Addiction is a problem that has plagued the world for many centuries, but it wasn’t until more recently in modern American history that it has become a significant issue.
Opioids have been the topic of conversation around the country and contributing to the epidemic that is killing thousands of people each year. Addiction is a complex disease that affects many factors in a person’s life. It permanently changes brain chemistry and the way a person perceives drugs and drug use.
Addiction is summed up as compulsive use that can spiral out of control quickly if you find yourself struggling alone. In the past few years, addiction was finally classified as a disease.
Like most chronic diseases, it can be treated through evidence-based therapies and professionals in addiction treatment. The problem has grown over the years, but the treatment for it has improved significantly.
Learn more about addiction treatment and the different services offered through recovery programs. Understanding the entire gambit of addiction treatment options is crucial when making the ever-important decision for you or a loved one to get started on the journey to long-term recovery from drug addiction or alcohol addiction.
Drugs and alcohol can lead to many problems that fall under a category classified as substance use disorders (SUDs). Addiction can be classified as one of the more severe cases on the SUD spectrum that includes chemical dependence and substance abuse. It is easy to assume these terms all refer to the same concept, but that’s not true. They are related to how they work, but there are pronounced differences to consider.
Substance abuse can be defined as using a prescription drug or illicit drug without the authorization to do so.
The user intends to get high when using drugs recreationally. This extends to self-medication and performance-enhancing drugs as well.
Some people can abuse drugs without becoming dependent or addicted to drugs, but abuse still carries its own potential risks. For example, those who abuse alcohol and never become addicted to alcohol can still carry the risk of being involved in a drunk-driving accident. In 2017, 10,874 people were killed in drunk-driving accidents.
Chemical dependence is a change in your brain of communication pathways. Drugs affect this by altering your central nervous system by introducing drugs that bind to neurotransmitters. All drugs affect these areas differently, but the chemicals will either activate the neurotransmitters, increase efficiency, or suppress other naturally occurring chemicals in the brain. During short-term use, the change is only temporary, but permanent changes usually occur with long-term drug use.
Once the brain has been altered after it adjusts to drug use, the body begins to rely on the outside substances to maintain its brain chemistry. In the event of sudden cessation, your body will experience extreme discomfort and perhaps dangerous withdrawal symptoms as a result. This does not equate to a severe substance use disorder, but it could indicate a growing dependence. If this is the case, you must immediately notify your primary care physician and have them begin weaning you off the drug.
In many cases, however, chemical dependence can result in addiction. Addiction is defined as compulsive use of a chemical substance despite clear consequences. For example, if alcoholism causes you to drive under the influence of alcohol, and you get arrested but continue to drink, this can indicate an addiction. Multiple attempts to quit a substance but failing to do so are also signs that you could be struggling with chemical dependence or addiction.
Addiction is a chronic disease that affects the brain’s reward, motivation, and memory centers. The disease is linked to the limbic system of the brain. This area is responsible for learning about rewarding activities and triggering the motivation to repeat them. In a healthy limbic system, activities such as sleeping, eating, sex, and positive emotional encounters trigger a release of chemicals such as dopamine and norepinephrine.
The limbic starts familiarizing itself with these activities and releases chemicals each time they take place. It passes messages to other parts of the brain so the next time you have an opportunity to engage in those positive actions, the brain will encourage you to do so. This is essential for the survival of human beings.
The problem is that drugs and alcohol tend to overrun this process and replace rewards for using instead of what was learned over time. Your limbic system begins to associate drug use as a positive life-sustaining activity. This, in turn, creates powerful cravings and compulsions that will push someone to act completely out of character and commit acts such as stealing.
Not all those who engage in drinking or drug use will become addicted or dependent. Several factors come into play when looking at the root of an addiction. This can include environment, genetic, and social factors that all contribute in different ways. Below, we look into how these influence addiction.
Genetic and biological factors remain very important when determining if a person will have trouble with substance use disorders in their life. There have been several studies published that show a link between grandparents, parents, and children with alcoholism and drug addiction. An individual’s genes can make up half of their addiction risk. This also offers a look into mental health predisposition and how these issues can increase the chances of developing a co-occurring substance use disorder.
