While addiction has plagued the world for longer than most of us have been alive, the problem in the United States has grown larger than government officials and citizens alike could ever fathom. The opioid epidemic, in particular, has ravaged the country from the West Coast to the East Coast with those young and old in its path of destruction.
It has reached a point where thousands are dying each year, and opioids have exploded into a new socioeconomic background. Drugs were once previously thought to affect only disadvantaged individuals from poor socioeconomic backgrounds, but the surge in overdoses nationwide has proven that theory to be false. From upper-middle-class neighborhoods in the suburbs to urban areas, no one is exempt from drugs’ reach.
The disease of addiction is a complex disorder comprised of many factors in a person’s life. It is characterized as compulsive use that can quickly get out of control without help. While addiction is generalized as a chronic disease, it has the potential to be treated through evidence-based therapies.
What is Drug Addiction?
Drug addiction is a complex disease that requires more than good intentions or a strong will to quit. Drugs change the brain in a way that makes it hard to quit, but today, researchers have a more in-depth knowledge of the topic that has provided relief for many people in recovery from substance abuse. Addiction can be characterized as seeking drugs compulsively and having little-to-no control despite the consequences that follow. While the initial decision to consume drugs is entirely voluntary, it is the repeated use of substances that lead to changes in the brain. This, in turn, interferes with the inability to resist urges for continued use of the drugs.
There are several categories of substance use disorders (SUD), and addiction tends to be the more severe of the classifications. While most believe these terms all hold the same meanings, it is simply not true. Substance abuse is used in reference to the use of illegal drugs or prescriptions without authorization. In this subsection of descriptions, it refers to recreational use with the intent of getting high. It can have a similar meaning for self-medication or using performance-enhancing drugs such as steroids. Individuals can abuse a drug without ever becoming addicted to or dependent on it. There are risk factors involved, such as operating a motor vehicle when intoxicated, which could translate into catastrophe.
Another phase in the realm of substance use disorders is chemical dependence. This can refer to a chain in your brain’s chemical communication pathways. Psychoactive drugs can do this by making changes to your central nervous system by introducing those chemicals that eventually bind with neurotransmitters. Depending on the drugs consumed, the chemicals can either activate the neurotransmitters, or they can increase efficiency by suppressing other naturally occurring chemicals in your brain. In most cases, these changes are temporary unless use of the substance is prolonged.
As the continued use of the substance begins to develop, your body begins to rely on it to maintain balanced brain chemistry. If suddenly you decide to stop using, you could immediately start to feel uncomfortable; but even worse, you could experience dangerous withdrawal symptoms.
This is all dependent on the length of use and the type of substance(s) being consumed. This, however, does not mean a significant substance disorder has been developed. However, in some cases, individuals may notice that their dependence is growing and notify a doctor. In this situation, the physician will wean you off the drug safely.
In many scenarios, though, chemical dependence leads to the path of addiction.
If you notice you’re taking risks despite the consequences due to your substance abuse, there may be a problem.
If, for example, if the police have charged you with driving while intoxicated (DWI), and you continue to get behind the wheel of a motor vehicle while intoxicated, it is likely an indicator of addiction. If you’ve attempted to quit on your own but find yourself falling back into the depths of drug use, you may want to consider getting help.
What Causes Addiction?
The American Society of Addiction Medicine (ASAM) refers to drug and alcohol addiction as a chronic disease that affects the brain’s reward, motivation, and memory centers. The disease’s origin is closely tied to the limbic system of the brain that is responsible for learning about rewarding activities. This, in turn, triggers the motivation to repeat, which creates habits. Typically, the limbic system registers activities like sleep, sex, eating, and anything positive with the release of chemicals like dopamine and norepinephrine.
The limbic system will then begin to associate those good feelings with foreign substances that enter the body and create a high, and when you have the opportunity to consume either drugs or alcohol, your body will encourage these behaviors. Simply put, they “hijack” these regions and correlate drug or alcohol use with positive emotions. This is when the limbic system will begin accepting drug use as a positive and life-sustaining activity. This is where cravings originate and begin to spiral out of control.
