Defining Substance Abuse & Addiction

How does addiction affect the body?

Repeated drug and alcohol use causes chemical dependency, or lasting changes to the way the brain functions and operates. In fact, all abused substances alter the areas of the brain responsible for self-control, judgment, emotional regulation, motivation, memory and learning by hijacking the brain’s normal reward pathways. Although abused substances—including alcohol, heroin, benzodiazepines, methamphetamine, nicotine and prescription drugs—act on different pathways in the brain, they all necessitate increasingly higher doses to produce a high or simply allow the user to feel normal. Issues such as mental illness, multiple addictions and ancillary health problems may complicate substance addiction. 

Why do people use alcohol and drugs?

Because many drugs act on the brain’s pleasure pathways, the user experiences intense euphoria followed by related emotional highs. Cocaine, for example, induces feelings of empowerment, confidence, high self-esteem and increased energy. People might chase these perceived emotional benefits for a variety of reasons, including:

• Social: People use alcohol and drugs often as a way to fit in with a particular group or to feel more at ease in a social setting,
• Stress: Substance abuse may be a means to escape problems or a way to reduce stress. The role of stress in beginning drug use, continuing drug abuse, or relapse in recovering patients should be addressed and approached holistically.
• Psychological triggers: People suffering from anxiety disorders, trauma, depression or other psychological illnesses may begin using alcohol and drugs to reduce or numb personal distress. Individuals with alcohol or drug dependence are nearly twice as likely to have a co-occurring psychological disorder.
• Peer pressure: Some people, especially teenagers and adolescents, are vulnerable to group pressure or the rationale that “everyone is doing it.” 

Addiction Interaction Disorder

Most addicts and alcoholics today face more than one addiction at the same time. These addictions not only coexist, they interact, reinforce, and fuse to become part of a package. This process is called Addiction Interaction Disorder (AID).

Addicted persons are likely to struggle with two or more of the following at any given time:

• Drugs and alcohol
• Gambling
• Sex
• Eating
• Work
• Internet

In addiction interaction disorder, addictions are separate and different, yet share similarities and consequences. The same emotions and stressors—including shame, trauma, denial and stress—fuel them. 

Addiction interaction disorder can become chronic and progressive if left unaddressed. While traditional substance abuse treatment programs have focused on a patient’s “drug of choice” (such as alcohol, cocaine, heroin or prescription painkillers), it’s important to focus on the unique set of addictions that defines an individual’s AID. Left undiagnosed and untreated, addiction interaction disorder can leave patients at high risk for chronic relapse.

Treating Addiction Interaction Disorder

Treating addiction interaction disorder can be difficult, as multiple addictions must be identified and assessed both as individual problems and as a pieces of the bigger picture. Clinicians must determine which addiction is the most severe or life-threatening while also attempting to break the overall cycle of addiction. Someone whose addiction interaction disorder involves cocaine and gambling, for example, should first be treated for the cocaine addiction. Once the patient has gone through detox and is abstaining from the drug, they are better equipped to confront the gambling addiction.

Patients suffering from addiction interaction disorder should be encouraged to undergo comprehensive multiple addiction treatment in order to acquire strong recovery habits and an understanding of how to best deal with issues such as anxiety or depression.

Relapse

Addiction to drugs or alcohol is a chronic disease and, as with other chronic diseases, there is a risk that a person who is in recovery may relapse. In fact, more than half of all people who undergo addiction treatment experience relapse, either briefly or on a long-term basis. Women are less likely to relapse than men, and patients who actively engage in aftercare following treatment are more likely to remain sober longer than those who do not.

Although relapse is common, it is predictable and largely preventable. If relapse does occur, it does not mean that the person has failed in his or her recovery. Relapse is part of a learning process that eventually leads to recovery.

Learning to recognize the stresses and triggers helps people in recovery from addiction to drugs or alcohol avoid relapse. Triggers could include:

• Being around others who are using
• Being exposed to a situation that is particularly stressful, such as the death of a loved one or a job loss. Even hearing a song or meeting someone who reminds the individual of a time when they were using can trigger relapse.

Family members and friends should be aware of signs that a loved one may be heading toward relapse. Relapse signs include:

• Decreased interest in attending support groups and meetings or “working the program”
• Mood swings or periods of moodiness
• Recurring withdrawal symptoms, such as anxiety or sleeplessness, which could tempt a person to self-medicate
• Changes in behavior, such as increased defensiveness or impulsiveness
• Loss of interest in social activities
• Loss of routine or structure
• Trouble making decisions or making unhealthy decisions
• Withdrawal from people or activities that were helping in maintaining sobriety