Finding Help for Addiction
Unfortunately, addiction can strike anyone, anywhere, at any time. Though some people can safely use alcohol and even experiment with certain drugs recreationally without developing an addiction disorder, others cannot. An estimated one in 10 Americans aged 12 and older is living with a drug problem, including addiction, according to the National Institutes of Health (NIH). The Substance Abuse and Mental Health Services Administration (SAMHSA) also notes that the number of Americans living with an addiction adds up to about 2.6 million people, yet report that only about 11 percent of that number get the addiction treatment they need to heal.
If you, or someone you love, are struggling with addiction, the time to seek addiction treatment is right now.
What Is Addiction?
What Is the Difference between Substance Abuse And Addiction?
SAMHSA defines use, abuse, and addiction to any illicit substance very specifically. “Use”of drugs and alcohol includes any alcohol or drug ingestion by any means with the intent to socialize and relax with others on a recreational level. Though the amount used may not seem to be harmful and may not ultimately lead to dependence upon the substance of choice, it may still put the individual in harm’s way if recreational drug or alcohol use leads to unsafe choices or situations while the person is under the influence.
“Abuse”of drugs and alcohol is defined as chronic use of any illicit substance that results in at least one of the following issues in the past year:
- An inability to maintain commitments or fulfill obligations in one’s career, at school, or in the home.
- Physically dangerous situations that could lead to accident.
- Legal problems related to use of any substance or choices made while under the influence.
- Relationship difficulties at home, with neighbors, and/or in the workplace.
“Addiction,”or dependence upon a drug or drugs, including alcohol, is defined by experiencing three or more of the following problems within the past year as a direct consequence of chronic use of the substances of choice:
- The individual builds a tolerance to the drug of choice (e.g., requiring higher and higher doses in order to experience the “high”associated with use).
- Money designated for survival (e.g., rent, food, utilities) is instead used to buy drugs and alcohol.
- Care of dependent family members or regard for the safety of others in general, including in the workplace and on the road, becomes negligent.
- The individual experiences physical withdrawal symptoms when without the drug of choice that will vary depending on the specific substance but may include nausea, shaking, chills, sweating, vomiting, body pains, and more.
- The individual takes the substance of choice more often or in larger amounts than originally intended.
- Despite a genuine desire to stop using or drinking, the individual is unable to moderate or stop use of all substances for any length of time.
- The major focus of almost every day is getting high or drunk, recovering from the effects of drugs or alcohol, obtaining more drugs and alcohol, or doing things that will in general enable the ability to get and stay high.
- Individuals may no longer take part in hobbies or social events that were once important to them due to substance abuse.
- Despite the fact that negative consequences of using drugs and alcohol continue to pile up, the individual is unable to quit.
How Does ‘Use’ Become ‘Addiction’?No one takes their first drink or tries a new drug with the intent to develop a dependence upon the substance. However, regular use of addictive substances can lead to a tolerance, or the need to take more and more in order to experience the original effects. This tolerance coupled with regular use can lead to physical dependence, which in turn may translate into withdrawal symptoms when without the drug. This experience is often also characterized by cravings for the substance and, when combined with the tolerance and withdrawal symptoms, individuals may suddenly find themselves living with an addiction despite their original intention to only use the drug or drink occasionally.
Common Signs and Symptoms of Addiction
There is a wide range of physical and psychological symptoms that can indicate a drug addiction problem. These will vary depending upon the specific drug and its mechanism in the brain and body as well the dose used daily, whether or not other drugs including alcohol are also being abused, underlying medical or mental health issues experienced by the individual, and how long the person has been abusing the drug of choice.
