A Guide to Drug Addiction

Addiction is a disease that alters the chemistry of its victim’s brains. More specifically, it affects the reward center of the brain, causing addicts to experience altered emotions, personality, and goals. People rarely intend to become addicted. Rather, they typically fall into a pattern of drug use and abuse because of peer pressure, self-medication, or experimentation. Also, not every person who tries an illicit drug falls into an addiction. There are many reasons a person might be susceptible to drug addiction, including upbringing, family life, genetics, and environment.

Also, there are many illicit substances and prescription drugs that are highly addictive even when used or taken as prescribed by your doctor. Even with moderate but regular use, a person of any age can become physically dependent. Once dependency or addiction has its grip on your life, your thoughts, efforts, and actions center on feeding your alcohol or drug addiction. Behaviors that you would have normally considered completely unacceptable may become the only viable option if it means acquiring drugs. For this reason, many people fall prey to the ideas and criminal activities of the crowds they associate with and may resort to lying, stealing, or worse.

Depending on the types of drugs being consumed, their amount, and the length of time, trying to “kick” or get through the withdrawal period at home by yourself can become quite complicated and can range from uncomfortable to deadly. Without a medical provider to monitor your progress, it can be very dangerous to just stop using the drug on your own. Medically monitored detox is necessary to assure a safe detoxification process, especially the recent use of substances such as fentanyl, carfentanil, heroin, benzos, and alcohol. But the process doesn’t end there. Long-term treatment programs are the most successful in establishing the foundation necessary for relapse prevention and long-term recovery.

What Is Drug Addiction?

While drug addiction has been historically viewed as a bad habit and a moral failing, we have come to understand addiction as a chronic and complex disease. As a disease, addiction primarily affects the part of the brain called the limbic system, otherwise known as the reward center. The limbic system links several parts of the brain that have to do with pleasure and learning. Under normal circumstances, the limbic system is a vital part of the brain that encourages you to participate in things that help you survive.

If you enjoy a nice balanced breakfast, feel-good chemicals like dopamine are released in your brain and your limbic system takes notice. You subconsciously learn that you like the full and satisfied feeling you are experiencing. The next morning, your brain encourages you to repeat that action through cravings, impulses, and other subtle nudges. That reward center response happens in a lot of circumstances, from warm hugs to comfortable beds. Your brain learns to repeat things that make you feel good.

However, drugs and alcohol release or cause a release of those feel-good chemicals in amounts that are way higher and more intense than you would naturally experience. When your limbic system is met with this intense reward response, it will begin to take notice. After continued drug use or after a heavy dose, your brain may start to associate the drug with other life-sustaining activities like eating and sleeping. Even after you stop using the drug, you will continue to have cravings for years. A large part of drug addiction treatment is learning how to deal with cravings and triggers without using drugs.

What Causes Drug Addiction?

Drug addiction isn’t purely a matter of pharmacology and how chemicals work in the brain. If that were the case, more people would be addicted to chemical substances. In 2016, there were over 214,881,622 opioid prescriptions written but only a small (but significant) portion became addicted. Every year, college students binge drink all over the country, but they don’t all graduate with alcohol use disorders. So why doesn’t anyone who uses and abuses these addictive chemicals become addicted?

In truth, there is still a lot we have to learn about what causes drug addiction but we have come to understand that there is no one definitive cause. Addiction can be caused by a number of factors, and it’s typically a combination of causes that eventually leads to a substance use disorder. Potential causes include biology, environment, and your development.

