant is “to use wrongly or improperly.” Therefore the definition for the term “drug abuse” might be “the wrong or improper use of medicines used in treating disease or the wrong or improper use of narcotics or hallucinogens.”

To follow that up the next question to ask is, “What is addiction?” According to the National Institute on Drug Abuse, addiction is defined as “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”

Today, addiction is considered to be a disease of the brain. This is because drugs change the brain, its structure, and how it works. These effects can be long lasting and can lead to behaviors that are harmful to the addict or to others.

Some commonly held myths about addiction include:

• Addiction is a voluntary behavior
• Addiction is a character flaw
• Addiction is a moral failing
• Addiction means a person has a lack of willpower

These early myths shaped how we as a society had dealt with drug abuse in the past and to some extent how we respond to addiction today. Much of that response was (and sometimes still is) based on a punitive approach rather than that of treatment.

Some scientists study the effects of drugs on the brain and on people’s behavior. Discoveries about the brain have been made that revolutionize our understanding of drugs and addiction. These discoveries enable us as a society to respond more effectively to the problem of addiction. Despite these advances, many people still do not understand how people become addicted or how drugs affect the brain.

People take drugs for a variety of reasons:

• To feel good
• To feel better
• To do better
• To fit in
• To escape
• To relax
• Boredom
• Rebellion
• Curiosity and Experimentation
• Because the media makes it seem attractive

Depending on the substance being abused, many people report common feelings like happiness, confidence, serenity, or even euphoria when on the drug. Often times there is an accompanying feeling that what they are feeling isn’t real and that the sensations are going to disappear at any time. The point is that the feelings that drugs produce are not real and are only temporary. After “coming down” from a high, drug users often feel powerful downsides like depression, anxiety, nausea, guilt, embarrassment, loneliness, and the desire to do more drugs.

At first people feel the positive effects of their use and believe they can control their usage but drugs will often times take over people’s lives. How? Not only might someone become addicted but also they might make decisions that could permanently damage their lives such as when a drunk gets behind the wheel of a car and crashes. Over time the pleasurable effects of the drugs become less pleasurable and users will often have to take more of the drug to get the same or “original” effect, or worse, will need the drugs effects to feel “normal.” A drug user might then continue to use well after having had negative consequences to their using.

Individual types of drugs are very different from one another, but they all mess with your nervous system’s basic functions and your muscular functions as well. Their brains, nerves, and muscles become all messed up and that is why people report the sensations that they do. Many drugs make it difficult to sleep or cause major weight gain or weight loss. In the longer term using drugs again and again for an extended period of time can cause medical problems ranging from lung cancer, to liver problems, to brain damage.

Every drug is different but “long-term” effects are just as the name implies. The effects will stick with an addict for a long time or for the rest of his or her life. Besides the physical negatives, drugs can cause other more subtle brain issues like depression. Then there are the negative social issues such as telling lies, stealing money, and becoming violent. Their highest ambition above all else becomes getting their next fix and things like setting high goals or following through with past goals take a way-back seat in life.

Sometimes people don’t get addicted to drugs. They still may continue to use drugs for the reasons they started using them in the first place: fitting in, escape, boredom, etc. For others, once they start taking drugs they become addicted. Whether mentally or physically, they want more, need more, and will do anything to get what they need. Trying to get drugs becomes the most important activity of the day, taking up much of their time, resources, and energy as well as having dire physical, mental, social, and spiritual issues.

A person’s initial use is often very voluntary. However, as drug abuse takes over a person’s life their ability to show and exert self-control becomes harder and harder until it can seem to be non-existent. Scanning the brains of drug addicted individuals reveal physical changes in the areas of the brain that control judgment, decision making, learning, memory, and behavior. Scientists believe that these changes alter how the brain works so as that compulsive, addictive behavior is the result.

Susceptibility to addiction is like susceptibility to any other disease and it differs between individuals. The more risk factors a person has, the more likely they are to become drug users and addicted at some point in their lives.

No one says, “hey! Today, I want to be an addict!” Addiction is a progressive disease, not an event. Drug users often start using only once in a while. Some never get addicted, per say. Some drugs, however, can make you feel so good that you are continually looking for that first high. After their initial encounter their continued use will not result in quite the same feeling as before. This results in taking more and sometimes different drugs. All the while permanent things are happening and the user is sometimes slowly, sometimes quickly, becoming addicted. No one knows when addiction is first activated in the brain and no one knows who will become addicted. The thing scientists do know is that the more drugs you do the closer and closer you will get to becoming addicted.

Addiction is not dependant on any single factor. The big picture shows that our biological makeup greatly influences the risk of addiction. Other factors include but are not limited to gender, ethnicity, the developmental stage of the individual, and their social environment.

According to the National Institute on Drug Abuse (NIDA) 40 to 60 percent of a person’s susceptibility lays in their genetic makeup. This includes how the environment affects our genetics. People with mental disorders and adolescents are at greater risk for addiction than others.

