Drug And Alcohol Addiction
The National Institute on Drug Abuse (NIDA) defines addiction as, “a chronic relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.” Even though addiction is now recognized as a medical condition, which requires proper treatment, many people who struggle with drug and alcohol addiction do not receive the treatment they need.
In part, people may not receive treatment because they fail to realize they are addicted, or are not ready to recognize they have a problem. What may start as recreational use (substance abuse), misuse of prescription drugs, or binge drinking, can quickly turn into addiction, tolerance, and physical dependence.
Once a person has become mentally addicted or physically dependent (experiencing withdrawal symptoms when not taking the drug), stopping use of the substance without help can be daunting, and is rarely successful. Prolonged substance abuse in any capacity can be harmful to a person’s physical, mental, and emotional health.
Addiction can affect your behavior, involvement in school or work, performance, family and personal relationships, and more. Understanding drug and alcohol addiction, the different types of drugs of abuse, and how to find proper treatment can better prepare you or a loved one for addiction recovery.
What Is Addiction?
Addiction is considered a brain disease because it changes the brain, affecting communication pathways, and effectively changing mood, behaviors, thought processes, and emotions. Brain changes caused by addiction can be long-term, and may continue long after a person has quit use of drugs or alcohol.
Signs of addiction may include:
- Taking drugs/drinking for longer than intended, or in larger amounts
- Strong cravings or urges to seek or use the substance
- Dedicating a lot of time to drug-seeking or use
- Continuing to use the substance even after experiencing harmful consequences
- Continuing to use the substance even after recognizing addiction
- Tolerance: no longer feeling the effects of the substance, and using more of it as a result
- Withdrawal: experiencing adverse physical symptoms when not taking the drug
The decision to take drugs for most people may be voluntary, but with time, addiction changes the brain in a way that subsequent drug use occurs as a result of changes to the brain. Most drugs of abuse and alcohol affect the brain the same way—by flooding the reward system with a chemical messenger called dopamine. Excess of dopamine, or other similar chemical messengers, is responsible for the “high” experienced with drug abuse.
The reward system is responsible for the body’s feelings of pleasure (reward), and drives behavior. When a person continues to abuse a drug, the brain alters the way it communicates by adjusting to the excess levels of dopamine. As the brain adjusts, people may experience tolerance to the effects of the substance, and start taking more of it to get the same effects as when they first started abusing it.
Alcohol addiction has been given the medical term “alcohol use disorder,” previously termed “alcoholism.” The National Institute on Alcohol Abuse and Alcoholism explains, “problem drinking that becomes severe is given the medical diagnosis ‘alcohol use disorder.’”
People may have a mild, moderate, or severe alcohol use disorder, according to how many criteria they meet for diagnosis of the disorder.
Signs of alcohol use disorder (alcohol addiction) include:
- drinking for more or longer than intended
- wanting to stop drinking, but being unable to succeed
- spending a lot of time drinking, or recovering from the after-effects
- drinking interferes with personal or professional obligations
- continuing to drink even after recognizing consequences
- increasing risk of injury due to drinking
- experiencing tolerance
- experiencing withdrawals when not drinking
- drawing back from activities or hobbies
- continuing to drink even if it causes friction in relationships
- continuing to drink even if it causes mental health issues, like anxiety or depression
If someone you know is experiencing any of these symptoms, they may have an alcohol use disorder. The more symptoms the person exhibits, typically the higher the severity of the addiction.
Alcohol addiction can affect health of multiple organs, including the brain, heart, liver, and pancreas. Prolonged drinking can affect overall health, weakening the immune system, or cause vitamin deficiencies, such as a thiamine deficiency. People who drink often increase chances of risky behavior due to drinking, such as risky sexual decisions. Ultimately, such decisions lead to increased risk of contracting sexually transmitted infections.
Weakened overall health also contributes to greater chances of contracting infectious diseases. Prolonged alcohol addiction can also contribute to the development of several types of cancer, including cancer of the breast, throat, mouth, esophagus, and liver.
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Opioids are narcotics, or pain-relievers, and take the form of prescription painkillers, illicit drugs, like heroin, combination opioids, like gray death, or designer drugs, like U-47700.
