Every year, 21.5 million Americans battle a substance use disorder. Due to the massive number of people struggling, the United States and the mental health community have responded by implementing new and improved addiction treatment methods.
Addiction, also known as a substance use disorder, is a mental health disorder recognized worldwide by medical and mental health professionals. The Diagnostic and Statistical Manual (DSM-V) has set forth certain criteria to help make professional and official diagnosis for people suffering from a substance use disorder (SUD).
The standardization of diagnosing the condition has made it easier for healthcare professionals to recognize the disease and treat it effectively and quickly. There can be confusion surrounding the differences between recreational usage, dependence, and full-blown addiction. The areas of the brain affected by dependence and addiction are physiologically different, meaning these two experiences are completely unique.
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Recreational drug use is categorized by using drugs and alcohol on occasion without the repercussion of repeating the behavior to a point of negative outcomes and self-destruction. Physical dependence is recognized as the body and brain requiring certain drugs and/or alcohol in order to maintain homeostasis. This affects a certain area of the brain that is different than addiction. Physical dependence occurs within the thalamus and the brainstem. Overcoming physical dependence is far easier than addiction since managing any withdrawal symptoms is the only action required.
Addiction, on the other hand, is different. The part of the brain affected is what’s known as the reward pathway. This is where dopamine is stored and synthesized. Dopamine is a neurotransmitter known as the “feel-good” chemical. Upon its release, euphoric and calming effects befall the individual. This is what makes repeating the patterns of using drugs and alcohol appealing and often impossible for one to stop on his or her own.
Thus, when making a proper substance use disorder diagnosis, medical and mental health professionals look for certain symptoms and characteristics that can distinguish the difference among recreational drug/alcohol use, physical dependence on drugs/alcohol, and overall addiction to drugs and alcohol.
The criteria set by the DSM-V to make a substance use disorder diagnosis are as follows:
- Taking the substance in larger amounts and for longer than intended
- Wanting to cut down or quit but not being able to do it
- Spending a lot of time obtaining the substance
- Craving or a strong desire to use the substance
- Repeatedly unable to carry out major obligations at work, school, or home due to substance use
- Continued use despite persistent or recurring social or interpersonal problems cause or made worse by substance use
- Stopping or reducing important social, occupational, or recreational activities due to substance use
- Recurring use of substances in physically hazardous situations
- Consistent use of a substance despite acknowledgment of persistent or recurrent physical or psychological difficulties from using substances
- Tolerance as defined by either a need for markedly increased amounts to achieve intoxication or desired effect or markedly diminished effect with continued use of the same amount
- Withdrawal manifesting as either characteristic syndrome or the substance is used to avoid withdrawal
Should you or your loved one possess at least two or three of these qualities, then a mild substance use disorder diagnosis is given. Having four or five of these characteristics equates to a moderate substance use disorder diagnosis. Finally, meeting six or more of the criteria is considered a severe substance use disorder. No matter what the level of severity is surrounding your addiction, seeking professional help for the disease is crucial to your success in life and recovery from addiction.
Causes of Addiction
There has always been much debate surrounding what exactly is the root cause of addiction. It remains unclear what the direct cause of addiction actually is, but there are solid arguments for both sides of the fence around the disorder.
It has been speculated to be entirely environmental, meaning addiction is culpable to the environment and external experiences of the individual as they progress throughout the various stages of life.
Others believe that addiction is strictly biological, meaning it is an inherited trait. People who have a history of addiction or addictive behaviors and if your mother or father were drug/alcohol addicts, you may be as well.
There are fair arguments for both sides of the source of addiction, however, most specialists believe it is a unique condition that is actually influenced by a combination of both. There are certain risk factors for people to develop a substance use disorder or addiction to self-destructive behaviors. Experiencing traumatic events, having a genetic predisposition to addiction, and growing up in an environment which supports drug/alcohol use are all pieces of the very complicated puzzle that is addiction.
The important part of looking at addiction isn’t so much the “why” behind it, but the application of the correct method of addiction treatment in order to change these behaviors.
Signs of Addiction
When it comes to identifying addiction in yourself and/or others, there are certain red flags and tell-tale addiction symptoms to be wary of. Prior to heading off to a medical or mental health professional to secure an official diagnosis and addiction treatment, you must first recognize that there is a problem.
