Modern medicine understands that addiction to drugs or alcohol to be a chronic disease of the brain in which the reward system, memory, learning, motivation, and associated brain systems are changed, leading to compulsive behaviors around specific triggers, most often substances. Treatment for addiction involves detoxing the body from any drugs or alcohol and working with specialists to change behaviors around these substances.
The National Institute on Drug Abuse (NIDA) compares drug addiction to other chronic illnesses like asthma, hypertension, and diabetes, which all involve long-term medical treatment along with periodic relapses of symptoms.
For people struggling with drug addiction, a relapse back into substance abuse is a symptom of the chronic illness, not a failure of morals or willpower.
For example, between 30 percent and 50 percent of people with type I diabetes experience symptom relapse and about 50 percent to 70 percent of people with hypertension experience a relapse of symptoms. Treating these medical conditions involves stabilizing people so they can live normal, healthy lives, and when symptoms recur or new symptoms appear, that is called a relapse.
Symptoms of drug addiction are similar. Between 40 percent and 60 percent of people with an addiction experience relapse, which means that symptoms associated with the chronic illness reappear or new ones appear.
There are several risk factors for developing a drug addiction. The most prominent are:
Genetics, gender, ethnicity, mental illnesses, and some physical illnesses all put one at risk of developing an addiction to drugs or alcohol.
One’s home environment while growing up influences levels of stress and coping mechanisms for that stress. Work, adult home environment, and other surroundings also influence when or how a drug addiction problem occurs.
The combination of genetics and the surrounding environment in childhood influences how genes are expressed and how stress will be managed later in life. Triggers from trauma in childhood may also lead to substance abuse problems.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists 11 criteria for drug addiction to help clinicians diagnose this condition. If someone shows at least two of these symptoms over a 12-month period, they may have an addiction disorder.
Not all of these symptoms will be immediately apparent to concerned friends or family. If you think your loved one struggles with drug addiction, you may notice certain behavioral or physical changes.
Typically, addiction occurs in four stages:
The National Survey on Drug Use and Health (NSDUH) tracks rates of drug and alcohol abuse across the United States. The 2016 report found that illicit drugs – substances that are illegal in the U.S. or manufactured as illegal versions of prescription drugs, like fentanyl – were abused by about 28.6 million people ages 12 and older in the month prior to being surveyed. This is about 1 in 10 Americans, or 10.6 percent of the overall adolescent and adult population.
Different age groups abuse drugs at different rates, with young adults between the ages of 18 and 26 abusing most substances at the highest rates. NSDUH found that 1 in 4 young adults in that age group abuses illicit substances.
Alcohol: Although this substance is legal for people in the U.S. who are 21 and older, it is addictive for many and a widely abused intoxicating drug in this country.
NSDUH reports that, in 2016, there were 136.7 million Americans ages 12 and older who reported currently drinking; 65.3 million reported binge drinking alcohol, which is defined as four or more drinks in two hours for women, and five or more drinks in two hours for men; and 16.3 million people reported heavy alcohol use in the past month, meaning they drank at least one alcoholic beverage every day of the week.
Binge drinking and heavy drinking are not the same as alcohol use disorder (AUD), the addiction to alcohol that used to be called alcoholism.
However, forms of problem drinking like consistent binge drinking or heavy drinking can indicate potential rates of AUD.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that there are about 15.1 million adults, and 623,000 adolescents, in the country who struggle with AUD. The U.S. Centers for Disease Control and Prevention (CDC) report that short-term, drinking problems can lead to:
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Opioids: The current epidemic of opioid addiction and overdose in the U.S. began in the early 2000s, as prescribing practices around painkillers were loosened, and new versions of painkillers, like oxycodone and hydrocodone, were more widely distributed to people after they suffered an injury or went through surgery. Scores of people developed addictions to these drugs and were not able to stop taking them when their prescriptions ran out. Recently, as regulations around opioid painkillers have tightened, many people struggle with prescription opioid addiction have turned to heroin because it is more potent, less expensive, and easier to find. With the introduction of illicitly made fentanyl, more people are overdosing because this extremely potent drug is mixed with heroin or other opioids. The CDC reports that in 2016, 115 people died every day due to an opioid overdose. Between 1999 and 2016, over 350,000 people overdosed on an opioid drug.
Tobacco/nicotine: In 2016, there were an estimated 51.3 million people in the U.S. ages 12 and older who smoked cigarettes; 29.7 million of those people were daily smokers, and 12.2 million smoked a pack or more per day. Currently, about 1 in 5 people in the U.S. is a current smoker, but smoking has been on the decline in this country since 2002. Still, there are about 480,000 deaths annually from cigarette smoking.