The environment that includes one’s family life, school, neighborhood, economic status, and quality of life can play into the susceptibility of addiction. Family pressure, peer pressure, societal pressure, and the availability of drugs and alcohol can all affect the risks of developing an addiction. A lack of parental supervision, early drug or alcohol consumption, drug or alcohol availability, and poverty are also risk factors. When they are coupled with other problems, such as being predisposed to drug use through genetics, they can create a breeding ground for developing an addiction problem.
Biological and environmental factors can affect a person’s development. This is the third factor in the development of an addiction. No matter the age at which a drug is consumed, it can eventually lead to an addiction. Studies have shown a link between substance abuse disorders occurring when drugs are taken early in development.
Teens are at a risky age for addiction as they are more likely to have access to drugs and alcohol while their brains are still developing. They also are inclined to take more risks that involve substance use. Drug and alcohol use at this age can stunt development and cause other problems than just addiction.
Addiction continues to grow at rates that the public has likely never seen before. This has led to the U.S. President Donald Trump declaring a state of emergency on the opioid crisis. Overdose deaths each year have consistently risen due to the growing opioid crisis, and the statistics were released showing that 115 Americans every day are dying from opioids. Unfortunately, even with the declaration and more access to treatment centers, these numbers continue to balloon each year. Other drugs like cocaine, methamphetamine, and alcohol also contribute their fair share of deaths as well.
One of the reasons the crisis has become this deadly is the increase in accessibility to heroin and other opioids. Pharmaceutical companies have dramatically increased the production of opioids, and overprescribing practices have decimated certain states like West Virginia. There has been no correlation in the number of pain Americans are suffering has increased. On the other side of this, there is no sign that the number has decreased either. More medication has been dispensed, but pain levels remain virtually the same.
The U.S. Centers for Disease Control and Prevention (CDC) has released figures showing 191 million prescriptions were dispensed in 2017. This means individuals are often prescribed more medication than what they need. This leads to having the drug(s) in abundance that kids can steal from medicine cabinets or be shared with family members. There are stories of kids stealing the painkillers from their parents, which signals the beginning of their recreational drug use. This easy accessibility to the drugs has been a major contributor to this crisis.
The increase in prescription opioids is just a piece of the pie. This is not the sole reason for the major influx of opioid addiction. Illicit drugs like heroin and fentanyl have become common in the United States due to a surging black market. Heroin has become one of the most available drugs in the United States, and the saturation of the drug has caused prices to drop. Another reason for this increase is the synthetic opioids being manufactured south of the border in clandestine labs.
Fentanyl is a synthetic opioid that has become popular in the drug scene. It is one of the most powerful drugs in existence and can be blamed for thousands of deaths. Even seasoned heroin users are taken back by its strength. Fentanyl is 50 times more powerful than heroin and 100 times more potent than morphine. It is more cost-effective to manufacture and easier to transport than heroin, which has become dealers go-to when cutting drugs. Adulterated heroin has found its place in the black market, which has been causing overdoses at an alarming rate. The unsuspecting user will consume unaware the heroin is adulterated and can instantly overdose.
Withdrawal from drugs is one of the main components behind someone who chooses not to get sober. At a certain point, drug users only continue their habits to maintain normalcy. It reaches a point where the drug does not have much effect on the person consuming it because of increased tolerance. The problem is the withdrawals are so difficult to deal with that they use just to chase away the sickness. Before using, the body created natural chemicals that helped balance the mind, but after extensive drug use, the brain has been reprogrammed to rely on the drugs for homeostasis. This is why treatment will net the best possible outcome.
Due to the sharp rise in the addiction epidemic recently, addiction specialists and researchers have explored many ways to treat addiction. Evidence-based practices and alternative therapies are commonly used in addiction treatment programs. Rigorous research has offered support that some therapies are more effective than others. Evidence-based treatment is a series of therapies that have been shown effective in scientific studies. These therapies can be used in many different treatment settings, which is another reason for their success.
