Addiction: Risk Factors, Symptoms & Treatments

Addiction is a complex, profound, but treatable disease that affects someone’s brain and body. It can show up in the form of a strong desire to use certain things. Alcohol, drugs, and tobacco aren’t the only things that can lead to addiction. People who have gambling or shopping addictions aren’t addicted to drugs, but they still need help.

What Is Addiction

Addiction is a complex disease of the brain and the body. Addiction manifests through the compulsive use of one or more substances, despite the potentially harmful consequences to your health and social life. The condition disrupts the healthy function of specific brain regions responsible for motivation, judgment, reward, memory, and learning.

Individuals with severe substance use disorder develop such an intense focus on using and thinking about a particular substance(s), such as drugs or alcohol, that their entire lives revolve around it. Addiction can damage their health, overall energy, family, relationships, workplaces, schools, neighborhoods, and communities. They keep using the substance even when they know these consequences and don’t intend to cause harm. Substance use and abuse is the leading cause of preventable premature deaths and illnesses in the US.

While addiction is spiraling out of control for many, it doesn’t have to lead to lifelong suffering or become fatal. There are effective treatment options available. Recovery and living a productive, healthy, and happy life are possible. Additionally, addiction is preventable with professional help, and support from family, friends, and peers is helpful, if not essential, for successful recovery and prevention. (1, 2, 3)

People Can Develop an Addiction to:

Alcohol
Tobacco
Marijuana
PCP, LSD, and other hallucinogens
Inhalants, such as glue and paint thinner
Sedatives, hypnotics, and anxiolytics
Opioid painkillers, such as oxycodone, codeine, and heroin
Cocaine, methamphetamine, and other stimulants

The Effects of Addiction

Substance use disorders cause changes in the brain’s wiring, leading to distorted thinking, behavior, and body function. Judgment, decision making, behavior control, learning, and memory also become compromised. A sense of intense pleasure, calmness, alertness and heightened senses can result from using certain substances. Addictions also result in intense cravings that make quitting difficult and relapses likely. Moreover, people can build a tolerance to certain substances, needing larger doses to feel the same effects and eventually experiencing little to no results from higher doses. It may lead to moving onto a different or a mixture of substances. Addiction can lead to other mental illnesses, physical health issues, social issues, and possible death. (3)

Why Do People Use Substances, such as Drugs and Alcohol?

The four main reasons that people take substances include (2):

Feel good, experience pleasure, self-confidence, freedom, and be ‘high.’
Feel better, relieve stress, feel less distress, and feel happier.
To get more focused, to improve cognitive or athletic performance.
Curiosity, peer pressure, wanting to fit in.

Symptoms of Substance Use Disorder and Addiction:

Impaired control is characterized by solid cravings and urges of substance use and failed attempts to control, cut down, or quit using the substance.
Social problems, such as failing to complete tasks at work, school, or home, not participating in former work, social or leisure activities in favor of or as a result of substance use
Risky use. It is characterized by using substances in challenging settings and complicated ways.
Drug effects leading to tolerance and withdrawal symptoms
Mental illness that may be present before the addiction may worsen, be triggered by, or develop as a result of the substance abuse (3)

Risks for Substance Abuse and Addictions

Various factors come into play with someone’s risk of developing a substance use disorder. In most cases, substance abuse is a combination of environmental, biological, and other factors. There is no single factor that can precisely determine the development of addiction. It depends from person to person. Child development and our earliest interactions are crucial in developing a substance abuse problem.

