Alcohol and drug use is one of the leading causes of preventable illnesses and premature death nationwide.
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What Is a Substance Use Disorder or an Addiction?
Substance use disorder (SUD) is a complex condition in which there is uncontrolled use of a substance despite harmful consequences.
People with SUD have an intense focus on using a certain substance(s), such as alcohol, tobacco, or illicit drugs, to the point where the person’s ability to function in day-to-day life becomes impaired.
People keep using the substance even when they know it is causing or will cause problems.
The most severe SUDs are sometimes called addictions.
People can develop an addiction to:
- PCP, LSD and other hallucinogens
- Inhalants, such as, paint thinners and glue
- Opioid pain killers, such as codeine and oxycodone, heroin
- Sedatives, hypnotics and anxiolytics (medicines for anxiety such as tranquilizers)
- Cocaine, methamphetamine and other stimulants
People with substance use disorder may have distorted thinking and behaviors.
Changes in the brain’s structure and function are what cause people to have intense cravings, changes in personality, abnormal movements, and other behaviors.
Brain imaging studies show changes in the areas of the brain that relate to judgment, decision-making, learning, memory, and behavioral control.
Repeated substance use can cause changes in how the brain functions.
These changes can last long after the immediate effects of the substance wears off, or in other words, after the period of intoxication.
Intoxication is the intense pleasure, euphoria, calm, increased perception and sense, and other feelings caused by the substance. Intoxication symptoms are different for each substance.
When someone has a substance use disorder, they usually build up a tolerance to the substance, meaning they need larger amounts to feel the effects.
According to the National Institute on Drug Abuse, people begin taking drugs for a variety of reasons, including:
- to feel good — feeling of pleasure, “high” or "intoxication."
- to feel better — relieve stress, forget problems, or feel numb
- to do better — improve performance or thinking
- curiosity and peer pressure or experimenting
In addition to substances, people can also develop addiction to behaviors, such as gambling (gambling disorder).
People with substance use and behavioral addictions may be aware of their problem but not be able to stop even if they want and try to.
The addiction may cause physical and psychological problems as well as interpersonal problems such as with family members and friends or at work.
Alcohol and drug use is one of the leading causes of preventable illnesses and premature death nationwide.
Symptoms of substance use disorder are grouped into four categories:
- Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use
- Social problems: substance use causes failure to complete major tasks at work, school or home; social, work or leisure activities are given up or cut back because of substance use
- Risky use: substance is used in risky settings; continued use despite known problems
- Drug effects: tolerance (need for larger amounts to get the same effect); withdrawal symptoms (different for each substance)
Many people experience substance use disorders along with other psychiatric disorders.
Often another psychiatric disorder precedes substance use disorder, or the use of a substance may trigger or worsen another psychiatric disorder.
- How Is Substance Use Disorder Treated
Effective treatments for substance use disorders are available.+
The first step is the recognition of the problem.
The recovery process can be delayed when a person lacks awareness of problematic substance use.
Although interventions by concerned friends and family often prompt treatment, self-referrals are always welcome and encouraged.
A medical professional should formally assess symptoms to identify if a substance use disorder is present.
All patients can benefit from treatment, regardless of whether the disorder is mild, moderate, or severe.
Unfortunately, many people who meet the criteria for a substance use disorder and could benefit from treatment don’t receive help.
Because SUDs affect many aspects of a person’s life, multiple types of treatment are often required.
For most, a combination of medication and individual or group therapy is most effective.
Treatment approaches that address an individual’s specific situation and any co-occurring medical, psychiatric, and social problems is optimal for leading to sustained recovery.
Medications are used to control drug cravings, relieve symptoms of withdrawal, and to prevent relapses.
Psychotherapy can help individuals with SUD better understand their behavior and motivations, develop higher self-esteem, cope with stress, and address other psychiatric problems.
A person’s recovery plan is unique to the person’s specific needs and may include strategies outside of formal treatment.
These may include:
- Hospitalization for medical withdrawal management (detoxification)
- Therapeutic communities (highly controlled, drug-free environments) or sober houses
- Outpatient medication management and psychotherapy
- Intensive outpatient programs
- Residential treatment (“rehab”)
- Many people find mutual-aid groups helpful (Alcoholics Anonymous, Narcotics Anonymous, SMART Recovery)
- Self-help groups that include family members (Al-Anon or Nar-Anon Family Groups)
13 Principles of effective drug addiction treatment
These 13 effective drug addiction treatment principles were developed based on three decades of scientific research.
Research shows that treatment can help drug-addicted individuals stop drug use, avoid relapse, and recover their lives.
- Addiction is a complex but treatable disease that affects brain function and behavior.
- No single treatment is appropriate for everyone.
- Treatment needs to be readily available.
- Effective treatment attends to the multiple needs of the individual, not just his or her drug abuse.
- Remaining in treatment for an adequate period is critical.
- Counseling— individual and group —and other behavioral therapies are the most commonly used forms of drug abuse treatment.
- Medications are an important treatment element for many patients, especially when combined with counseling and other behavioral therapies.
- An individual’s treatment and services plan must be assessed continually and modified to ensure it meets his or her changing needs.
- Many drug-addicted individuals also have other mental disorders.
- Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse.
- Treatment does not need to be voluntary to be effective.
- Drug use during treatment must be monitored continuously as lapses occur.
- Treatment programs should assess patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases, as well as provide targeted risk-reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases.
Source: National Institute on Drug Abuse. These principles are detailed in NIDA’s Principles of Drug Addiction Treatment: A Research-Based Guide.
- How to Help
Opioids produce high levels of positive reinforcement, increasing the odds that people will continue using them despite negative, resulting consequences.
