Addictions

What is Drug Addiction?

Drug addiction, also called substance use disorder ( SUD)  is a disease of brain and behavior that leads the person to an inability to control the use of a legal or illegal drug or medication. Substance use disorder changes normal desires and priorities and interferes with the ability to work and to have good relationships with friends and family.

Substances such as alcohol, marijuana, and nicotine also are considered drugs. When you’re addicted to a particular drug, you may continue using the drug despite the consequences or harm it causes to you or your loved ones.

Drug addiction may start with the experimental use of a recreational drug in social situations or peer pressure. For some others, particularly with opioids, drug addiction begins with exposure to prescribed medications or receiving medications from a friend or relative who has been prescribed the medication.

The risk of addiction and how fast you become addicted varies by the drug as well as individual vulnerability. Some drugs, such as opioid painkillers, have a higher risk and cause addiction more quickly than others. Similarly, some persons have a higher propensity to develop an addiction or problem use after initial recreational use.

Symptoms of addiction

•   Feeling or compulsion of having to use the drug regularly — daily or even several times a day.

•  Having intense urges/craving for the drug that blocks out any other thoughts or usual ideas about work/study/family etc.

•    Over time, needing more and more of the drug to get the same effect

•    State of unrest, irritability, anxiety when the drug is not taken.

•    Taking larger amounts of the drug over a longer period of time than you intended

•    Making certain that you maintain a supply of the drug

•   Spending money on the drug, even though you can’t afford it. Stealing from family, borrowing money or engaging in antisocial behavior to obtain money or drugs can get common over a period of time.

•   Not meeting obligations and work responsibilities, or cutting back on social or recreational activities because of drug use.

•   Continuing to use the drug, even though you know it’s causing problems in your life or causing you physical, psychological, social harm

•    Driving or doing other risky activities when you’re under the influence of the drug

•    Spending a good deal of time getting the drug, using the drug or recovering from the effects of the drug

•    Failing in your attempts to stop using the drug

• Experiencing withdrawal symptoms when you attempt to stop taking the drug

Causes of Addictions

The main factors are:

•    Environment. Environmental factors, including your family’s beliefs and attitudes and exposure to a peer group that encourages drug use, seem to play a role in initial drug use.

•    Genetics. Once you’ve started using a drug, the development into addiction may be influenced by inherited (genetic) traits, which may delay or speed up the disease progression.

•    Changes in the brain-Physical addiction appear to occur when repeated use of a drug changes the way your brain feels pleasure. The addicting drug causes physical changes to some nerve cells (neurons) in your brain. Neurons use chemicals called neurotransmitters to communicate. These changes can remain long after you stop using the drug.

RISK FACTORS FOR ADDICTION

People of any age, sex or economic status can become addicted to a drug. Certain factors can affect the likelihood and speed of developing an addiction:

•    A family history of addiction. Drug addiction is more common in some families and likely involves genetic predisposition. If you have a blood relative, such as a parent or sibling, with alcohol or drug addiction, you’re at greater risk of developing a drug addiction.

•    Mental health disorder. If you have a mental health disorder such as depression, attention-deficit/hyperactivity disorder (ADHD) or post-traumatic stress disorder, you’re more likely to become addicted to drugs. Using drugs can become a way of coping with painful feelings, such as anxiety, depression, and loneliness, and can make these problems even worse.

•    Peer pressure. Peer pressure is a strong factor in starting to use and misuse drugs, particularly for young people.

  • Lack of family involvement. Difficult family situations or lack of a bond with your parents or siblings may increase the risk of addiction, as can a lack of parental supervision.

•    Early use. Using drugs at an early age can cause changes in the developing brain and increase the likelihood of progressing to drug addiction.

•    Taking a highly addictive drug. Some drugs, such as stimulants, cocaine or opioid painkillers, may result in faster development of addiction than other drugs. Smoking or injecting drugs can increase the potential for addiction. Taking drugs considered less addicting — so-called “light drugs” — can start you on a pathway of drug use and addiction.

Treatment of Drug addictions-

•    The management of Drug addictions is often carried out in a stepwise manner. The following steps and treatment strategies are generally used for treatment-

1)    Detoxification-process of removing the drug from the body of the patient. The purposes are to safely remove the drug from the body without any medical complication and to ensure that the process of removal is not too distressing so as not to prompt getting back to the drug.

a.    Medical treatment/Pharmacotherapy- different medicine for different substances of abuse are used for detoxification purposes. This treatment is often carried out on an outpatient basis, however, may be done after hospitalization when the risks are presumed to be high in terms of medical health or propensity of getting back (relapse).

b.    Psychological treatment- various forms of therapies are used to enhance the motivation of the individual to continue with the treatment plans.

The goal of this treatment is either abstinence or harm reduction.

2) Prevention of relapse- after completion of stage 1 of treatment, the next goal is to keep the person away from these drugs. The likelihood of relapse can be reasonably high if maintenance treatment is not carried out.

•    Medicinal/pharmacological- use of these medications usually reduces urge/craving for these drugs and helps the individual stay away from these drugs. Highly effective medicines for maintenance are available for Alcohol, Opioids, and other drugs.

•    Psychological intervention- Manypsycho social treatment options like Cognitive Behavioral Therapy, Relapse Prevention Therapy, 12 Step program etc are available to help the individual at this stage

3. Rehabilitation and Reintegration- the person’s reintroduction and reintegration into the society is the final goal of Drug abuse treatment and is often carried out by qualified professionals with the help of the family and other organizations.