Addiction Health Article

Causes and symptoms

Addiction to substances results from the interaction of several factors.

Drug chemistry

Some substances are more addictive than others, either because they produce a rapid and intense change in mood or because they produce painful withdrawal symptoms when stopped suddenly.

Genetics

Some people appear to be more vulnerable to addiction because their body chemistry increases their sensitivity to drugs. Some forms of substance abuse and dependence seem to run in families; a correlation that may be the result of a genetic predisposition, environmental influences, or a combination of the two.

Brain structure and function

Using drugs repeatedly over time changes brain structure and function in fundamental and long-lasting ways. Addiction comes about through an array of changes in the brain and the strengthening of new memory connections. Evidence suggests that those long-lasting brain changes are responsible for the distortions of cognitive and emotional functioning that characterize addicts, particularly the compulsion to use drugs. Although the causes of addiction remain the subject of ongoing debate and research, many experts as of 2004 considered addiction to be a brain disease, a condition caused by persistent changes in brain structure and function. However, having this brain disease does not absolve the addict of responsibility for his or her behavior, but it does explain why many addicts cannot stop using drugs by sheer force of will alone.

Social learning

Social learning is considered the most important single factor in causing addiction. It includes patterns of use in the addict's family or subculture, peer pressure, and advertising or media influence.

Availability

Inexpensive or readily available tobacco, alcohol, or drugs produce marked increases in rates of addiction. Increases in state taxes on alcohol and tobacco products have not resulted in decreased use.

Personality

Before the 1980s, the so-called addictive personality was used to explain the development of addiction. The addictive personality was described as escapist, impulsive, dependent, devious, manipulative, and self-centered. Many doctors in the early 2000s believe that these character traits develop in addicts as a result of the addiction, rather than the traits being a cause of the addiction.

When to call the doctor

The earlier one seeks help for their teen's behavioral or drug problems, the better. How is a parent to know if their teen is experimenting with or moving more deeply into the drug culture? Above all, a parent must be a careful observer, particularly of the little details that make up a teen's life. Overall signs of dramatic change in appearance, friends, or physical health may signal trouble. If parents believe their child may be drinking or using drugs, they should seek help through a substance abuse recovery program, family physician, or mental health professional.

Diagnosis

In addition to noting a preoccupation with using and acquiring the abused substance, the diagnosis of addiction focuses on five criteria:

• loss of willpower
• harmful consequences
• unmanageable lifestyle
• increased tolerance or escalation of use
• withdrawal symptoms on quitting

Treatment

According to the American Psychiatric Association, there are three goals for the treatment of persons with substance use disorders: (1) the patient abstains from or reduces the use and effects of the substance; (2) the patient reduces the frequency and severity of relapses; and (3) the patient develops the psychological and emotional skills necessary to restore and maintain personal, occupational, and social functioning.

In general, before treatment can begin, many treatment centers require that the patient undergo detoxification. Detoxification is the process of weaning the patient from his or her regular substance use. Detoxification can be accomplished "cold turkey," by complete and immediate cessation of all substance use, or by slowly decreasing (tapering) the dose that a person is taking, to minimize the side effects of withdrawal. Some substances must be tapered because cold-turkey methods of detoxification are potentially life threatening. In some cases, medications may be used to combat the unpleasant and threatening physical and psychological symptoms of withdrawal. For example, methadone is used to help patients adjust to the tapering of heroin use.

The most frequently recommended social form of outpatient treatment is the 12-step program. Such programs are also frequently combined with psychotherapy. According to the American Psychological Association (APA), anyone, regardless of his or her religious beliefs or lack of religious beliefs, can benefit from participation in 12-step programs such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). The number of visits to 12-step self-help groups exceeds the number of visits to all mental health professionals combined. There are 12-step groups for all major substance and process addictions.

Alternative treatment

Acupuncture and homeopathy have been used to treat withdrawal symptoms. Meditation, yoga, and reiki healing have been recommended for process addictions; however, the success of these programs has not been well documented through controlled studies.