Home and Family

The home and family environment is an essential factors. If a child grows up with parents or family members using or abusing substances or engaging in criminal behavior, their risk of developing a substance abuse problem increases. Lack of parental supervision, lack of care, violence within the family, abuse against the child, and other forms of maltreatment also increase the risks. (2)

School and Peers

The peer and school environment are similarly crucial as peers strongly influence each other. Substance availability at school and a ‘drug culture’ can increase risks. Those who use substances are more likely to encourage children, teens, and even young adults to use drugs or alcohol frequently. Poor academic performance or social skills can increase the risks as well as students are more likely to look for a way out, a way to fit in, or a way to feel better. (2)

Community

The overall community environment influences the risks of substance use and abuse. Community poverty, the availability of drugs, lack of community support, lack of neighborhood pride, and living in a violent and unsafe area can increase the appeal risks of substance abuse. (2)

Genetics and Biology

Genetic factors may also account for 40-60 percent of someone’s vulnerability to addiction, but it doesn’t have to result in substance use or abuse. Besides genetics, certain medical conditions, mental health issues, and the person’s age or stage of development may also influence the risks. (2)

Early Use

The earlier age someone starts using a particular substance, the more likely they will develop a severe addiction. Early use can harm the developing brain leading to more vulnerability. Children and youth are still growing and haven’t fully learned healthy coping skills and self-care. Younger persons exposed to physical, sexual, or emotional abuse, neglect, an unstable family environment, financial issues, mental illness, or genetic vulnerability may be more prone to use and become addicted to substances than peers who are not exposed to these circumstances. (3)

Method of Administration

Different substances have different levels of addiction potential. It doesn’t only depend on the substance itself but the method of administration. Smoking and injection can increase the addictive potential as the substance enters the brain almost immediately, resulting in intense pleasure and ‘high.’ This feeling, however, fades away quickly, urging the user to resupply. (3)

Treatment, Rehab, and Therapy

Successful recovery from any form of addiction is possible, and practical treatment options are available.

The first and essential step to recovery is the initial recognition of the problem. If someone with an addiction denies that substance abuse is a problem, recovery can be difficult, if not impossible. An intervention may be necessary to help recognize the severity of the issue and begin treatment.

The first actual treatment step is an appropriate healthcare professional’s formal assessment of symptoms. There is no need to worry that addiction is not ‘bad enough’ or ‘too bad.’ People with the least severe and most severe cases of addiction can still benefit from treatment.

Addiction is a multifaceted issue involving many aspects of someone’s life, including mental, physical, and social health. Therefore, a multi-level treatment with medication, individual and group therapy, and possibly other methods is the most effective. The personal desire to recover and active participation in recovery is essential.

Severe treatment may require hospitalization, living in therapeutic communities, or attending outpatient programs. Medication can help with drug cravings and severe withdrawal symptoms. Therapy can help in understanding behavior, motivation, thoughts, and feeling. It can also help develop coping mechanisms, build higher self-esteem, and address mental health challenges. Therapy, in particular, group therapy, can also help with social situations, relationships, and how to relate to others. Family therapy can help to explore family dynamics. Self-help groups, such as Alcoholics Anonymous, Narcotics Anonymous, and their related family groups are often helpful in recovery phases, even years into sobriety. Vocational, social and legal services can be part of a successful recovery process and living a ‘clean’ life. (2, 8)

Principles of Effective Treatment:

Remember that addiction is a disease affecting the brain’s function and the person’s behavior. It’s complex but treatable.
No one size fits all: no single treatment works for everyone.
Treatment must be readily available to all in need.
Effective treatment considers all aspects of the individual and their lives, not just the abuse itself.
Remaining in treatment for as long as needed is essential for successful recovery.
Therapy and counseling are common and helpful forms of treatment.
Medication can be helpful, especially in the initial phases, in combination with various forms of therapy.
The treatment plan must be regularly assessed, evaluated, and modified.
Substance addiction often comes together with other mental disorders.
The first stage is medically assisted detoxification.
Treatment doesn’t have to be voluntary to work, though voluntary treatment is best.
Regular monitoring of drug use is necessary during treatment.
Treatment programs must assess hepatitis B and C, HIV/AIDS, tuberculosis, and other infectious diseases and provide necessary treatment and risk-reduction counseling. (3)

Prevention

Substance use disorder and addiction are preventable. Examining and addressing all risk factors is essential. Drug and alcohol education and prevention efforts aimed at children, teenagers, and youth can effectively prevent substance use, misuse, and abuse. Involving the children and youth and their families, schools, communities, and the media in these efforts is essential. (3)