As mentioned previously, not all who engage in drug and alcohol consumption will fall victim to addiction. Not everyone who uses is genetically predisposed as those who enter into addiction. Several genetic, environmental, and social factors that are considered when it comes to addiction.
There have been links in the medical community that show a correlation between one’s environment and addiction. Individuals who experience certain external events in their lives are more prone to becoming drug users. Many factors in an environment can contribute to drug use, and these urges could develop from a person’s friends, family, or even their school. Peers can play a huge role in experimenting with drugs at a younger age, and those who hold the addiction gene could potentially be entering a crash course just by experimenting.
Many addiction specialists in the medical community lean heavily in favor of biological inheritance as the main cause of addiction. They think if a parent has a history of drug or alcohol abuse, there is a higher chance that addictive tendencies will be passed on to their children. A study was released that found there is a biological trigger that causes drug users to switch over to compulsive acts of addiction. It’s necessary to reiterate that not all substance use will translate to addiction, but those with this gene are at greater risk.
While both sides have valid points to offer, there is another group of medical professionals that asserts addiction is stemmed from both of these risk factors. To experience a traumatic event that pushes someone with a genetic predisposition to self-medicate is the basis of their argument.
The real issue at hand, however, it’s not so much the “why” as it is the “how” to come up with solutions that help save lives. There are precautions parents can take to monitor their children better. If parents are aware there’s an addiction gene in their family, they should pay attention to who their children are spending time with, keep in touch with teachers about their children’s academic performance, and stay in constant communication about their lives. Being supportive in a child’s life will reduce the risk of experimentation of drugs or alcohol.
The Addiction Epidemic
Addiction has taken its toll on society, and it continues to grow at a record pace. Each year that passes illustrates the decline of culture in some cities, and as a whole in the country, addiction takes more lives than gun violence and auto accidents. A study revised in 2018 from the National Institute on Drug Abuse (NIDA) states that each day in the United States, more than 115 people die after overdosing on opioids. The problem here is that it is continuously growing. While addiction to opioids rises, other drugs such as meth, alcohol, cocaine and other prescription drugs continue to plague our culture.
A huge factor driving this surge is the easy accessibility for heroin and other opioids. During the past few years, pharmaceutical companies had sharply increased their production of opioids due to an influx of prescriptions doctors were writing. There was no indicator that showed the amount of pain American’s had reported was increasing, but opioid prescriptions were flowing freely. The U.S. Centers for Disease Control and Prevention (CDC) released a study showing that 191 million prescriptions had been written in 2017 alone for opioids in the United States. While the rate was 58.7 prescriptions per 100 people, there were other counties that were seven times higher than that.
In 16 U.S. counties, there were enough opioid prescriptions dispensed for every person to have one, and these rates still continue to be very high in some regions of the country. This leads to the next point: A large portion of people who become addicted start with prescription opioids, and with this lax distribution process, it’s easy to imagine why the problem has exploded into what it is today.
It’s easy to blame just one channel for this rise, and rightfully so. However, there also has been a significant increase in drugs that come into the U.S. from China and Mexican cartels. With relatively easy access at the border, drugs have been flowing in with ease. Heroin is the second most accessible drug only behind marijuana. While doctors have become more aware of these trends of overprescribing opioids, tighter regulations are being put in place. This is fueling the black market because when people cannot obtain their medicines from pharmacies, they find other means.
When a user turns to the street for their drugs, the problem is they aren’t really sure what they’re getting. The prevalence of synthetic opioids manufactured in labs outside the United States has posed a real threat to drug users. Fentanyl is a synthetic opioid that has been responsible for the increase in deaths across the country. Fentanyl is 50 times more potent than heroin, and 100 times more powerful than morphine. It’s easily made with precursors from China, and it’s a cheaper alternative to heroin.
Fentanyl is commonly used to cut bags of heroin to increase drug dealers’ profits. To put the strength of fentanyl into perspective, there have been cases where law enforcement officers investigating a crime have overdosed from just touching the drug. This is a huge reason for the increase in deaths from black market drugs.