• Biological factors – Genetics play a significant role in the development of an addiction. Studies show a link between addicted individuals and a family history of addiction which suggests that a person’s potential for addiction may have significant biological factors. By studying families, twins, and adopted children, researchers estimate that alcohol dependence has a rate of heritability (the likelihood that a genetic trait will be passed to offspring) of 50 percent or more.
• Co-occurring disorders – Addiction has high rates of dual diagnosis with other mental disorders including depression, trauma, anxiety, and mood disorders. Undiagnosed mental health issues are a significant risk factor for the development of mental health issues. Sometimes a person may turn to drugs or alcohol as a way to cope with negative feelings, stress, or mental health issues which is a phenomenon called self-medication. Ultimately, substance abuse and addiction make mental health issues worse.
• Environmental factors – Your environment has a big impact on the way you perceive and process drug use. Environmental influences can be in the home and include family parents or siblings. For instance, people who grow up with attentive parents that educate and warn children about drug use are less likely to have an addiction problem than someone with inattentive parents that ignore or openly participate in drug use. Your neighborhood and culture may also be environmental factors. Kids who walk to school through open-air drug markets or are constantly bombarded with alcohol ads may have increased risk factors for drug addiction. Peer pressure, stress, and drug availability are other factors that come from your environment.
• Developmental factors – This refers to learn behaviors and developed strengths and weakness you may have received over time. This is where your environment and your genetics meet. Your body and brain develop until the age of 25 and during that time you are like clay before it is placed into a kiln, malleable and impressionable. Addiction can happen at any point during a person’s life, but if your first encounter with drugs is in your teen years you are more likely to develop a substance use disorder at some point in your life. Plus, certain chemical substances can disrupt brain development and lead to cognitive issues and problems with decision making and impulsivity. For instance, alcohol disrupts a process called myelination that happens during your adolescent years. Myelination is a period of increased brain development that helps your neurons send messages more efficiently. After prolonged heavy alcohol abuse during your teens and early 20s, it could permanently stunt some cognitive functions. This is typically not debilitating, but it does cause slower thinking, and can lead to poor decision-making skills.

Of course, none of these factors mean that drug addiction is inevitable. And positive results in these categories doesn’t necessarily mean that you will be immune to addiction. Still, these factors significantly increase a person’s risk factors for addiction and together they may hold insight as to why some people struggle with addiction while other people don’t.

How the Brain Communicates

Becoming dependent on a chemical substance is often a big part of drug addiction, but they are not necessarily one and the same. The disease of addiction has to do with the reward center but drug dependence has to do with brain chemistry and the brain’s communication system. In simple terms, the brain communicates by passing chemical messages between nerve cells. Nerve cells are called neurons, chemical messages are called neurotransmitters, and the space through which they pass these messages is called the synapse. Different drugs disrupt this process in different ways but most affect the messages in the synapse.

Here’s how the most common addictive drugs affect the nervous system:

• Stimulants. Cocaine and meth affect the way dopamine is cycled through the synapse. Cocaine blocks the reuptake (or recycling) of dopamine by affecting the part of the sending neuron called the transporters. These transporters are designed to reabsorb neurotransmitters that are no longer needed. By blocking their reuptake dopamine continues to bind to receptors (how the receiving neuron gets messages) and creates the euphoric and energizing effect of excess dopamine. Meth does this as well but it also increases the amount of dopamine that’s released in the first place. So much so that it can damage dopamine receptors. People in recovery from meth addiction may experience a diminished ability to feel pleasure from anything other than meth because it is more difficult for natural dopamine levels to bind to damaged receptors.
• Opioids. Opioids are unique in that they actually have their own naturally occurring receptors in the brain. Your brain produces its own opioids called endorphins. Endorphins are used to mitigate pain, and opioids are often used for the same purpose. However, opioids are much more potent than your naturally occurring alternatives. Opioids bind to opioid receptors in the body and the brain to stop pain signaling. It also causes euphoria and relaxation.
• Depressants. Depressants include alcohol and some sedative sleep-aids. These increase the efficiency of chemicals called gamma-aminobutyric acid (GABA), which decrease the excitability of neurons. This serves to slow the nervous system to decrease anxiety, promote sleep, and stop seizures. If your brain becomes dependent a central nervous system depressant it can be dangerous to stop using abruptly. As your tolerance grows, your brain produces chemicals to counteract the suppression of the neurons. When the nervous system is suddenly unbridled by depressants it goes into overdrive. An over-excited nervous system can mean seizures, catatonia, hallucinations, and even death.

The Addiction Epidemic

Currently, the United States is going through an addiction epidemic that is more severe than ever before. More than 115 people die every day to overdose on opioids alone. Opioids are a commonly prescribed drug used to treat pain symptoms due to chronic pain, surgery, and injuries. Since the body has built-in opioid receptors at every point on the path pain takes from the pain site to the brain, it’s tremendously effective in stopping symptoms in their tracks. However, the euphoria that comes with opioid use can be powerfully addictive. In some cases, people who take legitimately prescribed opioids become addicted and move onto illegally acquired drugs. However, opioids are especially addictive when abused.