The most commonly abused opioids include:
- Hydrocodone (Norco, Vicodin)
- Hydromorphone (Exalgo ER)
- Meperidine (Demerol)
- Oxycodone (OxyContin)
Opioids work by binding to opioid receptors in the brain, and changing the way the brain responds to pleasure, making prescription opioids highly effective at treating chronic pain. However, opioids are potent, powerful drugs that quickly lead to addiction, so the drugs are only prescribed for a short time of use.
Opioids are prescribed according to potency and degree of pain; mostly, the drugs are used to treat pain in patients who are terminally ill (such as those who have cancer), or who have severe pain due to surgery. Used as directed, or under care of a physician, chances of developing addiction are far less. Yet opioid prescriptions have increased in recent decades, and opioids are now prescribed for conditions which are not as severe as pain from terminal illness.
The Centers for Disease Control and Prevention explains, “Opioids, (including prescription opioids, heroin, and fentanyl) killed more than 33,000 people in 2015, more than any year on record. Nearly half of all opioid overdose deaths involve a prescription opioid.”
Prescription opioid abuse constitutes taking the medication in any way other than prescribed: changing method of administration, taking more than prescribed, taking someone else’s prescription, or sharing your prescription with others. Unfortunately, people who abuse prescription opioids may be left with addiction or even physical dependence when the prescription is finished.
This may cause the person to doctor shop, or attempt to get prescriptions from a number of doctors until one agrees. When people cannot get a prescription, they may seek alternative drugs to find some relief.
Heroin is another opioid, and is less expensive and easier to obtain. Yet heroin is an illicit drug, and is manufactured and sold illegally. Heroin is often “cut” with other additives, which can contain harmful chemicals that affect your health, and may be mixed with other unknown drugs. This means each time a person takes heroin, he or she is at risk of adverse effects and greatly increased risk of overdose.
Perhaps the biggest risk of abusing heroin is that it will be mixed with other potent drugs, including fentanyl, or even more potent opioids. Fentanyl is 50 to 100 times more potent than morphine, and 25 to 50 times more potent than heroin. Consequently, fentanyl is also lethal in much smaller doses than heroin.
Addiction to prescription opioids is dangerous because it can have numerous effects to health, such as sedation, dizziness, nausea, vomiting, and decreased heart and breathing rates. When left untreated, prescription opioid addiction can quickly progress to heroin addiction, putting a person at increased risk for dependence and overdose.
Stimulants are a class of drugs which increase alertness, energy, and attention, and also increase a person’s breathing, heart rate, and blood pressure. Stimulants include amphetamine prescriptions, methamphetamine, and cocaine.
Amphetamine prescriptions are used to treat ADHD, sleep disorders, and sometimes obesity. Amphetamines produce feelings of euphoria, insomnia, loss of appetite, and increased attention and energy—the drugs can be very effective at treating certain conditions. Yet amphetamines can also cause addiction, especially when used over time as many of the medications are used.
Commonly prescribed amphetamines include:
The prescription form of methamphetamine, Desoxyn, works similarly to amphetamine prescription drugs. However, effects of methamphetamine abuse may be far more potent with prolonged abuse or addiction. The U.S. Drug Enforcement Administration explains, “the effects of amphetamines and methamphetamine are similar to cocaine, but their onset is slower and their duration is longer.”
Methamphetamine (meth) abuse takes a toll on the body, and quickly. The body does not completely metabolize meth, so the stimulating effects last longer. Long-term effects of methamphetamine may include psychosis, hallucinations, paranoia, and picking at skin lesions. Violent or erratic behavior is common among people who abuse methamphetamine or amphetamines.
Cocaine is a powerful stimulant that can result in addiction. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “cocaine has two main pharmacological actions. It is both a local anesthetic and a central nervous system stimulant—the only drug known to possess both these properties.”
Like other stimulants, cocaine increases energy and alertness, but people who abuse cocaine tend to also report a sense of increased confidence. Cocaine produces an extreme and quick “high,” a state characterized by intense euphoria. Following this phase, though, is a “low,” or the “comedown.” The low following a cocaine high can be extremely unpleasant, and people who experience it may feel restless, agitated, anxious, irritable, or experience insomnia.
People who abuse stimulants may experience some of the side effects long-term, particularly the brain changes and behavioral changes experienced when abusing meth or amphetamines. With proper treatment, some or all of these changes may be reversed and become manageable.