The rise of the addiction epidemic during the past few years has prompted researchers to explore various methods in addiction treatment. Right now, there are two methods of treating addiction—evidence-based and alternative therapy. Research has shown some therapies are more successful than others. Evidence-based treatment is used in reference to therapies that have shown to be effective in scientific studies and how these studies can be used in a variety of treatment settings.
When seeking treatment and researching the options available, looking into how effective a treatment program should be a requirement.
The National Institute on Drug Abuse (NIDA) found this to be a significant portion of the treatment process and released a 13-step guide when deciding on a treatment center. These are useful when considering the right treatment center. Choosing the right treatment can be the difference between prolonged sobriety or relapse. Here are some of the most important principles to consider:
- Addiction is a complex but treatable disease. Drug abuse alters brain function that results in changes long after drug use has stopped. This can be used as an explanation of why recovering drug users are at risk of relapse even after a long period of abstinence.
- No single treatment is appropriate for everyone. Treatment varies based on many factors such as the kind of drug used, how long the person used, and the characteristics of the individual. Matching the right type of treatment to the person’s specific needs is necessary to ensure a positive outcome.
- Treatment must address multiple needs. More often than not, a person is using drugs as a means to self-medicate a mental health disorder, and this needs to be addressed immediately upon entering treatment. This allows the team of professionals to devise a medical plan that will be tailored to help treat multiple issues. An effective addiction treatment should help treat medical, psychological, financial, social, and legal issues.
- Remaining in treatment long enough is crucial.The appropriate length of time someone stays in treatment will dictate their success. Research has shown that to receive the most positive results, addicted individuals must stay in treatment at least three months to either stop their drug use or reduce it dramatically. The best outcomes are linked with lengthy stints in a treatment center.
- Behavioral therapies.This is a type of therapy treatment that focuses on dealing with how the thoughts of a person affect their actions. This form of therapy has been shown to be highly effective. Cognitive-Behavioral Therapy (CBT) has become a main staple in the creation of relapse prevention programs nationwide.
Types of Treatment
Addiction treatment is the best available method for treating these problems. And, because addiction is a chronic disease that will continue to progress without intervention, delaying the process will diminish the user’s quality of life. There is no single cure for this disease, but with multiple therapies aimed at targeting the root of addiction, there is hope for a better future.
In the first stages of therapy, it’s a possibility that medical intervention is required. As the client begins to achieve sobriety, a less hands-on approach will be necessary. To maintain sobriety, treatment centers will encourage their clients to stay in treatment as long as they can.
The type of medical detox a patient will experience will depend on the type and severity of the addiction. In most cases, this is the most challenging part of the process. On the same note, this is one of the most important parts of treatment. The goal is to provide medical stabilization to transition the client comfortably into a sober state. All drugs pose a threat to cause withdrawal, but there are some in particular that can be dangerous and life-threatening. This is why quitting “cold turkey” on your own is not recommended.
Drugs such as benzodiazepines hold immediate dangers during the withdrawal process, and symptoms could include grand mal seizures in more severe cases. The stress and anxiety of wondering if this could happen to you could ultimately push you back into using, which is why being within the confines of a medical facility equipped with medications is the safest way to detox.
When you start the detox process, you will sit with a medical team for a full assessment. This will establish any mental health history, the period of use, the type of drugs used, and the dose taken. This will help the team determine what course of action is required for your treatment. The team will decide if you would thrive in an inpatient or outpatient setting, how long you’ll be in detox, and what medications will ease your discomfort.
The types of therapies the client will require is another part of this process. One thing to remember, however, is that these are not finite decisions. They can be changed at any time if the client is not responding as expected. After successful completion of detox, the client will move to the next level of addiction treatment.
Residential treatment typically follows a successful medical detox, and during this phase, the client will be required to live on-site at a treatment facility. Depending on the medical plan created, the length of stay could last for up to 30 days to 90 days. This is where the intense therapies will take place.
