What is Drug Addiction?
“I can stop anytime I want to.” It’s a familiar refrain from people who are addicted to drugs. These addicts are, in many cases, not trying to be difficult or obstinate. They may truly believe that they are not addicted to drugs at all, and this belief can be very difficult to overcome. Even if an addicted person enters and completes a detoxification program, that belief may not disappear. The person may believe that only one hit won’t do any harm, and suddenly, the addict is using regularly once more.
Drug addiction causes significant and persistent changes in the way the addict’s brain functions. Some addicts develop an inability to produce certain types of neurotransmitters, and this makes them less likely to think clearly and make rational decisions. Other addicts develop an inability to produce their own feel-good brain chemicals. They may experience crushing depression as a result, and that depression may seem to have no end. Depressed people are often unable to make clear decisions as well.
Combating an addiction means addressing these chemical imbalances, and the behaviors that support them, and this often means that the addicted person must enroll in a targeted, lengthy treatment program.
The idea that people are not getting the help they need is borne out by research. According to an article published by the National Institute on Drug Abuse, in 2007, 20.8 million people older than 12 in the United States needed help for a drug or alcohol abuse problem but did not receive that help. The Substance Abuse and Mental Health Services Association (SAMSHA) says that those who do receive addiction help tend to have a low educational status. Those who received treatment in 2009 were less likely to have graduated high school than those who did not receive treatment. SAMSHA speculates that people with these low educational levels may be more motivated to receive care because their addiction makes it even more difficult for them to find jobs. Competition for the jobs within this educational bracket can be fierce, and addiction might get in the way of landing a job.
This doesn’t mean, however, that people who struggle with drug addiction and have high-paying jobs don’t need addiction help. Drug abuse can impact anyone, at any income level, and the damage it causes can be much the same between economic groups. But it might mean that people in higher income brackets might need more pressure from families and friends in order to get help.
Tenets of Rehabilitation Programs
Drug rehabilitation programs can vary widely, depending on the needs of the addict and the amount of therapy that is required to address the addiction.
Most programs, however, tend to stick to a few fundamental principles:
- Therapies attack the problem on many fronts, from chemical imbalances to behaviors that support addiction to family relationships that drive the addict to use.
- Programs are tailored to meet the needs of the addict, since a one-size-fits-all approach is rarely effective in treating addiction.
- Therapies are provided over an extended period of time, and the addict is encouraged to participate in the program for an adequate time period.
- The addict must be monitored throughout therapies, to ensure that the addict doesn’t return to use.
- The treatment plan is constantly updated, to meet the changing needs of the addict.
- Other health problems, such as HIV/AIDS, mental health issues and hepatitis, must also be addressed.
Programs that provide this sort of multi-faceted approach tend to provide the sort of care that can help an addict improve and transition into a sober lifestyle. Programs that provide only one or two of these aspects may be less successful.
The Role of Counseling
When a drug addict emerges from a detoxification program, that person technically has a clean system and he or she is ready to begin work on thoughts, behaviors and habits that can support or reduce drug abuse. Counseling is crucial to success in this fight.
Many addiction therapists use a form of counseling known as Cognitive Behavioral Therapy (CBT).
Here, the addict meets with the counselor on a one-on-one basis and they begin a conversation about the addiction. The addict might discuss family relationships or struggles with friends, and the therapist might provide gentle prodding to help the addict think of how these difficulties might contribute to addiction. The addict might also be encouraged to think about situations that encourage drug use. If the addict always uses drugs before going to a party, for example, the therapist might encourage the addict to think about other things he or she could do before that party that wouldn’t result in drug use. The idea here is to encourage the addict to think about his or her behavior, and then come up with strategies to change that behavior.
Some addicted people, including addicted teens, need more help to resolve family conflicts. These addicts might benefit from counseling sessions in which the entire family participates. The addict and the family, with the help of the therapist, come up with new methods of communicating with one another, and they resolve past hurts that might still be poisoning the relationship.
Unless both the addiction and the mental illness are addressed, neither problem tends to improve.
When people have a drug addiction issue and a mental illness, counseling becomes all the more critical. Mental illnesses and addiction can play off one another. People who are depressed, for example, might lean on drugs in order to ease their symptoms and when they stop taking drugs, they may find their depression has become more intense and harder to deal with. Studies have made this connection quite clear. A study published in the Archives of General Psychiatry looked at addiction recovery rates between people who had mental illness and people who did not. People with severe mental illness showed virtually no improvement, while people who did not have mental illness did improve.
People with a Dual Diagnosis may also need medications to help them adjust to a drug-free lifestyle. These drugs could help them deal with their mental health issues, allowing them to participate in counseling sessions more fully.
In these counseling sessions the addict might learn:
- More about his or her mental illness
- How addiction augments that mental illness
- Why mental illness medications work better than drugs
- How to deal with mental health flare-ups
Many addicts benefit from participating in support groups. Here, they have a chance to interact with other people who are recovering from a drug addiction and they can learn how other people manage the disease.
Narcotics Anonymous is the most instantly recognizable of these support groups. Here, the addict is asked to admit that addiction is overpowering, and the addict is asked to work through a series of steps to deal with the disease and move forward. Often, these programs require an addict to ask for help from a “higher power.” This aspect of the program can be appealing to some people, but others might find the quasi-religious nature of the language a bit disconcerting. According to an article published in the Community Mental Health Journal, people with a Dual Diagnosis might find traditional 12-step programs to be unhelpful.
There are other support group options available, including the SMART Recovery program.
In this program, addicts are encouraged to take ownership of their addiction and use CBT approaches to change their behaviors. According to SAMSHA, there are about 300 of these weekly meetings held worldwide.
The Role of Medications
Some people addicted to drugs simply cannot stop taking the drugs without feeling severe consequences. These people may benefit from medication management that can take place for months or even years after the addict has completed a detoxification program. For people who have been addicted to heroin, methadone is a commonly prescribed drug. Methadone is often given in liquid form, and the addict must go to a specific methadone clinic in order to receive the drug. Methadone at the proper dose doesn’t sedate the addict and it doesn’t provide a significant high. According to an article published in the Mount Sinai Journal of Medicine, methadone is given to block the intoxicating effects of heroin and suppress heroin cravings, and it is remarkably effective in helping heroin addicts return to a normal life.
Some addicts use a medication called buprenorphine instead. Like methadone, this drug can reduce cravings and block heroin intoxication, but it can be prescribed in pill format and people can take the drugs at home. This might help addicts who feel stigmatized if they walk into a methadone clinic.
Where Treatment Is Provided
Many addicts begin their treatment programs in residential facilities, where they receive around-the-clock care and access to counseling.
Residential facilities are intensive facilities, where an addict can receive targeted help and really focus on addiction without the distraction of work, friends and family. At Rehab International, we can refer you to facilities that offer these sorts of treatments, and we believe they offer significant help to people struggling with a long-term addiction issue.
Other addicts choose to enter outpatient programs, where they return for counseling on a regular basis and attend support group meetings in the community. These programs can also be quite successful in helping an addict move forward.