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Addiction: Drug Addiction and Alcoholism

Addiction

Addiction takes many forms, but has some unique features regardless of the substance or behavior of choice. It is characterized by a compulsive craving or desire for the substance, impulsive behaviors, and continued use and abuse despite negative social, physical, and emotional consequences.

Addiction means, most simply, a repetitive compulsion to ingest a particular substance or engage in a particular activity that results in pleasant feeling or “high” in the short-term, but which has harmful long-term consequences to a person’s health, mental state or lifestyle. Like many other chronic diseases, addiction can have periods of remission (absence of behavior) and relapse (recurrence of behavior). If left untreated, however, addiction can lead to long-term physical, emotional and social damage or, even, death.

The most well known types of addiction are drug addiction and alcohol addiction; these addictions are often known as substance dependence. Substance dependence includes compulsive and repetitive use of alcohol or a drug that could result in tolerance, requiring more and more of the substance in order to achieve the same desired effect. Moreover, addicts often suffer from withdrawal symptoms when they (try to) abstain from substance use.


A lesser form of alcohol and drug addiction is called substance abuse. The American Psychiatric Association defines substance abuse as 1) continued use of a substance despite the fact that it causes social or interpersonal problems; 2) repetitive use that causes inferior job, school, or home performance; 3) repeated use despite physical dangers; or 4) substance use that results in legal problems, such as possession or DUI charges.

Substance abuse and addiction are a major financial burden to our society. The health, crime, and productivity-related costs of substance abuse and addiction are huge. Broken down, the cost of drug addiction, nicotine addiction, and alcoholism are roughly equal.

However, there are several other types of addiction that are just as detrimental to those suffering from them and society in general, including sex addiction, internet addiction, video game addiction, food addiction (compulsive eating), tanning addiction, gambling addiction, and shopping addiction. Simply put, people with these behavioral addictions cannot stop repeating the behaviors, even in the face of negative consequences.

Addiction and the Brain

Addiction is a complex disease that is often misunderstood by laypeople. People generally tend to think that drug addicts or alcoholics lack the willpower to stop drinking or ingesting drugs. However, research has shown that recovering from substance addiction is not just a matter of willpower. Drugs and alcohol, when consumed, cause changes to the structure and function of the brain. Eventually, these changes will weaken a person’s self-control and judgment, while increasing the compulsion to use drugs or drink.

Addictive substances attack the brain’s communication network, wreaking havoc on how nerves transmit information by imitating chemical messengers or over-stimulating the brain’s reward circuitry. Heroin and marijuana, for example, are similar to our normal neurotransmitters and trick the brain’s receptors into sending abnormal messages. Cocaine and methamphetamine, on the other hand, cause the nerves to release large amounts of neurotransmitters, which can disrupt the brain’s normal communication system.

Further, most drugs also impact the brain’s reward system with an overabundance of dopamine, the neurotransmitter responsible for emotion, motivation, and pleasure. This causes the person to feel a sense of euphoria after taking the drugs, a feeling that addicts quickly come to crave. As substance use continues the brain produces less dopamine or reduces dopamine receptors after each dose, requiring more and more of the drug to get the same euphoric effect. This phenomenon is known as tolerance.

Alcoholism

Alcoholism, often referred to as alcohol dependence, is a medical disease that causes alcohol cravings, an inability to stop drinking, physical dependence resulting in withdrawal symptoms once one stops drinking, and tolerance – the need to drink increasingly larger amounts of alcohol to get the same effects. Other mental illnesses, such as depression, can occur at the same time as alcoholism, and sometimes the abusive drinking began as a way to cope with such an underlying disorder. Alcoholics can be any age and many refuse to acknowledge that they have a drinking problem.

It is true that millions of people are able to drink alcohol and not become addicted. Typically, an acceptable amount of alcohol intake is two drinks for a man and one drink for a woman, per day. However, it is not necessarily the amount of alcohol one drinks that is the deciding factor as to whether one is an alcoholic. Some people who drink only a little alcohol can be diagnosed with alcoholism. Conversely, some people who drink much more may not have an alcohol problem at all. As with many mental illnesses, individual variations in diagnosis, treatment, and ability to stay sober abound.

Some compare alcohol cravings to the human need for food or water. Like other addictions, familial obligations, health concerns, or legal issues will usually not be enough incentive for an alcoholic to stop drinking. Alcoholism worsens the longer a person continues drinking. Left untreated, alcoholism can turn chronic, meaning that the person will never stop drinking without intervention; it can damage mental health, physical health, or lead to death. It is believed that whether or not a particular individual will develop alcoholism depends on a combination of genetics and lifestyle factors (friends, career, stress, availability of alcohol, etc.).

Symptoms of Alcoholism

Like any other disease, alcoholism has a set of common symptoms that can be helpful when trying to diagnose a drinking problem. Symptoms vary from person to person, and not all alcoholics will exhibit all symptoms of alcoholism. In the early stages of alcoholism, a person may drink alcohol to escape thinking about personal problems and, as a result, shift the obsessive thinking to thoughts of alcohol. Many early stage alcoholics will plan activities around the ability to drink and may start to hide alcohol or sneak drinks.

Although not everyone needs to drink excessively to be deemed an alcoholic, many alcoholics experience “black outs,” where they can’t remember periods of time. As the disease progresses, more and more alcohol needs to be consumed in order to approximate the early effects of alcohol, although some say they always feel as if they are chasing something they seem no longer able to achieve.

In the middle stages of alcoholism, those suffering from the disease will rarely admit to others that they even have a drinking problem, but will try to take steps to get the drinking under control on their own. For instance, many will set a limit on how much they can drink per day or per week, but will often breach that limit. Others will set parameters on when they can drink, such as never before noon or never on Sundays. They usually cannot stick to these “rules,” and some progress to drinking as soon as they wake up in the morning.

However, someone can meet the diagnosis of alcoholism that does not drink during the day, and some alcoholics are binge drinkers, meaning they confine their abusive drinking to discrete time frames, such as the weekends. Some reports indicate that binge drinking is more hazardous than daily maintenance drinking. Those in middle stage alcoholism will begin experiencing personality changes and mood swings.

In the late stage of alcoholism the alcoholic becomes completely dependent on alcohol, to the point where they experience heavy withdrawal symptoms if they do not drink for a short period of time. A typical symptom of withdrawal is the Delirium Tremens (DTs).

Treatment for Addiction

Till date, there is no cure for drug or alcohol addiction. However, these can be effectively treated through counseling, twelve-step programs, medications, residential rehabilitation treatment, or a combination of these. The goal of treatment is to help those with addiction issues stop taking the addictive substances, explore and address the psychological reasons behind the alcohol and substance use, and develop an ongoing treatment plan to help ensure that the person not relapse back into active substance use. Therapy or 12-step programs offer support for long-term maintenance of sobriety. It is unlikely an alcoholic/addict would be able to drink alcohol or take the addictive substances again in moderation.

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Initially, someone who is actively drinking or using drugs likely need to go through a medical detoxification ('detox') process, which allows the body to safely withdraw from the effects of alcohol/drugs under the supervision of a medical professional. Sometimes drugs are used to ameliorate the symptoms of withdrawal, and are then tapered down until the patient is completely drug-free. It is only after the body has been cleared of alcohol/drugs that true rehabilitation can begin.


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