The symptoms of addiction may manifest differently in each addict. As a mental health disorder, the manner in which it appears in a person is as unique and individual as that person. That said, there are certain commonly seen symptoms of addiction associated with various common drugs that may help narrow down the search and shed some light on what’s going on with the person.
Each individual drug category presents similar yet some different symptoms of addiction, as not every drug impacts the brain and body in the same way. Below are the main categories of drugs that are abused. Each section contains common symptoms of addiction that substance so you can successfully identify the problem in yourself or others.
- Drinking as a way to forget about problems
- Drinking outside of social settings or regularly drinking alone
- Feeling the need to lie or avoid the truth about drinking habits
- Feeling irritable when you haven’t had a drink for a while
- Losing memories of time frames and events while drinking
- Suddenly suffering work or school performance
- DUIs or arrests related to alcohol
- Continuing to drink despite legal, social, or medical consequences
- A sudden change in mood or personality
- Engaging in risky behavior because of drinking (like getting behind the wheel of a car.)
- Strong, seemingly unbearable cravings for stimulants
- Constantly thinking about stimulant drugs
- Going to great lengths to obtain stimulants
- Isolation from others; strained interpersonal relationships
- Taking the drug in a manner inconsistent with what is prescribed
- Experiencing withdrawal symptoms 24-48 hours after the drug is last taken
- Taking stimulants to avoid withdrawal symptoms
- Hiding stimulant use from family, friends, colleagues
- Feeling unable to stop using the drug despite repeated attempts to quit
- Feeling like you can’t function without the drug
- Mixing stimulants with alcohol or other drugs (polysubstance use)
- Using the drug despite the negative consequences that result from doing so, such as job or relationships loss
- Suicidal thoughts
- Loss of appetite
- Difficulty with memory
- Muscle spasms
- Motor impairment
- Feeling lightheaded
- Sensitivity to sound, touch, and light
- Having sensations of numbness
- Smell sensitivity
- Muscle pain
- Mood swings
- Sudden changes in weight
- Withdrawing from different social activities/obligations
- Mood swings
- Lethargy or fatigue
- Changes in social circles
- Insomnia or other changes in sleeping patterns
- Financial difficulties
- Lying and/or stealing
- Nausea or vomiting
- Red eyes
- Pinned pupils
- Cravings for opioids
- Experiencing withdrawal symptoms
- Unable to stop taking opioids even when faced with negative consequences
With the massive increase in overdose deaths in recent years surrounding all substances, as well as the notorious ‘Opioid Crisis’ currently plaguing the United States, time is of the essence when dealing with addiction. Receiving proper addiction treatment in a timely fashion may be the difference between life and death for some addicts. So, if you believe yourself or a loved one may be struggling, don’t delay, seek out help immediately for your addiction.
Addiction treatment is the only method available for dealing with addiction. Unfortunately, addiction is a chronic and progressive disease. This means that it may continually manifest either consecutively or periodically, and will continue to worsen, never get better, with time. There is no cure for addiction currently available. However, with the advent of modern medicine, many addiction treatment methods have become available.
The most commonly seen method of addiction treatment is through alcohol rehab or drug rehab. This is the process by which clients/patients undergo the full continuum of care in the quest to find lasting sobriety. The actual addiction therapies implemented during this process may vary, but the overall method to addiction treatment is often the same.
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The full continuum of care refers to completing each level of addiction treatment in a stepped curriculum. By starting in higher levels of care, which include a more hands-on approach by medical and clinical professionals, and slowly descending to lower levels of care, which allow clients more freedom and personal responsibility, it is extremely effective in treating addiction. It allows for the appropriate amount of medical/clinical care for the client at their particular stage of treatment.
In the precarious beginning stages, more medical and clinical intervention is required, but as the client amasses more time away from their drug of choice and undergoes more therapy, they will require less hands-on attention by the staff. The full continuum of care has proven effective time and time again by medical and mental health professionals, and it is always recommended to complete all levels of care in order to better increase your likelihood for success in long-term recovery/sobriety.