When considering a treatment program, looking at the effectiveness of a treatment program must be considered. The National Institute on Drug Abuse (NIDA) has created a list of 13 principles for effective treatment. These are very important to review during the consideration process. Choosing a treatment facility that offers the most effective therapies can mean the difference between long-term sobriety and relapse. The most important principles to consider include:
ADDICTION IS A CHRONIC DISEASE
It’s necessary to remember that treatment centers see addiction for what it is—a complex disease. Addiction must be treated medically, psychologically, and socially. It requires the understanding that evidence-based methods contribute to the treatment of this disease and more often than not, yield positive results. In the past, addiction has been viewed as poor habits or a choice, but this perspective turned out to be the least effective way of dealing with the issue.
ADDICTION TREATMENT MUST BE PERSONALIZED
Addiction treatment is not a one-size-fits-all solution. Just like some classes are not for everyone in school, addiction treatment is much of the same. The treatment must be tailored to address the client’s unique needs and any underlying factors. Personalized treatment is critical for success.
TREATMENT MUST ADDRESS MULTIPLE NEEDS
Addiction treatments must address more than addiction. There are other problems that fuel addiction such as mental health issues, legal problems, and homelessness. The right facility will address each end of the spectrum when it relates to needs. This can be a person’s medical, psychological, social, legal, and financial need.
TREATMENT MUST LAST THE PROPER LENGTH OF TIME
Studies have shown a strong correlation between success and maintained sobriety, and the amount of time spent in treatment. Participating in treatment for at least a minimum of 90 days can help address each need effectively. This will allow each need to be met and formulate a solution in the process.
BEHAVIORAL THERAPIES ARE RECOMMENDED
Behavioral therapies are a specific form of addiction treatment that focuses on how our thoughts affect behavior. Studies have illustrated that these are the most effective treatment options. Specifically, cognitive behavioral therapy has become the most reliable means of creating relapse prevention plans.
Addiction treatment addresses many issues that will be valuable for the client long-term. The most urgent medical needs will be the first to be discussed, and from there the staff will determine what will contribute to the client’s success. Because addiction affects the brain’s reward center, this process is rigorous and complicated and involves multiple levels of care. The treatment plan will be arranged based on specific needs, but it will always follow a continuum of care that begins at the most intensive level. This will gradually decrease as the client achieves stability.
According to the American Society of Addiction Medicine (ASAM), this is the continuum of care:
This is also referred to as medically managed intensive inpatient services, detoxification, or detox for short. This is the highest and most intensive level of addiction treatment. Its sole purpose is for those with medical needs or potentially dangerous withdrawal symptoms. If the client has recently stopped using or is intoxicated on arrival, they will be placed in detox. This process will allow medical professionals to assist in your body’s recovery from chemical dependence and transition into a more stable frame of mind. The staff will also monitor and manage any other medical needs.
If there are reasons such as psychological needs that require more intensive addiction treatment, the client will be placed into an inpatient program. These services can range from medical monitoring to clinically managed residential services. At this point of treatment, the client may not require intensive medical care but will be monitored for safety. Safety is always the staff’s top priority. There are scenarios where post-acute withdrawal symptoms, known as PAWS, can last longer than a week.
INTENSIVE OUTPATIENT (IOP)
Outpatient is one of the least intensive levels of care. Intensive outpatient requires more than nine hours of weekly clinical services. The client can attend therapy sessions around the schedule of work or school and other personal obligations. This is reserved for those undergoing intensive addiction therapies that have no medical or psychological requirements.
This phase in the continuum of care requires fewer than nine hours of services each week. This lower-level of care is a step between intensive outpatient services and the completion of treatment. Outpatient services are an excellent way to ease back into everyday life while receiving support from addiction specialists.
Medication-assisted treatment (MAT) uses medications that have been approved by the U.S. Food and Drug Administration. This is done in conjunction with counseling and other behavioral therapies called a “whole-patient” approach. Clinicians will use drugs such as methadone, Suboxone, and buprenorphine for a fresh approach to addiction recovery. It has become an extremely effective approach to treating former users and helping them maintain long-term sobriety. It helps to dissuade future use through softening cravings with opioid drugs.
The most successful treatment centers offer aftercare or alumni programs. This is the unofficial last step in the continuum of care that will connect you to continued support. To remain successful and manage this lifelong disease, the client must attend aftercare programs to manage the disease.
