Drug and alcohol addiction can be defined as use of alcohol or another drug/substance that is out of the individual’s control. An addict continues to use the substance despite having negative consequences from using the substance. Drug and alcohol addiction cause changes in the brain; these changes are often characterized as a brain disorder or a mental illness.
Alcohol and drug dependence is a different, but related, concept. Not everyone who has an addiction develops dependence on the substance they’re addicted to. Dependence is one condition that can come about as part of an addiction, in response to the repeated use of the substance. Not every addictive substance causes dependence.
Dependence is a health condition in which a person who has repeatedly used a substance over a period of time adapts to that substance. The body’s reaction when the person is no longer using the substance is to experience withdrawal symptoms.
Withdrawal symptoms fall into two general categories: physical and psychological. A person who experiences psychological withdrawal symptoms is said to have a psychological dependence on the drug/substance.
Psychological dependence on a substance causes withdrawal symptoms that are related to emotion and motivation. For example, a person who goes through a period of alcohol abuse and becomes addicted to alcohol, then goes through a detox period of not drinking alcohol, might then experience emotional and motivational withdrawal symptoms.
Withdrawal symptoms of psychological dependence might include:
• Decreased ability to feel pleasure (anhedonia)
• Low mood (dysphoria)
• Sense of dissatisfaction or unease
When a person uses alcohol and other drugs, the substance activates nerve cells (neurons) in the brain. Our brains use these cells to send and receive chemical messages. Alcohol and drugs mimic the effects of naturally occurring chemicals in the brain, particularly a natural chemical substance called dopamine.
Dopamine in the brain is responsible for positive feelings we have for things that are naturally rewarding, such as eating and making love. When someone uses alcohol or a drug over time, the drug mimics the effect of dopamine so well that the brain makes less and less natural dopamine. This low level of dopamine is what causes the mood-related symptoms of alcohol and drug withdrawal.
This effect may be even more pronounced in people who have psychological health issues before and during drug and alcohol abuse. A person suffering from major depression, for example, is thought to have naturally lower-than-average levels of dopamine in their brain. When the person stops using the addictive substance, the symptoms of their depression might be even more severe. Mental health disorders can complicate a person’s treatment options for substance abuse.
Some believe that marijuana is not addictive and/or does not cause dependence, but studies have shown that marijuana dependence and addiction are possible. Marijuana users have reported withdrawal symptoms that include:
• Decreased appetite
• Mood disturbances
• Physical discomfort
• Sleep disturbances
Withdrawal symptoms last for approximately two weeks after the last use of the drug. The more marijuana a person uses, the more likely they are to experience withdrawal symptoms when they go through a detox period. It’s thought that about nine percent of marijuana users overall are physically or psychologically dependent on the drug. Of those who started using marijuana as teenagers, about 17 percent are thought to be substance dependent.
Using tobacco products can lead to physical and psychological dependence on nicotine, the main psychoactive substance found in the tobacco plant. Withdrawal from using tobacco products can cause psychological withdrawal symptoms that include anxiety and irritability.
Like other chronic conditions that affect the brain, substance dependence can’t necessarily be cured, but it can be treated successfully. Each person with an addiction is unique, so treatment options vary according to factors such as the person’s mental health history, medical history, and social issues. For many, a combination of behavioral therapy (which may or may not include taking part in a rehab program) and medication helps them successfully treat substance dependence.
Some medications that are sometimes prescribed to help with substance withdrawal include these:
• Acamprosate (alcohol/drug addiction)
• Buprenorphine (opioid addiction)
• Bupropion (tobacco addiction)
• Disulfiram (alcohol/drug addiction)
• Methadone (opioid addiction)
• Naltrexone (alcohol/drug/opioid addiction)
• Varenicline (tobacco addiction)
In general, people who undergo a combination of medication therapy and behavioral therapy have better recovery rates than people who only undergo medication therapy. In behavioral therapy programs, patients learn to identify stressors and triggers in their lives that may have led them to use alcohol and drugs. They learn new, alternative behaviors to substance use and new attitudes and approaches toward stress.
An inpatient or outpatient rehab or substance abuse treatment program can be an important part of a successful recovery strategy. This is true whether the dependence is caused by alcohol, illicit or “street” drugs, misuse of prescription drugs, or nicotine. Tobacco users who undergo some form of counseling are more likely to quit successfully than those who use only medication to help them recover from dependence.
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