Prescription sedatives and stimulants: Benzodiazepines like Valium or Xanax, sedative-hypnotics like Ambien, and stimulants like Adderall and Ritalin are widely abused. Stimulants are typically abused as performance enhancers, sometimes by athletes but more often by students or young adults in a competitive workforce. Sedatives may be abused by people who struggle with an anxiety disorder or insomnia, who received a prescription for the substance; by people who want to enhance the experience of other CNS depressants like opioids or alcohol; or to lower the negative side effects of stimulants like Ritalin or cocaine. Stimulants increase focus and physical energy while sedatives increased relaxation and pleasant feelings. Long-term, these drugs can cause serious harm, including:
Cocaine: Although this drug is technically legal as a prescription substance in the U.S. – it is a Schedule II drug because it can be used as a local anesthetic – cocaine is most famous as an addictive, recreational drug. It is made from the leaves of the coca plant, which is native to South America. Powdered cocaine is snorted or smoked while crack cocaine is smoked. This stimulant is very potent and can cause various side effects.
Marijuana: This is the most popular illicit drug in the U.S. Although many states are passing recreational legalization, and over half the states have legalized medical marijuana use, this drug is still illegal at the federal level, listed as a Schedule I substance per the Controlled Substances Act (CSA) and enforced by the Drug Enforcement Administration (DEA). In 2014, about 22.2 million Americans ages 12 and older reported abusing marijuana at least once in the past month, and about 2.6 million adolescents that year reported trying marijuana for the first time.
Marijuana is a psychedelic drug, meaning it has effects similar to hallucinogens like mushrooms or LSD; however, it also has some central nervous system (CNS) depressant effects, like relaxation and sleepiness. A marijuana high comes with various short-term effects.
Smoking marijuana, which is the most common form of abuse, increases the risk of lung irritation, infections, chronic illnesses like emphysema, and even lung cancer. The brain can also suffer long-term harm from any kind of marijuana abuse.
NIDA recognizes numerous approaches to evidence-based addiction treatment, ranging from detox and group therapy through an outpatient program to long-term, medically supervised residential treatment. The foundation of addiction treatment, however, begins with detox. It is important to work with medical professionals who can monitor withdrawal symptoms and provide medication to ease the most intense symptoms if needed.
Some drugs, like alcohol, tobacco, and opioids, have associated medication-assisted treatments (MAT) available to taper the body off physical dependence on the substance.
This is not replacing one addictive drug with another but instead used to ease the brain and body’s transition from relying on the chemical’s presence to achieving a normal balance of neurotransmitters without an intoxicant.
Tapering with MAT may mean months, or even years, of taking a prescription medication to ease withdrawal, but during this time, therapists will work with you to change your behaviors toward drugs.
This reduces the risk of relapse while also keeping you medically stable.
Once detox is complete, or a long-term tapering process has been established, you should proceed to a rehabilitation program.
These programs provide counseling that focuses on behavioral change, so you can manage stress or triggers, learn what may cause stress, and better understand how specific behaviors have developed based on genetics or personal history. When you understand why your addiction developed, it can be easier to avoid substances in the future, and when you understand how to find better outlets for stress that can prompt compulsive behaviors, you can lead a healthier life.
There are many different approaches to therapy.
NIDA states that you should remain in a rehabilitation program for 90 days, or three months, at a minimum. This might involve a combination of outpatient individual and group therapy, short-term residential treatment followed by outpatient group therapy, or long-term inpatient treatment. There are many approaches to fulfilling this minimum time for a behavioral change.
If you are worried about how long you can stay in any program, speak with an addiction specialist at Delphi Behavioral Health Group at 844-899-5777. We can help you manage resources so you get the best combination of treatment approaches available.
Treatment should be readily available, and no single treatment is right for everyone. Help for co-occurring mental or behavioral illnesses is also a crucial part of treatment, and diagnosing associated illnesses like HIV, hepatitis B or C, pneumonia, tuberculosis, cancer, heart disease, or conditions related to substance abuse is essential so the individual receives coordinated medical care.
Even if you do not have extreme physical, mental, social, or financial difficulties from abusing substances, you may struggle with a drug addiction, and this addiction will likely deepen over time. Evidence-based treatments are available, so get help today.
“Definition of Addiction.” (April 12, 2011). American Society of Addiction Medicine from https://www.asam.org/resources/definition-of-addiction
“What Is Addiction? Stages.” (September 29, 2016). Healthline from https://www.healthline.com/health/addiction#stages
“Substance Use Disorders.” (October 27, 2015). Substance Abuse and Mental Health Services Administration from https://www.samhsa.gov/disorders/substance-use
“Treatment Approaches for Drug Addiction.” (January 2018). National Institute on Drug Abuse from https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction
“Principles of Drug Addiction Treatment: Behavioral Therapies.” (January 2018). National Institute on Drug Abuse from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies
Drug Enforcement Administration. Controlled Drug Schedules. Definition of Controlled Substance Schedules from https://www.deadiversion.usdoj.gov/schedules/#define