How do you know if you have problem?
Every time you see the news, there seems to be at least one story about the opioid epidemic. Since this has been going on for a few years and we are making minimal progress towards correcting it, it brings forth many questions. Why are so many people addicted to opioids? How does one become addicted to a medication or drug? How do you know if you or a loved one has a problem? Why is it so hard to quit?
Definition
Drug abuse quickly can lead to addiction, which is a person seeks and uses drugs in a compulsive, or unable to control, way even though there are harmful consequences. The reason for this is how your brain responses to the drug. While there are many different kinds of drugs and each one interacts with your body differently, they all affect your brain’s “reward center.” This means that your brain releases dopamine (a chemical messenger) and this gives you a sense of bliss. The positive rush caused by the dopamine reinforces to your brain that you need to repeat the behavior in order to experience it again. This reward mechanism is good when we are trying to reinforce healthy behaviors, but can be extremely detrimental when it comes to unhealthy behaviors. Our brain is very powerful, so overtime it is able to adapt. It cues your body’s reward center to not be as responsive to the drug, which in turn, decreases the blissful feeling. Often this is referred to as developing a tolerance to the drug. In order to get the same feeling as you did with the initial use, you would need to take in higher quantities of the drug to get the same affect. Ultimately, your brain further adapts and you aren’t unable to enjoy other things that you once did because it doesn’t provide your body with the same level of the blissful feeling that the drug does. Sadly, your brain’s adaptations aren’t limited to just your reward center. Long-term use of a drug can alter other chemical systems in your brain and affect your ability to learn and judgement/decision-making process. Also, it can increase your stress level, impact your memory and cause behavioral changes. All of these changes to your brain interfere with your self-control, making it incredibly hard to quit or not relapse after quitting. While there aren’t any specific factors that can accurately predict whether or not someone will become addicted, there are a few things, like family history of drug addiction, growing up in an environment that exposes you to drug use and early experimentation with drugs, that when combined together significantly increase the likelihood that you’ll have a drug addiction problem.
The symptoms of drug addiction can include the need to use the drug regularly (daily or several times a day), intense urges for the drug block out all other thoughts, you need to take more of the drug to get the same feeling that a lesser amount used to provide, you make sure that you have a supply of the drug on hand at all times, you spend money you can’t afford on drugs, you miss obligations at work/home due to your drug use, you participate in activities that you wouldn’t normally do (especially risky ones), you use the drug even though you realize it is causing problems in your life, you start having withdrawal symptoms when you stop taking the drug and you tried to stop using the drug and failed. Withdrawal symptoms often depend on the drug being used, but the most common are nausea, vomiting and sweating. For symptoms of use and intoxication of the main classes of drugs, please see Fast Facts Box 2.
Treatment
Most individuals are in denial about having a drug problem; therefore, they will not seek treatment on their own. Typically, they require an intervention from family and friends to encourage them to obtain treatment. An intervention is a carefully planned, structured discussion where the consequences of addiction and need for treatment are laid out. It’s essential to note that an individual has to want to get help. If they are going along with it just because family and friends want them to, then they are less likely to stick with the recovery process. If you are an individual who is using drugs and can’t stop, continue using them even though you know that they are harming you, using has led you to practice unsafe behavior or you have withdrawal symptoms when you do stop using, then you should see a doctor for treatment. You should seek emergency help if you, or someone you’re with, may have overdosed, has changes in level of consciousness, difficulty breathing, seizures/convulsions, signs of a heart attack or any other worrisome reaction to a drug.
Due to the nature of the disease, treatment for drug abuse takes a long-term approach and, for some individuals, it’s a lifelong process to remain drug free. Most treatment programs start with detoxification (detox) from the drug. This is a medically managed withdrawal from drugs and is usually done in an inpatient setting. Since different drugs act differently on your body, the process of detox is handled specific to each one. There are medications that can be given to you during the detox process that can help with some of the symptoms. After detox, most treatment programs focus on behavioral therapy. This is counseling from a psychologist, psychiatrist or licensed alcohol and drug counselor. The purpose of this type of therapy is to help you understand what led you to using drugs, develop ways to cope with cravings, come up with strategies to avoid drugs to prevent relapse, offer ways to deal with a relapse if it happens, talk about any issues you are having (ex. job, legal problems, relationships), increase communication skills with family and friends and deal with any other mental health concerns. These sessions start while you’re in an inpatient facility and continue on an outpatient basis for as long as you need them. Typically, there are three main types of behavioral therapy that you’ll participate in, such as individual, group and family therapy. The main goal of the treatment process is to understand what addiction is, become drug-free and prevent relapse.
Prevention
In order to prevent drug addiction, the easiest way is to not take them. If you need to take a prescription medication that has a high risk of addiction, be sure to follow the instructions your doctor gives you regarding how and when to take them. Remember, it’s for your safety that the instructions are so strict. Since most experimentation with drugs starts when a person is a teenager, it’s vital to address drug use and abuse with your children during this time period. The key is communication. You need to explain the risks to them and listen to what they have to say about peer pressure and resisting use. By being supportive and strengthening your connection with your children, they’ll be less likely to use and abuse drugs. Also, it’s essential to set a good example for them by not using/abusing drugs yourself.
If you have a history of drug addiction, it can be challenging to prevent a relapse. By monitoring your cravings and continuing to see a therapist or go to group meetings, you’ll be more likely to stay with your treatment plan. Another important element is to avoid situations that will increase you’re chances of relapsing. This means don’t participate in activities that you did when you were using drugs. If you do relapse, get help immediately because this will decrease the chances of your using getting out of control and help get you back on the path to sobriety.
Drug abuse and addiction are a challenging, lifelong disease process. The good news is that there are things to be done that can help. You have to want to make the change and be prepared for the trials that you’ll endure. If you have any questions or concerns, please see a doctor. If you would like more information, please visit the National Institute on Drug Abuse at https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction, Narcotics Anonymous at https://na.org/ or the Find Treatment page on the Substance Abuse and Mental Health Services Administration (SAMHSA) at https://findtreatment.samhsa.gov/