During residential, the client will be heavily involved in a full-time schedule of addiction treatments and therapies. The person will learn coping skills that help to identify triggers, as well as life skills that will be tough alongside relapse prevention techniques. These will help the client long after treatment concludes. The primary objective of these therapies is to create a foundation for recovery that lasts a lifetime.
The goal of residential is to work toward the root of addiction and heal the reasons you began using. This level of treatment is beneficial in that it offers a secure and substance-free environment that promotes positivity.
Outpatient is the next step in the continuum of addiction treatment, and this is just as important as the last. This allows recovering users more freedom to carry on a normal life while treating their addiction. This level of care will continue to address physical or psychological issues while living off-site.
Intensive outpatient (IOP) is a form of treatment many people opt to receive because they are not required to live on-site at a facility. This allows for freedom and opportunities to use what they learn in therapy immediately in the real world. The client will be required to find alternate housing and their own transportation to show up.
Many who choose this treatment type live in sober living facilities that help them maintain the structure that is being learned in therapy. Some choose to stay at home, but if they are leaving an unhealthy environment where drug use is rampant, it’s a better choice to remain in a sober living facility during this process. Therapy sessions in IOP are similar to what you’d find in residential, and drug tests are required during off-hours.
Partial hospitalization (PHP) is another type of outpatient care. It shares similar characteristics of IOP, requiring clients to seek housing and transportation to sessions during the week. The main difference between PHP and IOP is that PHP requires the client to attend treatment for upward of 20 hours a week, while IOP requires nine to 20 hours per week. PHP is similarly structured requiring attendance and intense therapy regimens.
Addiction Therapy Types
As mentioned above, there are various types of addiction therapies aimed at targeting the root of the addiction, coping with triggers, and how to change behaviors. This is done through a series of sessions to help establish new boundaries in a client’s life. Altering the behaviors in the brain can help resist cravings and give the client an entirely new outlook on life. Therapy types you may see in your treatment include:
Depending on the needs of the client, their length of treatment, and level of care, there will be regular sessions with their primary therapist. This could take place one to two times a week. This is where treatment plans are developed with the input of staff, doctors, and the client. This one-on-one time will give the client time to ask questions and really understand the process in depth.
Addiction often has been described as a family disease because it can affect everyone around the user. Searching for a facility that offers family therapy can be vital to the long-term success of everyone. These will include participation from parents, partners, siblings, colleagues, and others. Depending on the client’s preference, these sessions can occur in person or through HIPAA-compliant technology.
One of the most enriching pieces of treatment, whether residential or outpatient, is being around others on the same path to sobriety. Group therapy consists of therapeutic groups that are led by licensed clinical professionals that provide clients with the option to explore issues in a peer-supported environment.
Through engagement with therapists, an individual can recognize change as a process and find the motivation to make it happen. Therapy is all about building confidence, and once they have established their ability to achieve sobriety, motivation from others can create a successful pathway to a healthier life.
Dialectical Behavioral Therapy
This type of therapy is geared toward learning how to regulate emotion and build insight into emotions, biological, and cognitive reactivity. This therapy allows the client to challenge their reactivity while learning effective coping skills that identify opportunities promoting a positive change. When the client can challenge their own way of thought and interrupt negativity, healing has truly begun.
This therapy teaches self-regulation and how to manage emotional responses in the moment. There is a time where you will be out of treatment and months have passed, but a trigger will manifest that takes you by surprise, and based on the mindfulness therapy, you will be more in tune with your emotion and not be controlled by urges.
Cognitive Behavioral Therapy
This has been the most effective treatment through evidence-based findings. This will help the individual identify self-defeating beliefs and negative thought processes that contribute to addiction. This will, in turn, begin challenging and changing the thought process. When you’re able to successfully conquer your own bad thoughts, you will begin to change how you act and behave.
Clinicians understand that no one treatment is necessary to healing a client, and that they are adaptive to effectively treat the needs through individualized care. This will all begin at the detox stage where they start deciphering the individual’s needs and creating the tailor-made medical plan. Life does not need to be filled with struggle, and creating the best care for you or a loved one will lead to a better life.