The environmental factors that increase the risk of addiction are the home and family, and school and peers. When a child, the home is usually more important and parents or other family members living in the home who abuse alcohol or drugs are influential in whether or not the child will one day develop their own drug problems. During adolescence, friends and peers have a greater effect on whether or not the adolescent will use drugs. They can play a key role in whether or not an adolescent, independent of their risk factors, will use. Other factors to consider are how the use of drugs can affect an adolescent academically and socially. The negative effects drugs have on scholastic achievement and social interaction can cause increased use when an adolescent has already been using and suffering from such effects.

One other factor to be considered in the overall risk of addiction is how early the drug user starts. Taking drugs at any age can lead to addiction, however research shows that the earlier a person uses the greater likelihood is of them developing more serious problems down the road.

The method of administration also greatly influences whether or not a person becomes addicted. Smoking or Injecting can get the drug into the brain within seconds causing a rush of pleasurable effects. However this high can decrease within minutes requiring the user to administer more and more to keep at the same level. Between the high and the eventual low there is a big difference. That is a huge motivating factor on whether or not a person will use more after the initial use.

There are many different drugs and the treatment of one drug from another significantly varies. Treatment also depends on the nature and characteristics of the patient.

Problems with active addiction can vary significantly from person to person. People who use drugs and are addicted come from all walks of life. Many have problems mentally, occupationally, socially, physically, spiritually, or any combination of the above. These problems often make it much more difficult to treat. Even if the problems are few, their implications and the severity of addiction can range widely between people.

There are a variety of scientifically based approaches to the disease of addiction. Some of which are behavioral while some include medication or a combination of the two. The behavioral therapies give people tools for coping with cravings, teach them ways to avoid drugs and triggers to prevent relapse, and helps them cope with having a relapse if one should occur. The involvement of medical, psychological, and social services can be crucial for the struggling addict. Better programs provide a combination of therapies and services to meet what needs the individual patient has.

Some medications are critical to the well-being and treatment of such mental disorders as depression, anxiety, bipolar, or psychosis. Treatment can vary in different places, forms, and for different lengths of time. Drug addiction is chronic therefore a one-time quick fix is usually not sufficient as many will relapse at one time or another during their recovery. Many continue treatment for a long time with multiple interventions.

It is a widely common belief amongst drug addicts that they can stop on their own. Many will try to stop without utilizing treatment. Most of these attempts fail to achieve long-term abstinence. Changes in the brain remain for a long time after a person quits. These changes in the brain and its function may have behavioral problems and problems with quitting.

One thing that may help explain an individual’s difficulty in achieving abstinence without treatment is the biological factor. Psychological stress, social interaction, and the environment around the addict can mix with biological factors to hinder sustained abstinence and make relapse a likely reality. Research indicates that the most severely addicted persons can actively participate in their treatment, which is essential to a positive outcome.

Can addiction be treated successfully? Yes. The disease of addiction is very treatable. Many methods of treatment have been shown scientifically to allow patients to resume healthy, normal lives. Addiction is not a death sentence nor is it a life sentence. Addiction, like many chronic illnesses, can be managed successfully. Treatment lets people work against addictions powerful hold on the brain and behavior and allows for people to regain control of their lives.

Stopping drug use is the goal of treatment but so is the return of the individual to society as a productive worker, family member, and an asset to the community. The ability to measure the effectiveness of success depends often upon decreased levels of criminal behavior, increased family functioning, increased employability, and an increase ones overall medical condition. The treatment of addiction is possibly just as successful as the treatment of other diseases such as diabetes, hypertension, and asthma.

According to certain studies treatment reduces drug abuse by 40 to 60 percent and can significantly decrease criminal activity during and after treatment. Other studies show that treatment reduces the risk of HIV infection and that form of intervention costs far less than treating HIV itself. Treatment can also improve the ability to find work with gains after treatment of up to 40 percent.

However, it should be noted that individual treatment depends upon the extent and nature of the patient’s problems, how appropriate the treatment is, and how actively engaged the patient is in the treatment process.

Individuals in treatment progress at differing speeds and there is no predetermined length of treatment. Research, however, has shown that good outcomes are contingent on how long treatment adequately continues. For residential treatment or out patient treatment participating for less than 90 days is ineffective.

Many people drop out of treatment before receiving all the benefits that the program has to offer. To be successful, patients often must have more than one treatment experience. Addicted individuals can have multiple treatments, however it should be noted that often times these episodes of treatment have a cumulative effect.

Drug addiction treatment is effective in reducing drug use and its health and social costs. Treatment is ultimately less expensive than incarceration or simply not treating addicts at all. By a conservative estimate, every dollar invested in treatment programs sees a return of between 4 and 7 dollars in crime reduction, criminal justice costs, and theft. The savings jump to 12 to 1 when we consider health care. Savings to the individual and society also come from drops in interpersonal conflicts, reductions in drug accidents, and can come from increases in productivity at work.

Often times the person must stay in treatment long enough to see the full benefit of treatment. Strategies of keeping and individual for the full program are essential. Staying in treatment depends on the individual and the program. Engagement and retention depend upon the motivation to change drug-using behavior, the degree of support from family and friends, and whether there is pressure to stay in treatment from outside sources such as the criminal justice system, child protective services, employers, or family. In treatment the counselors that successfully develop a positive, therapeutic relationship with the patient are more capable than those who cannot. The counselor should help the individual know what to expect during treatment by establishing a plan of action and following it through. Social services, psychiatry, and other medical services should be available.

