Addiction: what is it?

What is addiction?

National Institute on Drug Abuse defines addiction as:

“Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control, and those changes may last a long time after a person has stopped taking drugs.”

People start drugs to get some sort of benefit such as feel better, improve their sleep, enhance their sexual performance, reduce anxiety, improve their mood, get connected to peers, improve their concentration and attention or enhance their physical performance. However, over time, drugs take over the body, mind and life. Continuous use of drugs results in losing those early benefits and individuals have to continue using them just to feel their baseline normal. prior to drug use. Missing any doses or stopping drug use, would result in severe physical and psychological withdrawal symptoms and could cause sleep, appetite and mood disturbances.

Drug addiction is a complex illness and a chronic health condition. Continuous and repeated use of drugs becomes compulsive and affects person’s ability to stop using it, and over time compulsion take over the individuals day-to-day life.

Why do people get addicted?

Addiction is a multifactorical illness and a combination of several of the following factors could make people susceptible to using drugs and developing dependence:

  1. Genetic predisposition
  2. Poor family nevironment
  3. Drug user parents
  4. Peer pressure
  5. Underlying physical or mental illnesses such as, chronic pain, depression, anxiety, eating disorders, obsessions, poor body image, low self-esteem, poverty…

What are the consequences of addiction?

Addiction, affects individuals, their families and the entire society. The following are some of the negative consequences of addiction:

Effects on individual:

Mood swings

Anxiety

Psychosis

Poor appetite and weight loss

Temper loss

Unemployment

Infections:

People who inject drugs are 59 times more likely to get HIV than people who do not inject drugs.

Among people who use injection drugs, 11% have HIV and 68% either have or have had hepatitis C.

 

Increased risk of heart diseases and heart attack

Increased risk of stroke

Experiencing withdrawal symptoms

poor concentration

Constipation/diarrhea

Anemia

Lung diseases

Infertility

Overdose and death

 

Effects on family:

Child and family neglect

Low income

Homelessness

Partner and child abuse

Malnutrition

Social instability

Increased crime

Risk of imprisonment

Increased accidents

How is addiction treated?

Treatment of addiction often requires a combination of medical, psychological and social interventions. Treatment plan depends on the type of the substances being used and some medications could be used for managing symptoms of multiple substances.

Counseling and psychotherapy has been found as effective and important component of any addiction treatment program. Regular weekly or monthly counseling is helpful in identifying the underlying causes of the addiction and potential risk factors, so that appropriate preventive measures are set to improve treatment success and to prevent relapse.

Over the past couple of decades, special attention has been given into the social risk factors such as poverty and homelessness. Research studies has found that access to safe and stable housing and prerequisites of life are necessary for treatment of addiction.

Addiction is a chronic condition and like any other chronic diseases, treatment of addiction takes time and efforts. It requires commitment from individual and support from family and society. Often it takes multiple attempts before an individual successfully stops his addictive behavior.

Treatment of addiction may include several steps:

  1. Detoxification
  2. Recovery
  3. Maintenance
  4. Relapse prevention

What is detox or detoxification?

Detoxification, or withdrawal management, refers to the management of substance withdrawal in order to reduce severity of symptoms. Most MMT patients are also dependent on other substances, and these dependencies must be individually addressed in order to achieve long-term stability. In-patient or outpatient detoxification for other psychoactive substances such as alcohol, sedative-hypnotics or stimulants should be offered concurrently.

What is Residential and Support Recovery Programs?

Residential and support recovery programs vary in structure, length and mandate. Physicians practising addiction medicine must be familiar with the philosophy, entrance criteria and treatment objectives of a variety of residential programs. Many programs accept patients in the MMP and offer patients with addictions a substantial opportunity for behaviour change and long-term abstinence. These programs offer safe, supportive housing as well as aftercare for patients who have completed detoxification or who are on MMT.

What is Outpatient and Day Treatment Programs?

Most health authorities, community substance use services, employee assistance programs and private service providers offer a range of outpatient and day treatment programs. Physicians prescribing methadone must be familiar with outpatient programs in their community and build relationships with other care providers. Successful treatment for opioid and other addictions is based on counselling and individual or group programs, together with regular brief interventions by physicians.

References

  • National Drug Intelligence Center. The economic impact of illicit drug use on American society.  Washington, DC: United States Department of Justice, 2011.
  • Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet 373(9682):2223-2233, 2009.
  • Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs—2014. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.
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