How to Help Someone with Addiction

Learn about addiction as much as possible.
Express your love and concern.
Offer and show support.
Listen to them.
Show compassion, empathy, love, and understanding.
Support their entire recovery process.
Accept that change is not immediate and recovery is a process.
Don’t expect them to change without help.
Don’t make excuses for them.
Don’t judge, blame, preach, threaten, bribe, moralize, or bully.
Don’t guilt them but don’t feel guilty either.
Don’t take on their responsibility; understand that recovery is their responsibility.
Don’t join or encourage them in their behavior. (3)

How to Find Help?

If you or your loved one is dealing with an addiction, talk to your doctor or mental health professional to seek treatment. The following websites and helplines can help find appropriate treatment options and support. (8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)

Search Engines

Behavioral health treatment locator: findtreatment.samhsa.gov
Addiction recovery finder: https://www.recovery.org/
Drug treatment center finder: https://www.drugtreatmentcenterfinder.com
Rehab finder: https://www.rehabs.com/
Treatment center finder: http://treatmentcenterfinder.org
Buprenorphine Physician and treatment locator: www.samhsa.gov/medication-assisted-treatment/physician-program-data/treatment-physician-locator
Opioid treatment program recovery: dpt2.samhsa.gov/treatment/

Hotlines

Suicide Prevention Lifeline: 1-800-273-TALK (8255)
Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline: 1-800-662-HELP (4357)
Addiction and Alcohol Hotline: 1-844-244-3171
Heroin Addiction Hotline: 1-877-2724
Disaster Distress Helpline: 1-800-985-5990
Veterans’ Crisis Hotline: 1-800-273-TALK (8255)
Drug-Free Workplace: 1-800-WORKPLACE (967-5752)

Online Options

7 Cups of Tea online support: https://www.7cups.com
Online counseling: https://www.betterhelp.com
Online non-12 step: https://lifeprocessprogram.com/
Online substance abuse counseling: https://www.lionrockrecovery.com/
Online Alcoholics Anonymous: https://www.aa-intergroup.org/
Online Narcotics Anonymous: http://www.na-recovery.org/Narcotics_Anonymous_Online_Meeting_Schedule.html

Find a Support Group

Alcoholics Anonymous: https://www.aa.org/pages/en_US
Narcotics Anonymous: https://www.na.org
Addiction meeting finder: https://www.addiction.com/meetingfinder/
Support groups: https://americanaddictioncenters.org/therapy-treatment/aftercare-support-groups/
Recovery Support: https://startyourrecovery.org/

What to Do in the Case of an Overdose?

Call 911 immediately if someone you know has overdosed, collapsed, or stopped breathing.
Start CPR if necessary.
Call poison control even if there are no immediate symptoms at 1-800-222-1222
Collect all the drugs, pills, and substances (anything leftover, containers, bags, etc.) and give them to the emergency team for an examination. (22)

Related Disorders and Addictions

Addictions come in all shapes and forms. Not all addictions are substance use disorders, and not all are related to drugs or alcohol. Some addictions and addiction-like disorders are classified in the DSM-V under another category. Some other addictions are not classified in the DSM-V or as any form of a health condition today. These additions would be more like food, television, or social media addiction, yet can cause addictive patterns and serious disturbances in one’s life. (2, 4, 5, 6) Some non-substance addiction examples include:

Gambling Disorder
Internet Disorder
Caffeine Use Disorder
Non-substance related addictions, such as Internet-related behaviors like video games, shopping, pornography, compulsive sex, and compulsive exercise
Food addictions

Recovery from non-substance-related addictions and addictive behaviors is also possible through appropriate therapy and support.

Addiction is a severe disease, but effective treatment options are available for you and your loved ones. Recovery is possible. If you are struggling with addiction or know someone with an addiction, talk to your doctor and/or mental healthcare provider to find the best treatment option and begin recovery.

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Partha Nandi MD, FACP

`Partha Nandi MD, FACP`