Opioids have become a widespread issue for multiple reasons. The number of prescription opioids has flooded the market, quadrupling between 1999 and 2014. The increase in opioid prescribing has flooded the market with the drug and, as of 2016, more than 40 percent of overdose deaths involve prescription opioids. The majority of these incidents involve abuse of prescription drugs, where patients take more than the prescribed dose or when people acquire opioids from family or friends illegally.

Illicit opiates have also flooded the U.S. through illegal trade especially involving transnational criminal organizations like the Mexican cartels. The larger cartels, like Sinaloa cartel, have distribution offices all over the U.S., in almost every major city that support widespread drug trafficking. Potent synthetic opioids have also dramatically increased availability in the U.S. and are currently causing a surge in overdose deaths all over the country.

Fentanyl Overdose

Fentanyl is one such opioid that is 100 times more powerful than morphine and 50 times more powerful than heroin. Fentanyl is used in medical settings in carefully controlled amounts. It’s fast-acting for an opioid, taking effect in as little as five minutes. Its quick onset of action makes it popular to use in epidurals to alleviate labor pains. However, its fast-acting nature also makes it a popular drug of abuse. It’s also cheap and easy to make in clandestine laboratories and its potency makes it easy to transport in small but significant packages.

To increase profits, dealers will cut heroin with other, cheaper substances like cornstarch or flower. However, this can also make the product noticeably weaker. Adding fentanyl can make up for it and even increase potency. The problem is that fentanyl can be deadly in tiny amounts, and a safe dosage is impossible to guess without exact measurements. According to the Drug Enforcement Administration (DEA), as little as two milligrams of fentanyl can kill the average person. 

Most opioid users don’t seek out fentanyl. Instead, they typically buy and use heroin or prescription pills that turns out to be contaminated by lethal levels of fentanyl. The drug makes its way into heroin bags and can even be pressed into pills without the user realizing it until it’s too late.

Opioids cause your body to slow down. It relaxes muscles, stops the pain response, and causes euphoria. During an overdose, it can dramatically slow or even stop breathing. Little is known as to why this happens. One theory is that opioids suppress your body’s ability to detect carbon dioxide levels, which fails to trigger breathing. Opioid overdoses can ultimately cause unconsciousness, hypoxia, brain damage, coma, and death.

Other Drugs in the Epidemic

Opioids are the leading issue in the addiction and overdose epidemic in the U.S. but other drugs continue to pose a significant threat to public health. Alcohol, though legal, has been an addiction threat to many Americans. Its ubiquity in our culture means that abuse of alcohol is widespread.

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 According to the 2015 National Survey on Drug Use and Health found that 6.2 percent of adults (over the age of 18) met the qualifications for an alcohol use disorder. And only 6.7 percent of people with AUDs sought addiction treatment. Alcohol use is linked to 88,000 deaths annually, which includes overdose, preventable alcohol-related diseases, and auto accidents.

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Meth use has risen in the past few years. While deaths from meth use happen at slower rates than opioid overdoses, it has not received as much media coverage. However, meth addiction is notoriously difficult to recover from, as meth use damages dopamine receptors and makes it difficult for you to experience pleasure apart from a meth high. Depression and thoughts of suicide are closely linked with meth use and withdrawal. It’s important to seek help to combat meth addiction, especially if you’ve experienced suicidal ideations.

Cocaine use and overdose have dropped since its peak in the 80s and 90s and its second spike in the mid-2000s. However, it has seen a steady increase since 2012. By 2015, nearly 7,000 deaths were attributed to a cocaine overdose.

As the opioid epidemic increases, other drugs have followed and left the nation in an addiction crisis. However, treatment options are available that can help you get the help you need to achieve lifelong recovery.

