There are two types of addiction to drugs and alcohol: substance abuse and substance dependence. Regardless of the substance, either type can cause upheaval in someone's life.
Whether it involves abuse of alcohol or drugs (prescription or illegal), addiction can be a scary problem to face. It can also be complicated: Symptoms of addition vary widely from person to person, and determining the right treatment plan can be tough.
Addiction: Diagnosis of Substance Abuse
The common term “addiction” isn’t entirely accurate. Most medical professionals diagnose clients who misuse substances with either “substance abuse” or “substance dependence,”
Abuse would be a milder form of the disorder than substance dependence, to be medically classified as a substance abuser, clients must exhibit a recurrent pattern of substance use and meet at least one of the following criteria within a 12-month period:
· Have frequent difficulty fulfilling role responsibilities; for example, not going to work due to drinking or using drugs.
· Use substances in physically hazardous situations. That would be, say, if you drive when you’re too high to operate a vehicle.
· Have repeated legal problems due to substance use, like multiple driving under the influence (DUI) citations or drug charges.
· Continue to use alcohol or drugs despite the fact that their use causes social problems, such as isolation from loved ones.
Along with these criteria, the client must also experience “clinical distress” over one or more of the above situations. A person who drives drunk once may not medically qualify as a substance abuser. You don’t get diagnosed by one bad thing that happens to you, It needs to happen recurrently and cause distress.
Addiction: Diagnosis of Substance Dependence
Substance dependence is a more severe form of addiction. A patient must have a recurring pattern of substance use over a year’s time and meet three of the seven following criteria:
· Tolerance for the substance. Over time, an addict may need a larger amount of alcohol or drugs to achieve the same effects.
· Withdrawal symptoms. Patients who are dependent on a substance will sometimes undergo physical stress when they stop using it. “When you don’t dose your body, the body sends a message: ‘Hey, dude, you need to get the drug.’ For a heroin-dependent person, for instance, you’re going to have gooseflesh (a temporary condition that causes skin to become rough), bone pain, a runny nose, diarrhea — it feels really awful.
· Extended use. This occurs when the person has been using a drug for a longer period than they originally intended.
· Inability to stop. People who are substance dependent will have difficulty avoiding or cutting down on their drug of choice.
· Lost time. The patient spends a lot of his or her time getting, using, or recovering from the substance after use.
· Missing work or other activities. “You miss Mondays at work, and leave early on Fridays, or maybe you’d rather go hang with your drug buddies instead of spending time with your family.”
· Disregard for repercussions. Substance-dependent persons continue to use the drug even though they are aware of its negative consequences. For example, someone dependent on alcohol may continue to drink even if it causes them to have stomach pain and liver problems.
Addiction: Effects on the Brain
A person’s brain will change with repeated misuse of alcohol or drugs. Sometimes, the brain’s dopamine transmitters, special nerves that send feelings of pleasure to the brain, stop working as well. This may leave the person feeling depressed when they stop using the substance,
It's like a cloudy day where the clouds won’t lift, it’s common to people in recovery.
The brain’s gray matter volume, which consists of valuable nerve tissue, may also be reduced. Additionally, damage can occur to the hippocampal region of brain, affecting critical functions like short-term memory.
Some of these problems can persist for years after the client has stopped misusing alcohol or drugs. The whole process of recovery is not like a skinned elbow. The damaged brain recovers at a much slower rate [than other parts of the body].
Addiction: The Need for Treatment
While drug and alcohol dependence are lifelong disorders, they can be managed by an effective treatment program. A good place to start is a 12-step program, such as Alcoholics Anonymous or Narcotics Anonymous. These programs, which consist of people with substance abuse or dependence helping others with the same problem, can work for many. For every client I see, that’s the place I recommend they start..
Other treatment methods can include:
· Cognitive behavioral therapy. This helps clients recognize and change their thought patterns with specific, individualized strategies.
· Motivational interviewing. This type of interactive discussion encourages self-awareness and helps people to recognize that their substance use is a problem.
· Medications. These include ReVia (naltrexone) and Subutex (buprenorphine with naloxone which block receptors in the brain and prevent a person from getting high or drunk when they use substances. People addicted to alcohol may be prescribed Antabuse (disulfiram), a drug that causes nausea and flushing whenever alcohol is ingested.
Understandably, the loved ones of substance users may want to try an “intervention,” an activity where friends and family members confront the user and strongly encourage medical treatment., however, is skeptical about the efficacy of this method.
For some people, it works, but for the person who says ‘I’m outta here’ — that’s a new situation you then have to deal with. It might have been easier to get them into the treatment process without the intervention.
If you or a loved one has a problem with substance abuse or substance dependence, it's important to understand that you are not alone and that there are worthwhile treatments available. Don’t wait to talk to a healthcare professional, like myself, about resources that can help.
Reach out.... you are not alone. I can help.