Substance Abuse/Addiction

Very generally, substance abuse and addiction occurs when an individual compulsively and uncontrollably seeks out a substance or action despite the consequences associated with it. It is possible to be addicted to anything that activates the pleasure center of the brain. Dopamine is released in the reward pathway and triggers the pleasure response. Normally, this rewards you for doing behaviors that are essential for survival, like eating or socializing. But in addiction, the substance or action overloads the reward pathway with dopamine and the person then attempts to have the same “high” as the first time they experienced it. Addictions can be physical, where the body has adapted to the drug existing in the body and tolerance is developed. Sometimes cues related to the substance, such as walking into a bar, increase the desire for it. Psychological dependence occurs when the search for a high is related to coping with stress or other negative emotions. Someone who is addicted, no matter what the addiction is, will have a number of characteristics associated with the addiction. They do not have control over their substance use. They likely take more of the substance than planned or for a longer period of time than intended. They may make multiple attempts at lowering their intake of the substance or quitting use altogether with no success. Addicts spend much of their time obtaining substances, taking them, and recovering from the effects. They may have physical symptoms of craving and withdrawal. Use typically interferes with family and other role obligations, though the addict will continue to use the substance despite these social or interpersonal conflicts. Addicts may only realize they have a problem when they hit “rock bottom”. Treatment takes into account the individual and the type of addiction itself. Individuals are encouraged to quit with the help of a medical professional. Alcohol, benzodiazepine, and opiate withdrawal can be deadly and should not be quit “cold turkey”. Relapse, even years after successful treatment, is still possible. The structures in the brain and new circuits created from the addiction remain even after use is stopped. Recovery is completely attainable and maintainable with consistent treatment.