However, there are numerous signs and symptoms of drug abuse and addiction that can help family members to recognize the need for treatment when it arises. These include:
- Increased physical illness (e.g., cold and flu symptoms) or low energy and complaints of fatigue
- Extreme changes in eating patterns (e.g., eating far more than usual or in binges, eating far less than usual, and avoiding food completely for long stretches of time)
- Extreme changes in sleeping patterns (e.g., spending more time in bed than usual, sleeping at odd hours, or not sleeping for days on end)
- Development of chronic health disorders related to drug use (e.g., asthma and breathing complications when the drug is smoked, liver damage due to drinking, or heart problems due to heroin or stimulant abuse), including mental health disorders
- Exacerbation of symptoms of underlying medical or mental health disorders
- Extreme mood swings that vary with use of different drugs
- Extreme physical illness (e.g., withdrawal symptoms) that come on quickly and/or disappear quickly with use of the drug of choice
- Refusal to spend time with family or old friends, manage work and other commitments, manage finances effectively, or prioritize general health and wellness
Whether or not an individual’s use of drugs and alcohol is defined as “abuse”or “addiction,”if the person is unable to stop drinking and getting high without support, it’s a problem that requires treatment.
Common Drugs of Addiction
There is a range of substances ” legal and illegal ” that are used recreationally to get high or in the maintenance of an ongoing addiction. Some commonly abused drugs include the following:
- Prescription opiates (e.g., oxycodone and hydrocodone)
- Prescription benzodiazepines (e.g., lorazepam and diazepam)
- Prescription stimulants (e.g., amphetamine/dextroamphetamine and methylphenidate)
- Synthetic cannabinoids (e.g., synthetic marijuana and Spice)
- Synthetic cathinones (e.g., bath salts)
- Steroids and performance-enhancing drugs
- Inhalants (e.g., cleaners, aerosols, and sprays)
- Over-the-counter medications (e.g., certain cold medications and weight loss supplements)
- Club drugs (e.g., ecstasy and Molly)
- Hallucinogens (e.g., LSD, peyote, and mushrooms)
- Crystal meth
When Is Treatment Needed?
The development of addiction is a process, one that happens quickly in some people and more slowly in others. Like everything about a person’s experience with drugs and alcohol, how long it takes to get to the point that treatment is recommended is unique and thus will vary greatly from one person to the next.The National Institutes of Health (NIH), however, has identified a process they call the stages of change that can mark the path a person takes from first use of drugs and alcohol to full-blown addiction. Again, different people will spend different amounts of time in each stage, and depending upon the impact of their drug use on their health, their loved ones, and their ability to function, different types of treatment services may be valuable at any point along the way.
When people begin using drugs or alcohol, they often drink or use small amounts. Their use is tentative and occasional, and the repercussions are usually related to the process of recovering from the effects of the drug or alcohol the following day. For most people, use of alcohol and the occasional use of other substances may fall into this category. While their substance use may not necessarily help them in any way or enhance their lives, it doesn’t cause any severe damage or long-lasting harm unless an accident occurs under the influence. Treatment is not usually necessary during this stage; if the effects of drug or alcohol use become too overwhelming, the individual often does not find it difficult to stop drinking or getting high.
When experimentation becomes a regular occurrence, the risk of harm increases. Individuals who drink and get high and the people around them may be at risk due to their behaviors under the influence, and because it happens more frequently, there may also be a negative impact on individuals’ abilities to function productively at work, maintain health, or exist in healthy and functional personal relationships. Additionally, the details of their lives may change to accommodate ongoing use of drugs and alcohol (e.g., a less restrictive job, permissive friends, etc.). In some cases, certain interventions and treatment services may be effective during this stage.
When regular use becomes chronic (e.g., daily or multiple times per day), it frequently becomes the main priority in the person’s life. Individuals will often cease to value their relationships with others, their standing in the community, their reputation at work and among friends, and their health. They will often seek out use of drugs and alcohol above all else, sacrificing former interests, friendships, family relationships, financial stability, and health along the way. It is in this stage that individuals’ choices under the influence may become life-threatening and/or threatening to their freedom (e.g., criminal activities), and immediate cessation of use of all substances through treatment services may be the best option.
When individuals crave their drugs of choice and obsess over getting more of those drugs when they are not actively high or drunk, and they simultaneously struggle with physical withdrawal symptoms when they are without their drug of choice, they are living with addiction. Addiction is hugely intrusive in a person’s ability to function on any level. Individuals quickly find that without intensive treatment that includes detox and long-term therapeutic support, they are unable to stop using on their own, even if they want nothing more than to be free of the medical disorder that is addiction.