Since some problems increase the chance of the patient dropping from the program, intensive treatment with a range of components may be required for such things as mental illness, severe usage, criminal involvement, etc. In these cases and others it may be necessary for the provider of care to follow up with “aftercare” even after treatment has formally ended.

Some commonly held myths about treatment include, “The addict has to want drug treatment for it to be effective,” “Treatment for drug addiction should be a one-shot deal,” and “scientists should strive to find a magic cure to treat all forms of drug abuse.”

Another important area of discussion is relapse. The nature of the disease of addiction has shown that relapse is not only possible, but also likely. The rates of relapse are comparable to other chronic diseases such as the ones mentioned before. The treatment of a chronic disease requires changing behavior. Having a relapse is not a sign of failure. For an addicted person, a relapse means that treatment needs to be reinstated or something in treatment needs to change.

Some medications may be helpful or even necessary during various stages of treatment. These medications help the patient stop abusing drugs, stay in treatment, and avoid relapse.

• Treating Withdrawal: When a patient first stops abusing drugs they can go through a variety of physical and mental stresses including depression, mood disorder, anxiety, sleeplessness, and restlessness. Some medications are meant to alleviate these negative symptoms
• Staying in Treatment: Some medications are used to get the brain to adapt slowly to not having drugs. These medications can have a calming effect as well as staving off cravings for the drug. By doing this patients are better able to deal with treatment and be more engaged rather than suffering from negative symptoms.
• Preventing Relapse: Science shows that certain triggers for relapse are stress, cues (people, places, things, and moods) related to drug use, and exposure to drugs. Medications are being developed to help patients deal with these triggers so as that they do not relapse.

With treatment medications the question often arises, “do medications simply replace the drug?” Some 12-step organizations would tell you that by using a medication to stop the use of drugs is simply switching from one drug to another. To a certain extent they are right, that is what you are doing. The problem with this philosophy is that some medications are necessary, effective ways of treating or managing physiological and psychological symptoms. In the case of antabuse, which is a drug used in the treatment of alcohol, the drug makes the user sick every time he tries to drink. The problem is that if a user won’t stop drinking they are doing far more damage to their body than if they were drinking while not on it and they are causing themselves to be miserable when they drink while on it. The positive effect is that many will not drink while on it knowing that it will make them sick. Even medications like methadone and LAAM are used in maintenance treatment; they are not substitutes for the drug heroin. These are safe and effective medications used to treat opiate addiction. They are administered by mouth regularly in fixed doses. Injected, snorted, or smoked heroin in contrast causes an immediate “rush” or a sensation of euphoria that eventually wears off and becomes a “crash.” The point is, with the medications used to treat heroin they are not intended to get a person high, they are intended to maintain a person during treatment.

Does this mean that 12-step meetings are wrong? No. They have a point. Why replace one drug with another if you can help it? Some people choose to stop using medications all together and go on to lead healthy, normal lives. However, it should be noted that this is not the case for everyone. Some people absolutely, positively need medication to function and in the case of drug treatment it is often necessary to use a drug to get a person away from the substance they normally would abuse.

Behavioral therapies are another factor in treatment. They are meant to modify a person’s attitudes and behaviors toward drugs, engage them in treatment, and increase their skills in handling stressful circumstances and environmental cues that may trigger cravings that may lead to relapse. Behavioral therapies can enhance the use of medications and help people remain in treatment for longer and more successful stays.

Stopping the use is only the first part in the process of treating addiction. Addiction often times has taken over the life of the addicted person before they enter treatment. Drugs have replaced everything in their life that was once valuable. It disrupts their family life, community life, social life, and made them less employable. It also makes them more susceptible to other diseases. Because addiction can affect many areas of a person’s life it is necessary to treat the whole individual by addressing their special needs. This is why rehabilitative services and a comprehensive treatment programs are important and the best treatment plans include them. Counselors will select from a variety of services that meet the patients medical, psychological, social, vocational, and legal needs.

So, where do 12-step or self-help programs fit into the disease of addiction and its treatment? Self help groups compliment and extend what professional treatment began. It is strongly encouraged that an addicted person, whether in treatment or not, utilize one of these groups or other similar groups that are more appropriate to the needs of the addict.

Lastly, family and friends play an essential role in the motivation of the individual with a drug problem and my ultimately influence their choice to begin or stay in treatment. Therapy, including family therapy is important, especially for young patients.

In this article I have talked about drug addiction and touched a little on treatment. My sources for this article included (1) “Health Reference Series: Drug Abuse Sourcebook, Second Edition,” Edited by Catherine Ginther, (2) “Drugs, Brains, and Behavior, The Science of Addiction” by the National Institute on Drug Addiction, and (3) “The American Heritage Dictionary, Fourth Edition” published by Dell Publishing, a division of Random House, Inc.