There has been much in the news recently about how drug use has reached epidemic proportions locally and across the country. The devastating effects of substance abuse are obvious to non-users. However, if you have never experienced an addiction it is difficult to understand how someone could continue to use, despite all the negative consequences. With a little exposure to the current understanding of what addiction is and how it is treated, it is easier to feel empathy for people with addiction, and to learn how to deal with it in our lives and communities.
When I started my master’s degree in clinical counseling, I had no intention of working in addiction. It took an eye-opening internship in an addiction treatment center to ignite my passion for this work. I have found that the people with addiction with whom I have worked are some of the most devastated but hopeful people I know. I am inspired often by my clients’ desire for change, the depth of their sorrow, their ability to overcome, and their dreams for the future. In working with the families of addicted people, I have learned that a little understanding about the complex physical, psychological and environmental factors underpinning addiction helps people see addiction not as a moral failing, but as an illness.
The seat of addiction is in the brain. The human brain is “hardwired” through the limbic system to seek out pleasure, because that is what keeps us alive and perpetuates the species. Being warm and dry, eating food and drinking water, feeling connections to loved ones – these are things that feel good and help us survive, so we constantly pursue them. This drive to survive is what allows people to bypass their rational mind during a crisis and do whatever it takes to live, even if that means severing their own limbs, resorting to cannibalism, or doing other seemingly outrageous things that people are unlikely to do in their daily lives.
When a chemical such as those found in opiates, stimulants, hallucinogens or alcohol binds to receptors in the brain that were meant to process naturally-occurring brain chemicals such as dopamine, addiction may begin. The drugs prevent the brain’s normal functioning, and instead introduce the strongest “good” feeling the body has ever felt. The brain responds to this “high” by wanting more. Remember, up to this point the brain’s perspective has been, “If it feels good, it must be good for me, so do it more!” The chasing of that “high” feeling becomes obsessive, and negative consequences follow. The brain falsely believes it now needs drugs to survive.
For a more detailed explanation of the effect of drugs on the brain, including excellent diagrams, visit the National Institute on Drug Addiction at www.drugabuse.gov, and type “drugs and the brain” into the search box.
As the brain continues to be exposed to drugs and alcohol, physical changes take place, suppressing the body’s natural production of dopamine and reinforcing the brain’s reliance on outside substances. Physical changes occur in other parts of the body as well, such as the stomach, intestines, and other major organs. The liver and pancreas must work harder to process the increased chemicals in the body and heart and lung function decreases in response to suppressants like alcohol, opiates (Percocet, Oxycontin) and benzodiapines (Valium, Xanax).
Science has yet to determine conclusively why some people become addicted to substances and others do not. It has shown, however, that a combination of factors contribute to addiction. Lack of family involvement, having a mental health issue, gender (men are twice as likely to become addicted), peer pressure, family history of addiction, and experimenting with highly addicting substances like heroin or cocaine, can increase a person’s odds of becoming addicted.
Treatment professionals use the “disease model” of addiction for treatment. From this perspective, addiction is considered a primary, chronic, progressive disease. “Primary” means addiction needs to be treated before, or concurrent with, other disorders such as depression or cirrhosis of the liver in order to be successful. Addiction is “chronic” because like diabetes or heart disease it is something that can be managed, but not cured. Finally, addiction is “progressive” because it follows a predictable course of decline that left untreated, results in the death of the afflicted.
Treating addiction requires a complex and radical change in both the person with addiction and the people around them. People with addiction heal through practicing abstinence, building sober social support in friends and family, addressing mental health issues, learning healthy coping skills and changing people, places and things in their lives.
Addiction is a devastating disease. It ravages families, increases community crime rates, drains personal and community resources, and causes heartbreak. The best way to combat addiction is with education and empathy. By learning about the disease of addiction we can provide more focused support in preventing it. By learning how to treat it, we can take steps necessary to help addicted individuals, heal families, and improve the overall health of our community. For more information on addiction services, please call Signature Health at 440-992-8552 (Ashtabula), 216-663-6100 (Garfield Heights), or 440-953-9999 (Willoughby).