Help Organizing an Intervention
It is not always the case that a person struggling with addiction is ready to embrace the idea of change through intensive addiction treatment. In this case, concerned family members may decide that an intervention is the best course of action.
An addiction intervention is the preplanned, formal request to the person living with addiction to recognize that addiction is in fact the major underlying cause of the problems facing the family and that treatment is the only option. Here are some tips to aid in the organization of an intervention for a loved one living with addiction:
- Include only 3-5 concerned friends and family members in order to avoid overwhelming your loved one.
- Hold a planning meeting prior to the intervention in order to ensure that all understand their roles in the intervention.
- All participants should plan out what they will say in advance and avoid being judgmental, angry, or overly emotional.
- Focus on the fact that addiction is not the fault of the person living with the disorder but a medical ailment that will benefit from medical treatment and therapy.
- Ask the person with addiction to not only agree to go to treatment but to also leave immediately for treatment that day.
- Enroll the person living with addiction in a drug rehab program prior to holding the intervention.
- Participants are encouraged to make it clear in a loving way that the family member living with addiction will continue to be loved but no longer enabled in addiction if the offer for rehab is rejected. The individual will be supported throughout recovery if the offer is accepted.
Entering a Detox Program to Manage WithdrawalsDetox is often a valuable and essential first step in recovery from drug and alcohol dependence. Because many people are physically addicted to their drugs of choice, when they stop taking all illicit substances, they often experience a range of withdrawal symptoms. Depending on the person’s specific circumstances, these withdrawal symptoms may range from mildly uncomfortable to severe and potentially life-threatening.
It may not always be possible to guess how a person’s body will respond to the sudden cessation of use of an addictive substance; thus, if there is any indication that physical or psychological withdrawal symptoms may be an issue, it is often advised that all people entering treatment choose a program that will provide medical care and monitoring.
Is an Inpatient Treatment Center or Outpatient Care the Right Choice?
Patients who are ready to seek medical and therapeutic care for substance abuse and addiction will find that they have a range of addiction treatment programs to choose from, each characterized by a different array of services, a different underlying goal and philosophy of care, and different expectations of the client. Most clients will begin their process of determining which program is best for their needs by deciding between inpatient and outpatient treatment. Though inpatient programs are often considered the gold standard in addiction treatment services due to the round-the-clock support and comprehensive nature of care in the first weeks of recovery, in some cases, outpatient treatment may be more appropriate.
Inpatient drug rehab often offers medical detox, 24-hour care and support including medical monitoring, a range of group therapies and traditional treatments as well as holistic and alternative options, family education and support, and aftercare support for the client.
Outpatient programs vary widely. Intensive outpatient addiction treatment programs often offer the same comprehensive care provided by inpatient drug rehab programs ” the only difference is that clients are responsible for providing their own room and board and commit to remain sober when they are not actively in treatment. At the other end of the spectrum are outpatient treatment services that may include a single weekly group therapy session or multiple types of therapies and treatments coordinated into a client’s treatment plan and managed by a therapeutic team.
Before choosing an outpatient or inpatient treatment program, clients will need to assess the following:
- Their ability to stay sober without 24-hour monitoring
- The possibility of medical complications that may require treatment at any time
- The existence of co-occurring mental health symptoms that may require more intensive treatment and care
- The availability of a safe and sober home to return to each night
- The funds available to pay for treatment
- Goals for their experience during treatment and beyond
Aftercare Is Essential to Long-Term Recovery
Treatment does not end when the client goes home after inpatient rehab or completes an outpatient program. In fact, aftercare services are often considered a cornerstone of recovery and play a critical role in the client’s ability to remain sober for the long-term after treatment. These services may include any combination of the following and can be chosen based on the client’s specific goals for life after treatment:
- Support groups and 12-Step meetings
- One-on-one therapy with a substance abuse treatment professional
- Work with a life coach, peer recovery partner, or sober companion
- Holistic treatment services, such as meditation, yoga, and others
- Alternative therapies such as nutritional therapy, psychodrama, animal-assisted therapy, and others
Stats and Facts
- The Centers for Disease Control (CDC) report that, in 2013, an estimated 9.4 percent of Americans over the age of 12 had engaged in illicit drug use and 2.5 percent used prescription drugs nonmedically in the past month.
