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Addiction  Print [PDF] Version
SOME MISCONCEPTIONS
Once it was thought that a person was addicted to a drug only if he needed the drug daily, or if he went through withdrawal symptoms (vomiting, seizures, cramps, death) when he abruptly stopped using the substance. It was thought that alcoholics and addicts were unemployed, poor, and from the inner city.
These are misconceptions. Many addicted people do not use drugs or alcohol daily and do not experience physical withdrawal when they stop using. The majority of addicted people are employed and appear to be functioning normally.
Another misconception dealt with the differences between physical and psychological addiction. Physical addiction was thought to be the determining factor in addiction, and little attention was paid to psychological addiction. For example, many people believed that cocaine was not a dangerous drug because it was psychologically, but not physically, addictive.
The cocaine epidemic in this country broadened the understanding of addiction. It is now known that all addictions are characterized by physical and psychological changes. Addiction is far more than physical or psychological dependency. Drug addiction is a complex brain disease that is characterized by compulsive, at times uncontrollable, drug craving, seeking, and use that persist even in the face of extremely negative consequences. Drug seeking becomes compulsive, in large part as a result of the effects of prolonged drug use on brain functioning and on behavior. For many people, drug addiction becomes chronic, with relapses possible even after long periods of abstinence.
CHARACTERISTICS OF ADDICTION
Loss of Control
The user cannot predict what will happen when he uses the substance. One day he may be able to stop after one drink or after one line of cocaine. The next day he may not be able to control his use at all.
Compulsive Preoccupation
The addict spends a great deal of time thinking about the substance.
Continued Use Despite Negative Consequences
If drinking or drug use causes problems, but the user continues to do it, he is tempting addiction or is already addicted. The person has lost voluntary control of the use of that substance.
A nonuser or casual alcohol/drug user may have difficulty understanding why addicts don't just stop. Use and abuse of psychoactive (mood-altering) drugs seem to be voluntary; addiction seems to be characterized by involuntary, compulsive use. In most cases, addicts don't stop because they are addicted; they cannot stop on their own. A person may start out taking drugs voluntarily. But as times passes, and drug use continues something happens that makes a person go from being a voluntary drug user to a compulsive drug user. Why? Because the continued use of addictive drugs changes your brain - at times in dramatic, toxic ways, at others in more subtle ways, but often in ways that result in compulsive and even uncontrollable drug use.
SIGNS OF ADDICTION
If a person is compulsively seeking and using a drug despite negative consequences, such as loss of job, debt, physical or mental problems brought on by drug abuse, or family problems, then he or she is probably addicted. The following are simple screening questions that health care professionals who screen for drug use employ to detect substance abuse.
- Have you ever ridden in a car driven by someone (including yourself) who had been using alcohol or drugs?
- Do you ever use alcohol or drugs to relax, feel better about yourself, or fit in?
- Do you ever use alcohol or drugs when you are alone?
- Do you ever forget things you did while using alcohol or drugs?
- Do your family or friends ever tell you to cut down on your drinking or drug use?
- Have you ever gotten into trouble while you were using alcohol or drugs?
What Causes Addiction?
There has been controversy over the cause of addiction. Historically, it was thought that addiction was caused by lack of willpower, by poverty, moral weakness, mental illness, genetics, family socialization, anti-social personalities, and societal problems. Today addiction is seen as a disease; and like any other disease, many factors contribute to it.
Drug addiction is a brain disease. Every type of drug of abuse has its own individual mechanism for changing how the brain functions. But regardless of which drug a person is addicted to, many of the effects it has on the brain are similar: they range from changes in the molecules and cells that make up the brain, to mood changes, to changes in memory processes and thinking, and sometimes changes in motor skills such as walking and talking. And these changes have a huge influence on all aspects of a person's behavior. A drug can become the single most powerful motivator in a drug abuser's existence. He or she will do almost anything for the drug. This comes about because drug use has changed the individual's brain, their behavior, their social and other functioning in critical ways.
The Drug
Some drugs are more addictive than others. This is due to the pharmacology of the substance, and how it affects the mood of the user.
The User
The genetics of the user and his overall self-concept contribute to the potential for addiction. A person from a family with alcoholic or drug-addicted parents is twice as likely to develop an addiction. Studies are now being done to learn more about the genetics of addiction, and to develop early intervention programs for people who have a greater potential for becoming addicted.
Intervention - How to Help
An addict usually does not know he is out of control. He looks at his drug-using peers and his own use appears normal in comparison. He needs objective feedback on his behavior.
It was once thought that an alcoholic or other drug abuser had to "hit bottom" before help could be offered and accepted; that an addict could only get better if he was self-motivated to change. This has changed to the view that a skilled professional counselor can motivate an addict toward recovery. This is called intervention.
Intervention is a process that helps an addict recognize the extent of his problem. Through a non-judgmental, uncritical, systematic process, the addict is confronted with the impact of his alcoholism or drug use on others. The goal of intervention is for the addict to accept the reality of his drug- or alcohol-impaired lifestyle and to seek help. Most prevention and treatment facilities can help arrange an intervention and assist the addicted person and his family in finding appropriate treatment.
Groups such as Alcoholics Anonymous (AA), Cocaine Anonymous (CA) and Narcotics Anonymous (NA) provide continuing support for people with drug and alcohol problems. These "fellowship" programs exist in most communities and are free of charge. The only requirements are a willingness to choose total abstinence, and acceptance of recovery through fellowship with other recovering people, one day at a time. Fellowship groups are a valuable resource for the addict, his family and friends. The telephone numbers of local chapters of AA, CA, and NA are in the phone book.
Conclusion
Drug abuse is the excessive use of legal mood-altering substances and the use of illegal drugs. Addiction is the extreme end of a continuum that starts with the first use of drugs or alcohol, and progresses through experimentation and abuse to addiction.
Professional treatment and prevention programs and community-based organizations are available to help the addict and his family. These resources can help with education, intervention, and treatment of the addict and those who care about him.
To find a treatment program in your community, call 1-800-662-HELP.
REFERENCES:
NIDA For Teens: http://www.teens.drugabuse.gov/
Principles of Drug Addiction Treatment, National Institute on Drug Addiction, October 1999.
Funds for this document are provided by the Substance Abuse Program Office, Florida Department of Children and Families contract #LD079.
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