Adolescent addiction treatment is different in the sense that during childhood the brain is still developing. Those who use addictive substances before age 18 have a much higher chance at developing a full-blown drug addiction. What makes adolescent treatment so different is that the family will be present and participate in the child’s treatment process. This is their main influence in life, and having them present can be especially important in developing healthy habits that they maintain throughout their young lives.
Medication-assisted treatment (MAT) is the use of medication in combination with counseling and behavioral therapies. This is thought to be one of the more effective means of treating opioid use disorders (OUD). There have been some indicators that this form of treatment can help sustain those in recovery. This is not a means of treatment someone would experience for their first stint. Medication-assisted treatment is designed to address OUD as a chronic disease with long-lasting effects. This is a beneficial treatment for someone who has gone through treatment and has a history of relapse.
More must be down, however, to remove the stigma following this type of treatment. Some believe that adding more opioids to someone attempting to recover is counterintuitive, but the World Health Organization (WHO) believes that buprenorphine and methadone are essential medications to treating OUD.
MAT is shown to decrease opioid use, opioid-related overdose deaths, criminal activity, and infectious disease transmission. MAT also has been shown to increase social function and retention in treatment. Those who are treated with medication were more likely to remain in therapy than those who did not receive medication.
All treatment requires a caring approach, but it is even more important to apply this to adolescents.
These children or young adults who suffer from substance use disorders are doing so with a developing brain. This requires delicate attention to treating the matter. There are a variety of approaches for the treatment of adolescents, such as evidence-based approaches, including behavioral and family-based interventions. In some cases, a medication-assisted treatment will be used.
Each approach is designed to address specific aspects of adolescent drug use and the consequences for the individual, their family, and society as a whole.
For these interventions to be effective, the clinician must be trained and well-supervised to ensure they adhere to instructions and guidance described in treatment manuals.
The 12-step program was pioneered by Alcoholics Anonymous and is used by a staggering 74 percent of treatment centers. The premise of the 12-step model is that people can help one another achieve and maintain sobriety. This can be done through meetings where experiences are shared to support the ongoing effort of maintaining abstinence. Positive mental health can contribute to longer-term recovery. Twelve-step programs allow someone to recognize and admit there are an addiction problem and surrender to the fact that addiction exists. People who participate in this program also decide to seek outside guidance. This can be beneficial for people who are recovering from either drug or alcohol use or both.
When treating someone with alcohol addiction, it is important to begin the continuum of care in a medical detoxification center. Alcohol withdrawal can range from mild to downright dangerous. Over time, your system begins to adjust to having alcohol around all the time. Your body does this by working a little harder to stay in an awake state and to keep the nerves communicating.
When these levels suddenly drop, it results in withdrawal. Some of the symptoms can be headache, nausea, insomnia, but they can become serious and include hallucinations or delirium tremens (also known as DTs). This is characterized as vivid hallucinations and delusions that can cause death.
For this reason, it is necessary to attend detox. This will ensure your safety from the withdrawals and place you in an environment where if anything did go wrong, medical professionals can treat your condition immediately. They could administer medications such as benzodiazepines to calm your nervous system down and take it out of overdrive.
This is one of the most important steps in the recovery process of addiction. Relapse stemming from addiction happens as frequently as the relapse of other chronic diseases like asthma or hypertension. Addiction relapse rates can be as high as 60 percent. Since relapse is such a large threat, the staff will spend a large amount of its time dedicated to creating a solid relapse prevention plan.
Relapse prevention therapy follows the cognitive-behavioral model. These therapies will allow you to learn how your thoughts can cause relapsing behavior, and in turn, it will teach you to increase self-efficacy and control your own behaviors.
A therapist will go over your triggers and high-risk situations so that you know when to use these tools. It will teach you to avoid these scenarios and how to cope with them if they are not avoidable.
This will allow you to develop strategies that require you to respond to stress and triggers as they occur in healthy manner. This could include familiarizing yourself with the possibility of relapse and reaching out to your sponsor, clinician, or therapist for help should life become too overwhelming. A bulletproof relapse prevention strategy could be the difference between life or death.
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