- The National Survey on Drug Use and Health (NSDUH) report released by SAMHSA in 2014 found that about 24.6 million Americans over the age of 12 were current users of illicit drugs in 2013 and that more than 60 million people over the age of 12 had indulged in a binge drinking session in the past month. An estimated 22.7 million of these individuals met the criteria for a substance abuse problem that required treatment, but only 2.5 million people enrolled in a treatment program to get help.
- The National Center for Health Statistics (NCHS) reports that, between 2008 and 2011, the results of their National Hospital Ambulatory Medical Care Survey determined that every year an average of 1.1 million trips to the emergency room were contributed to drug poisoning (e.g., overdose or medical emergency caused by use and abuse of drugs or alcohol). That survey also found that people between the ages of 20 and 34 were most commonly among those admitted for drug poisoning treatment. Admission rates did not differ according to age or gender, with the exception of the 35-49 age group, in which women were more frequently admitted for drug poisoning. Almost 25 percent of all drug poisoning ER visits ended with admission to the hospital.
- The National Institutes of Health (NIH) reports that rates of overdose deaths caused by the use and abuse of all prescription drugs increased 2.5-fold between 2001 and 2013; that increase includes a threefold increase in overdose deaths caused by prescription painkillers and a fourfold increase in deaths caused by the use of prescription sedatives. Additionally, NIH reports that, during that same period, there was a 29 percent increase in ODs caused by abuse of cocaine and a fivefold increase in deaths caused by heroin overdose.
- Relapse is not uncommon among people in recovery from addiction, and it does not signify that treatment ” or the client ” has “failed.”Rather, relapse rates among people in recovery from addiction are comparable to those experienced by people in recovery form other chronic disorders, including asthma, diabetes, and hypertension.
- Addiction to drugs and alcohol does not just negatively impact the person dependent upon the substance but others in the community as well. Drugged driving is a particular problem; NIDA says that around 31 million people reported getting behind the wheel after getting high in 2012. People between the ages of 18 and 25 had the highest rates of drugged driving compared to other age groups, and the most common drug of abuse among drivers who drove after getting high was marijuana ” more common even than alcohol.
Yes, addiction is a disease. In fact, it is defined by NIH as a chronic disease comparable to cancer, diabetes, and other disorders that must be managed for a lifetime. Just as with other chronic diseases, those in recovery from addiction are encouraged to make lifestyle changes that will support a lifetime of progress in recovery, to work to prevent relapse/remission, and if relapse occurs, to acknowledge it immediately and, in response, to increase focus on recovery in order to get back on track.
Close family members (e.g., parents and siblings) who have struggled with drug or alcohol dependence may contribute to an increased risk that an individual might also develop a substance abuse or addiction disorder. However, coming from a family that has a history of addiction among one or even multiple family members does not guarantee that an individual will develop the problem, and zero family history of addiction does not guarantee that someone will not develop an addiction.It’s important to remember that there is a host of different factors that may contribute to the development of drug addiction. They may include any combination of the following:
- Early age of first use
- Regular use of any substance during adolescence
- Physical and/or brain trauma
- Co-occurring mental health disorder or mental health symptoms
- Growing up and/or living in an environment or community that is permissive of drug use and abuse
Also, even in the absence of all these issues, stress and emotional issues that arise may contribute to the abuse and/or chronic use of drugs and alcohol, which can also lead to an addiction.
Physical dependence upon a drug, or tolerance, can happen to anyone who takes any addictive drug regularly. This does not indicate an addiction but simply means that the person will require higher and higher doses in order to achieve the original effects ” whether the effect is meant to be therapeutic in nature or a high. In the event that the person would like to stop taking the substance, all that is required is a medically supervised “tapering”period, whereby the dose is slowly lowered until the person is no longer using it. As a result, the person experiences lessened withdrawal symptoms along the way.Dependence upon a substance is defined by both a physical dependence upon the drug of choice and a psychological dependence. Cravings for the drug of choice, obsession with getting and staying high, and compulsive use of the drug all characterize the psychological aspects of addiction.