The first stage in the full continuum of care is medical detox. At this point, you’ll be at risk of experiencing withdrawal symptoms from suddenly stopping or greatly decreasing the intake of your drug of choice.
Medical detox is intended to provide medical stabilization and guide you safely and effectively through the withdrawal process. Every drug has some sort of withdrawal symptoms associated with the cessation of use, however, some are more severe than others.
This is what makes at-home detox so risky. Many drugs like alcohol and benzodiazepines present potentially life-threatening withdrawal symptoms like seizures. Seizures can result in permanent physical injury or in certain cases, death. Attempting to detox on your own with medical intervention can be incredibly hazardous to your physical well-being.
Apart from the actual health risks associated with at-home detox, there is a greatly diminished success rate among addicts who choose to undertake this cumbersome task alone. Dealing with the withdrawal symptoms can prove to be too much and you may return to the drug despite desperately wanting to be sober.
Another risk factor for at-home detox is the availability of getting whatever substance you’re craving. During withdrawals, the craving for your substance of choice will be at an all-time high. Without being in a protected medical environment, you will still maintain access to whatever your source was for your drugs, making relapse not only a possibility but also a likelihood.
At detox, you’ll undergo a full medical assessment by a team of doctors, nurses, and medical support staff. They’ll take into consideration the level of severity of your addiction, what substance(s) you were using, and your overall physical health and will create a personalized detox plan for you.
This individualized detox plan will typically use a combination of detox medication or medication-assisted treatment options with different behavioral and addiction therapies. You will also have access to a clinical team of therapists, case managers, and support staff who will start minor therapy sessions with you which intend to address the underlying causes of addiction.
Your progress throughout medical detox is closely monitored, to ensure your safety, comfort, and the effectiveness of your treatment. Upon completion of detox, you will be fully medically stabilized and ready to undertake the next level of addiction treatment.
Inpatient, or residential treatment, follows medical detox. This level of care requires patients to live onsite at the facility as they undergo intensive addiction therapy for an extended period of time which may be anywhere from 30 to 90 days in length. Obviously, this will vary on a case-by-case basis, but this level is the one typically equated to “rehab”.
While here, you’ll have a full-time schedule of different addiction treatment methods and therapies. Every facility will feature a different treatment regimen and amenities, so it’s important to look into the drug rehab prior to attending the program.
Addiction has physical and psychological symptoms, and since the physical portion was addressed in medical detox, inpatient is left to sort out the majority of the psychological aspect.
During inpatient or residential treatment, you’ll learn new coping mechanisms, life skills, and different relapse prevention techniques designed to help you maintain your recovery even after you leave inpatient treatment. If you’re at a medication-assisted treatment drug rehab, you’ll undergo different treatment therapies.
The goal is to provide a solid foundation for recovery upon which you can build even after rehab ends. Since recovery is a life-long journey, you’ll need to take active measures to ensure you don’t fall back into old patterns and relapse.
Inpatient or residential treatment hopes to help you work out some of the more severe underlying issues in a sequestered environment away from external triggers. This is a crucial step in the full continuum of care that can be the difference between relapse and recovery.
Outpatient programs are the next phase of the full continuum of addiction treatment care. There are two levels of outpatient that are each important to the further development of your program of recovery. These levels will continue to address any physical and psychological needs you may have as you progress through treatment and should not be overlooked.
Intensive Outpatient (IOP) is a type of outpatient program that typically follows inpatient or residential. This level of care is different than inpatient in the sense that you will no longer live at the facility while undergoing the program. You will be required to find alternative housing and transportation to and from your therapy sessions throughout your stay in the program.
Many individuals opt to turn to sober living or halfway houses during this time as they provide structured living with strict rules regarding substance use that help provide accountability. Since early recovery is a precarious time, as relapse most commonly occurs within the first few months of sobriety, this can prove to be very useful for you. You may also choose to return home, but regardless of housing, you’ll still be required to maintain complete abstinence from drugs and alcohol during your IOP treatment.
The IOP sessions will utilize similar intensive therapy techniques seen in inpatient/residential treatment. IOP sessions will usually occur multiple times per week for several hours at a time, providing substantial clinical support to clients. Clients will also be required to submit to random drug testing to ensure abstinence during your off hours.