Benzodiazepines (benzos) are depressant medications that contain one of the following properties: amnesiatic, anti-anxiety, anti-convulsant, muscle relaxant, or sedative-hypnotic. Benzodiazepines are among the most commonly prescribed medications in the United States, known for their relaxing and calming effects.
Common benzodiazepine medications include:
- Alprazolam (Xanax)
- Chlordiazepoxide (Librium)
- Clonazepam (Klonopin)
- Diazepam (Valium)
- Flunitrazepam (Rohypnol)
- Lorazepam (Ativan)
- Temazepam (Restoril)
- Triazolam (Halcion)
While other drugs of abuse affect dopamine levels in the brain, benzodiazepines affect a different neurotransmitter called gamma-amino butyric acid (GABA). This chemical affects motor neurons. Abuse of benzodiazepines creates an excess of GABA in the brain, which affects neuronal movement, slowing nerve impulses—thus producing the calming and relaxation effects.
In high doses, benzodiazepines can be harmful. Regular side effects of the drug can make a person drowsy, confused, or cause slow breathing, among other effects. When people increase the dosage due to abuse, they may also experience hostile or erratic behavior, mood swings, and slowed reflexes.
Benzodiazepines can cause addiction as well as physical dependence. Addiction tends to result in tolerance, when left untreated, and tolerance often causes a person to take more of a drug in an attempt to get the same effects. The effects produced by benzodiazepines can be far more dangerous in higher doses, though.
Withdrawal symptoms can be life-threatening if a person attempts to withdraw alone. A tapering method, which allows a person to slowly wean off a drug, can help people safely withdraw from benzodiazepines and prepare for a treatment program.
Barbiturates are depressant drugs used to treat a number of conditions, including anxiety, insomnia, and seizures. Barbiturates are also used as anesthetics during surgeries. The drugs produce effects similar to benzodiazepines, which have largely replaced barbiturates in medical use.
While barbiturates are no longer among the most commonly prescribed depressant medications, the drugs are still abused for the sedative and hypnotic effects they produce.
Barbiturates are powerful, highly addictive drugs. Abuse of the drugs quickly fosters addiction and/or physical dependence.
The following are some of the most commonly prescribed barbiturates:
- Amytal (Amobarbital)
- Alurate (Aprobarbital)
- Butisol (Butabarbital)
- Nembutal (Pentobarbital)
- Luminal (Phenobarbital)
- Seconal (Secobarbital)
- Pentothal (Thiopental)
Addiction to barbiturates is dangerous not only for the effects the drugs produce, but because the difference between a lethal dose and a safe dose is very small; people can accidentally overdose on barbiturates. Medical News Today explains that, “sudden withdrawal from a barbiturate drug after becoming physically dependent can result in death.”
Like benzodiazepines, a tapering method works best to help people overcome benzodiazepine addiction, and medication may be used to help ease the symptoms of withdrawal.
Treatment For Drug And Alcohol Addiction
Treatment for drug and alcohol addiction varies by the person, needs in treatment, substance of abuse, degree of addiction, duration of abuse, and frequency of abuse. There are many types of drug and alcohol rehabilitation, but one of the most effective is inpatient drug and alcohol rehab.
At an inpatient treatment facility, clients will stay on site for the duration of treatment. Short-term programs may be 30, 60, or 90 days, while long-term treatment may last for 120 days, six months, or longer if needed.
Inpatient treatment has proven the most effective approach for comprehensive treatment across all levels of addiction and for many people with differing treatment needs. Residing at a drug or alcohol rehab center for the entirety of recovery ensures a person is removed from triggers in their home environment, which often contribute to addiction. Seeking addiction recovery at a drug rehab center gives a person a chance to focus solely on healing.
Addiction recovery will look different for each individual, as each person brings their own unique needs to treatment. In general, some of the most effective methods for treating addiction include counseling; behavioral therapy, such as cognitive behavioral therapy, or dialectical behavioral therapy; alternative therapy, such as holistic healing; medication-assisted therapy, and wilderness and adventure therapies.
If you or someone you know is struggling with drug or alcohol addiction, we would like to help you find a treatment center that’s right for you. Contact us today to learn more.
Center for Substance Abuse Research—Benzodiazepines
Drug Enforcement Administration—Amphetamines
Forbes—Why Fentanyl Is So Much More Deadly Than Heroin
Medical News Today—What Are Barbiturates? Uses, Side Effects And Health Risks
U.S. Food and Drug Administration—Opioid Medications