A number of studies support the fact that men and women are exceedingly different in every way when it comes to drug use, abuse, addiction, and treatment. According to NIDA, the following facts on gender differences and addiction are research-based:
- Men are more likely than women to develop a substance abuse or addiction problem, but in recent years, the gap between the number of men and the number of women living with the disorder has been closing.
- From first use, however, men and women are just as likely to progress to an addiction when the drugs of abuse are inhalants, hallucinogens, cocaine, or heroin. However, women may be more likely to develop a dependence upon or addiction to prescription drugs prescribed for insomnia or anxiety, and men may be more likely to become dependent upon marijuana and alcohol.
- Animal studies suggest that women may be more sensitive to health problems caused by drug use and abuse. Women may also experience those health problems more quickly with similar drug and alcohol usage as compared to men.
- When it comes to men and women who seek treatment, women are more likely to be functional addicts (e.g., employed high school graduates), to have co-occurring medical health problems, to have attempted addiction treatment in the past, to struggle with suicidal thoughts or behaviors, and to have been the victim of abuse.
The human brain continues to develop up until the person’s mid-20s, thus any use of addictive substances including alcohol can negatively impact a teen’s cognitive development, mental health, and physical growth. The specifics of how a drug impacts a teen’s brain and body will vary depending upon the drug of choice, the dosage, if the teen also uses other illicit substances, and/or if the teen is living with a co-occurring behavioral, mental health, or medical disorder that may impact how the drug functions.Often, the drug will either imitate naturally occurring chemicals in the brain or trigger a huge release of “feel-good”chemicals that create the “high”that an individual may experience when using a drug or drinking. When the behavior is repeated, the brain adjusts its function based on the expectation that a certain amount of the drug will continue to be ingested. This can result in a depletion or overload of certain chemicals in the brain that will negatively impact the ability to grow and function as compared to non-drug-using peers.
Drug use in any amount can be dangerous to the user, especially if the individual is living with an underlying medical or mental health issue. In the short-term, some possible risks of drug use include:
- Accident that may be life-altering or life-threatening
- Acute medical emergency, including overdose
- Psychotic episode, depending upon the drug of choice and/or underlying mental health conditions of the individual
- Sudden death
With ongoing use of a substance of abuse, the above risks are still a daily concern and additional risks may include:
- The development of chronic medical conditions related to drug use
- Exacerbation of underlying medical disorders and/or mental health disorders
- Difficulty maintaining a job and financial difficulty
- Divorce and loss of child custody as well as other family relationships
An effective treatment program will offer the client everything necessary to progress from active drug and alcohol use and addiction to a stable life in recovery. There is no such thing as a one-size-fits-all treatment program that will be appropriate for every client in every situation. In fact, the same client may require different interventions and treatment options at different points in life. It is important that the chosen treatment program offers a personalized treatment plan for each individual client that will include a range of treatment services to address the unique needs of that person.
The most important factor to keep in mind when seeking out the most appropriate treatment center is that each client will require a range of treatment options to choose from and a voice in the development of the treatment plan. Clients are encouraged to:
- Note whether or not there are evaluation and assessment services offered to aid in pinpointing all diagnoses
- Ensure that any potential rehab is certified and staffed by experts in substance abuse treatment
- Find out the specific services that each program has to offer
- Call prospective treatment centers and ask questions and/or schedule a tour if possible
Like the treatment services necessary to help clients meet their goals, the duration of treatment will be determined on a case-by-case basis. Clients are encouraged to stay enrolled in treatment and actively working toward recovery until they:
- Feel stable enough to avoid relapse in independent living
- Have a safe and sober home to go to
- Have a job that will support them
- Have created a treatment plan that will provide them with the aftercare and support that will help them make the transition into sustained recovery
The amount of the bill for any drug rehab experience will vary significantly from client to client depending upon:
- The type of treatment chosen
- The treatment center’s rates
- Whether or not the client has health insurance coverage
- How much and what services the insurance provider will cover
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