What we do know is that addiction, whether it be to alcohol, cigarettes or illegal drugs, is characterized by an inability to stop using the substance, even though it might be causing lifestyle, relationship or health problems.
In recent years, medical researchers have begun to have a much better understanding of how drugs work on the brain, and even how a dependence on drugs develops.
Drugs, addiction and the brain
Drugs act on dopamine, which is the brain’s ‘fun’ chemical – it tells us that we are enjoying whatever it is we are doing. It’s the same chemical that is activated whenever we do anything we enjoy – whether that is sex, sports, gambling or shopping!
Drug use results in increased amounts of dopamine being released. The feeling is so good that we want to repeat the activity. Or on the flipside, the extra dopamine released may mean that any pain or anxiety that we may have been experiencing is dulled or hidden, so our emotions feel balanced or ‘normal’. The more often we repeat the drug use, the likelihood increases that new chemical pathways are being created in the brain and we may need to use the drug in increasing quantities to keep achieving that feeling.
How do you know if you have an addiction problem or whether you just like to regularly drink or use drugs?
Addiction happens when we rely so much on our drug of choice that it feels like we can’t function normally without it, even though it could be causing problems for us in other areas of our lives. For most (but not all) drugs, if we suddenly stop using it and then start to experience withdrawal symptoms (we get shaky, headaches, feel sick), it’s a good sign that our bodies have become dependent on the substance.
It doesn’t matter which substance you prefer, a standard checklist is used worldwide to determine whether you may have a ‘substance use disorder’ (this is the term that medicos now use instead of ‘addiction’). Developed by the American Psychiatric Association, the questionnaire will not only determine whether you have a dependence on alcohol or another drug, it will be able to tell you whether that disorder is ‘mild’, ‘moderate’ or ‘severe’.
The checklist looks at factors which include:
- Amount and frequency of use
- Ability to stop using when you want to
- Whether your use is interfering with other things such as work and relationships
- Whether you have withdrawal symptoms when you stop using your preferred drug
- Whether you use in dangerous places or in ways that are harming your health.
Remember that you can still have a drug-related problem, even if you aren’t diagnosed as dependent on drugs. You may find that your use is causing you difficulties, even if you only use occasionally, but have a binge when you do. And even if you’re not dependent on drugs, using large amounts of any drug will still be causing damage to organs in your body, such as your kidneys, liver or heart.
Being dependent on drugs or alcohol doesn’t mean your life has to spiral out of control. Too often, we only hear or see stories about ‘addicts’ who are now living in the gutter, homeless, estranged from their families and generally facing a hopeless life. While that can definitely happen, that’s just one part of the story.
Society is full of people who have experienced a substance dependence but are now leading happy, functional, successful lives. Often, they don’t talk about their problem, because they know others will judge them and may discriminate against them.
There ARE many ways out of addiction.
Many people never seek formal help, but quit their drug or alcohol use because they realise it is causing too many problems, or their circumstances change and they have little access to the drug they have been using. They may decide their use is threatening other areas of their lives (such as health, work or relationships) which are more important to them. They may go ‘cold turkey’ without any treatment. Or they may rely on the support of family or friends. These individuals will never be identified in the ‘official’ drug treatment statistics.
However, this is not an easy road, and there are many options if you do want to seek help. They include:
- Self-help groups. Alcoholics Anonymous is the world’s best-known self-help group. Known as ‘AA’, this organisation has been joined by Narcotics Anonymous (NA) for people who want to address their dependence on drugs other than alcohol. AA and NA focus on an abstinence-based, ’12-step’ approach to overcoming addiction, while a newcomer ‘Smart Recovery’ uses a cognitive-based therapy approach to help people assess how they use drugs to both help and hinder themselves.
- The first port of call may be your family doctor for one-on-one management of a drug or alcohol problem.
- Drug & alcohol treatment clinics. A dedicated team of health professionals clustered in a clinical setting, providing specialised treatment.
- Many people’s addiction is linked to traumatic life experiences. Counsellors can help them work through the emotional or physical pain they try to dull with drug or alcohol use.
- Residential rehabilitation. A live-in group therapy experience where people can work intensively on the factors behind their drug use. Depending on the program and its after-care options, the residential experience could last anything from 30 days to a year or more.
- Methadone or Suboxone treatment. Designed for people who are experiencing problems with the opioid family of drugs (ie. heroin, morphine, codeine), this prescription medication replaces the need for the individual to seek out illicit drugs. Different countries use a variety of systems to help people access this medication.
- Online treatment. In the past decade, internet-based treatment programs have become popular. These are useful for people who are time-poor and may wish to remain anonymous.
All of these options are valid, and the one that’s right for you is the one that works for you. The first step is admitting that you have a problem with alcohol or another drug, and being prepared to reach out for the help you need.
To help you with your journey, I’ve established www.BeatAlcoholandDrugAddiction.com. This website focuses online-based programs which may be helpful to people who want to overcome a drug or alcohol problem but may not have the time or ability to visit a clinic or GP, or who are on a waiting list for a place in an over-full drug and alcohol clinic.
American Society of Addiction Medicine. Definition of Addiction. www.asam.org/for-the-public/definition-of-addiction. Accessed 14 December 2015.
Gilly PA 2015. How and Why to Diagnose Substance Use Disorders under DSM-5. MOJ Addict Med Ther 1(2): 00009 DOI: 10.15406/mojamt.2015.01.00009
Philos 2010. The Liberal View of Addiction, Psychiatr Psychol. 2010 March 1; 17(1): 1–22. doi:10.1353/ppp.0.0282.
The official definition
Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.
– American Society of Addiction Medicine
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