At this stage, you’ll have more freedom and subsequent responsibility. You’ll be required to maintain your course in recovery even while not at IOP. Many addicts may return to work or family obligations during this stage of treatment, although it’s not required. IOP will usually last for six to eight weeks before moving to the next phase of treatment.
Partial Hospitalization (PHP) is another level of outpatient care. Very similar to IOP, it requires clients to seek alternative housing and transportation to multiple several-hour long sessions per week.
The primary difference between PHP and IOP is the location at which these therapy sessions occur. PHP will be conducted in a hospital or hospital-like setting. This may be beneficial for clients still in need of ongoing medical care during their treatment.
PHP is structured just like IOP in that consistent attendance is required, as is abstinence. Group and individual intensive therapies will be conducted, providing you or your loved one with ongoing clinical attention.
Once completing your outpatient program, it’s important to understand that your journey in recovery does not end. Recovery is ongoing, lifelong process, and while that may seem scary and formidable in the beginning, there are awesome aftercare program options available to help keep you on track in recovery.
Many facilities offer what’s known as alumni programs. These programs keep you in touch with the facility even after you complete the program. They will often schedule outings and fun activities and invite other past clients to help foster lasting sober relationships between recovering people. It also helps you maintain a point of contact should you ever need help or find yourself struggling with recovery.
Other aftercare options are maintenance programs such as 12-step programs or SMART Recovery. These are separate fellowships that each have their own approach to recovery that can help you access another network of sober support and have a program to follow as you venture through life as a sober person.
Other people still choose to find other sources of aftercare that may include private therapy sessions or groups dedicated to recovering people. Regardless of what your personal choice in aftercare may be, it’s important to find some form of aftercare to continue growing in recovery and avoid slipping back into active addiction through relapse. Remember, if you’re not moving forward in recovery, you’re moving backward!
Withdrawals are an extremely unfortunate aspect of addiction and physical dependence. Whenever any substance, whether prescription or illicit, is used and/or abused for a long period of time, the body develops a physical dependence on the substance to function properly. This is true whether it’s merely physical dependence or full-blown addiction.
Withdrawals are a series of different symptoms the brain and body undergo as a result of the cessation of substance use. Whenever the substance that was being abused is suddenly removed, the body must go through an adjustment period to return to normalcy and regular functioning. This adjustment period is known as the withdrawal process, and it can be not only uncomfortable but also dangerous.
As mentioned earlier, different substances feature different withdrawal symptoms. Some withdrawals are worse than others. There are also a variety of factors that directly impact the withdrawal experience you or your loved one may encounter.
Things like age, overall physical health, the type of substance used, how long it was used for, the frequency of use, and the average dosage all factor into how the withdrawal process will play out for the individual. This is what makes medical detox decidedly important. Circumventing these symptoms is crucial to find and maintain both recovery and your physical health. Taking control of the withdrawal process is key in setting yourself up for success in recovery.
Relapse is sometimes a part of recovery, although it doesn’t have to be! However, if you do unfortunately experience a relapse, do not be afraid or blame yourself. Addiction is a disease that is difficult to overcome but entirely possible. There are some key tips to help you respond appropriately to a relapse should this become a reality two days or two years into recovery:
- Don’t toil in relapse; seek help immediately
- Take a look at what went wrong and correct that behavior in the future
- Undergo more relapse prevention therapy and learn/utilize new coping skills
- Reach out to other recovering people/your support system for help
- Be honest about your relapse and where you’re at
- If you feel a relapse coming, preemptively take precautionary measures to avoid falling victim to relapse
- Look at relapse as a learning experience rather than a mistake- there’s always an opportunity to grow and learn more
Relapse does not have to be the end of the road for you. Help is always available and it’s up to you to seek it before falling deeply back into active addiction. The sooner you address a relapse, the better. Recovery is always possible and finding what works for you can help you reach your end goal: long-term sobriety.
If You’re Suffering From Addiction, We Can Help!
Are you or a loved one currently struggling with an addiction to drugs and alcohol? Let our experts here at New Perspectives help you! Specializing in medication-assisted treatment, we are confident our evidence-based practices can help get you or your loved one healthy, happy, and most importantly sober!
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