Opioid use disorder is a chronic lifelong disorder with serious potential consequences, including disability, relapses, and death.
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, describes opioid use disorder as a problematic pattern of opioid use leading to problems or distress.
In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gambling disorder is included in a new category on behavioral addictions.
This reflects research findings that gambling disorder is similar to substance-related disorders in many ways.
Recognizing these similarities will help people with gambling disorders get needed treatment and services and may help others better understand the challenges.
Internet gaming disorder is included in DSM-5 in the section of disorders requiring further research. This reflects the scientific literature showing that persistent and recurrent use of Internet games, and a preoccupation with them, can result in clinically significant impairment or distress.
The condition criteria do not include general Internet or social media use.
Caffeine Intoxication and Withdrawal
Caffeine intoxication and caffeine withdrawal are included in DSM-5.
Caffeine use disorder, however, is in the section of DSM-5 for conditions requiring further research.
While evidence supports this as a disorder, experts conclude it is not yet clear to what extent it is a clinically significant disorder.
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- National Institute on Drug Abuse: Drugs, Brains, and Behavior – The Science of Addiction
- National Council on Alcoholism and Drug Dependence
- National Center on Addiction and Substance Abuse at Columbia University
- Alcoholics Anonymous
- Narcotics Anonymous
Our character is often most evident at our highs and lows. Be humble at the mountaintops, be strong in the valleys, and be faithful in between.
Why are we feeling this way—so beaten up and worn down?
Why do we, who start out passionate, courageous, worthy, and believing, become utterly bankrupt by age 30, 40, or 50?
Why is it that one of us drowns in material consumption and debt, another self-mutilates, a third seeks oblivion in hard liquor and gambling, and a fourth, to stifle fear and judgment, cynically tramples and berates her own individuality, intelligence, and priceless youth?
Why is it that, once fallen, we don’t attempt to rise back up?
Or, having lost one thing, why don’t we attempt to seek another?
Why? Why? Why!!!
Because we give up on ourselves too soon.
We let that negativity monster chew us up and spit us out into a murky puddle of self-doubt.
And we’ve all been there at some point too. So, if you can relate right now, here are some important reminders to keep handy…
- When your marriage, parenting, faith, etc., gets tough, it’s not a sign that you’re doing it wrong. These intimate, intricate aspects of life are toughest when you’re doing them right – when you’re dedicating time, having tough conversations, and making daily sacrifices.
- On tough days when you feel you can’t endure, remember that your track record for getting through hard days is 100% so far.
- Please have a little faith that the universe has a plan for you, and it’s all being revealed in the right time frame. You will eventually learn through all your ups and downs that there are no wrong decisions in life, just choices that will take your life down different paths. Sometimes you must get hurt to grow or lose to gain. Sometimes the lesson you need most can only be learned through a little pain.
- Pain is inevitable. Suffering is optional.
- Life is not about maintaining the status quo. Life is not about playing it safe every second. Life is not about standing still and wallowing in self-doubt. It’s about connecting with your soul, respecting your integrity, and telling yourself you can. It’s about taking a few steps, regardless of how hard and small they may be, so you can move forward and evolve. (Read Daring Greatly.)
- It would be best if you decided that you would move forward. It won’t always happen naturally or automatically. Sometimes you will have to rise up and say, “I don’t care how hard this is. I don’t care how disappointed I am. I’m not going to let this get the best of me. I’m moving on with my life.”
- No matter what’s happening, you CAN efficiently fight today's battles. It’s only when you add the battles of those two relentless eternities, yesterday and tomorrow, that life gets overwhelmingly complicated. Realize that it’s not the experience of today by itself that devastates you, but the regret and resentment about something that happened yesterday or the fear and dread of what tomorrow might bring. It’s necessary, therefore, to let yourself live just one day at a time – just today – just right here, right now.
- When you stop worrying about what you can’t control, you have time to change what you can control. And that changes everything.
- Don’t worry about mistakes and failures. Worry about what you’re giving up when you don’t even try.
- Making mistakes means you’re DOING something in the real world and learning from it. Listening or reading is often just listening or reading. It’s not real learning. Real learning comes from making mistakes. And mistakes come from gradual implementation.
- If you never go after it again, you’ll never have it. If you never ask again, the answer will always be no. If you never step forward again, you’re stuck right where you are.
- In the space between “I’ll try again” and “I give up,” there’s a lifetime. It’s the difference between the path you walk and the one you leave behind; it’s the gap between who you are capable of being and who you have become; it's the legroom for the fairy tales you’ll tell yourself about what could have been.
- Everyone has a little talent. What’s rare is the courage to follow it into the dark places where it leads and beyond. (Marc and I discuss this in detail in the “Goals and Success” chapter of 1,000 Little Things Happy, Successful People Do Differently.)
- Courage doesn’t always roar; sometimes, it’s simply a whisper at the end of the day that says, “I’ll try again tomorrow.”
- If you’re still sitting there thinking, “Things should be different right now,” take a deep breath. That’s not true, and you know it. Because if it were true, things would be different right now. Stay present and focus on what you can create today. And tomorrow will reveal itself exactly as it should, just as yesterday has.
Now, it’s your turn…
It’s your turn to reinforce your better judgment.
All the love and validation you need is yours to give yourself.
Let that sink in.
Then leverage the reminders above to let it sink in even deeper.
Someday everything will make better sense.
Unimaginably good things will transpire in your life, even if things don’t turn out exactly how you anticipated.
And you’ll look back at these past times, smile, and ask yourself, “How did I get through all of that?”
So take a deep breath right now.