Drug Addiction Treatment

There are a variety of methods to treat drug and alcohol addiction and there is some debate as to the best treatment options. However, research evidence does show that effective addiction treatment has several common factors. Some of the most important factors in effective treatment include the following:

• Treatment should be individualized. There is no one treatment plan that will work for everyone. Addiction affects people differently and there are different underlying issues that can lead to addiction. The treatment plan should be built around the individual rather than trying to fit an individual to a specific plan.
• Evidence-based behavioral therapies are recommended. Behavioral therapies like cognitive-behavioral therapy (CBT) have shown to be effective in addiction treatment. They are able to address a wide variety of issues related to addiction and their effectiveness has been backed up by studies.
• Treatment needs to last for an adequate amount of time. Studies show that 90 days is the most effective time to spend in treatment. Treatment duration needs to be adapted to a client’s needs like other aspects of treatment. However, 90 days is the gold standard.

Relapse Prevention

Because addiction is a lifelong disorder, relapse is the number one threat to people in recovery as cravings can occur long after the chemicals have left your system. For that reason, relapse prevention is essential for a lasting and successful recovery. There are many ways to prevent relapse including residential or intensive outpatient programs that teach you to identify risky situations and avoid triggers. Actively participating and attending support groups such as Narcotics Anonymous, Alcoholics Anonymous, and other 12-step groups in your home area will help you surround yourself with a positive support network.

Family Support

Addiction doesn’t just affect the addicted individual; it also affects the friends and family members that surround that person. It’s difficult to watch a loved one suffer through the challenges brought on by active addiction, especially because the situation may get out of control, often causing that person to hit rock bottom before he or she seeks the help they desperately need. Learning to understand the difference between actually helping an addicted loved one and enabling him or her can be both challenging and difficult. 

Finding the Right Addiction Drug Addiction Treatment Center

There are scores of addiction treatment centers across the country. However, for every highly qualified drug addiction treatment center, there are others that are, at best, ineffective and, at worst, fraudulent. It is important to identify a treatment center that has proven experience and can safely provide the treatment appropriate for you. Not all treatment programs offer the type of treatments necessary for the different addiction disorders.

Sober Living

Sober living housing is the ideal bridge between addiction and re-entering the real world. As temptations and cravings emerge, the best defense is to make sure you are in an environment where drugs and alcohol are unavailable as you focus on recovery. Then, residents can spend time learning how to deal with addiction and maintain their sobriety.

Other Addiction Articles

• Long-Term Alcohol Treatment
• College Addiction Guide
• DMT
• Dsuvia
• Ecstasy
• Gabapentin
• Inpatient Rehab
• Intensive Outpatient
• MDMA
• Mescaline
• Modafinil
• Nootropics
• Outpatient Programs
• OTC Drugs
• Partial Hospitalization Programs
• PAWS
• Prescription Painkillers
• Psilocybin (Mushrooms)
• Post-Rehab Aftercare
• Religion & Rehab
• Residential Programs
• Synthetic Drugs
• Tianeptine

Sources

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Alcohol Facts and Statistics. (2017, June). from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics

Dick, D. M., Ph.D., & Agrawal, A., Ph.D. (2008). The Genetics of Alcohol and Other Drug Dependence. from https://pubs.niaaa.nih.gov/publications/arh312/111-118.pdf

FENTANYL FAQs. (n.d.). from https://www.dea.gov/druginfo/fentanyl-faq.shtml

National Institute on Drug Abuse. (2014, July). Drugs and the Brain. from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain

National Institute on Drug Abuse. (2017, September 15). Overdose Death Rates. from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

National Institute on Drug Abuse. (1999, December 01). Thirteen Principles of Effective Drug Addiction Treatment. from https://archives.drugabuse.gov/news-events/nida-notes/thirteen-principles-effective-drug-addiction-treatment

Opioid Overdose. (2017, July 31). from https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html

Prescription Opioid Overdose Data. (2017, August 01). from https://www.cdc.gov/drugoverdose/data/overdose.html

Schuppe, J. (2017, July 2). As America deals with its opioid crisis, meth is also on the rise. from https://www.nbcnews.com/news/us-news/twin-plagues-meth-rises-shadow-opioids-n776871

Vargas, W. M., Bengston, L., Gilpin, N. W., Whitcomb, B. W., & Richardson, H. N. (2014, October 29). from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212071/