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Addiction — Substance Use Disorder

Substance Use Disorder (SUD), commonly known as addiction, refers to the habitual misuse of any substance, often including alcohol or narcotics, leading to a loss of self-control. Around 21 million individuals in the United States are struggling with addiction, including substances like alcohol, opioids, cannabis, and others. Despite the legality and accessibility of many addictive substances, the ramifications of addiction on health, interpersonal connections, and overall well-being are profound and enduring. Left unchecked, addiction can precipitate catastrophic outcomes.

Thankfully, addiction can be effectively addressed through evidence-based interventions. Several research-supported approaches exist to assist individuals overcome substance abuse and return to a state of wellness and productivity.

Key points

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Overview

Addiction manifests as an overwhelming and unmanageable compulsion to use substances or participate in detrimental behaviors, frequently surpassing what is considered healthful limits. Substance Use Disorder pertains specifically to the dependency on alcohol or drugs, marked by excessive and compulsive usage despite the detrimental outcomes.

Addiction frequently results in a lack of control over personal actions, persisting despite acknowledgment of harm to oneself or others. Normally, addiction ensnares individuals as they repeatedly pursue substances or behaviors, such as alcohol, illicit drugs, sexual activities, gambling, compulsive gaming, or excessive internet usage, for immediate gratification or to evade discomfort. Once established, this pattern becomes progressively challenging to break.

Sunset view over a rocky coastline with the ocean gently swirling around the stones, a scene that reflects the peaceful yet enduring transformations Dr. Mijin Kim fosters through her therapy.

The path toward addiction usually begins innocently, with initial exposure to the addictive substance or behavior happening in a casual and seemingly innocuous manner. Nevertheless, without intervention, what begins as an occasional use can swiftly evolve into an unyielding cycle of addiction. This advancement results in a condition where both physical and psychological control over the substance’s use or involvement in the activity is forfeited, leaving the addicted individual ensnared, often with grave repercussions.

Symptoms

Instead of outwardly observable cues, addiction manifests in its impact on an individual’s life. For instance, a significant marker of addiction involves demonstrating a profound absence of control and an enduring incapacity to cease the addictive conduct, despite recognizing the harm it inflicts upon oneself or others.

Another characteristic of addiction is the intense craving for the addictive substance, which emerges as the primary motivator behind one’s actions, frequently resulting in hazardous, reckless, or potentially unlawful conduct driven by the urge to acquire it. Furthermore, individuals commonly develop a heightened tolerance over time, necessitating larger quantities of the addictive substances to attain the same effects and, in numerous instances, to simply maintain a sense of normalcy.

Unfortunately, addiction has enduring repercussions on both your physical and mental well-being, your professional achievements, your capacity to foster healthy relationships, and your overall enjoyment of life. Despite recognizing these consequences and earnestly attempting to abstain, the withdrawal symptoms may prove intolerable, compelling you to revert to using the substance you earnestly desire to relinquish.

Causes

Addiction can stem from a multilayered interplay of genetic, psychological, environmental, and social influences. Frequently, addiction evolves as a behavioral mechanism to manage persistent stress, trauma, anxiety, and various adversities. Developing healthier coping skills typically constitutes a crucial aspect of the recovery process.

Risk factors

Explaining why one individual develops an addiction while another in similar circumstances does not is challenging. In practical terms, an individual devoid of any apparent risk factors for addiction can still become addicted, whereas another individual with multiple risk factors may not succumb to addiction.

This said, there are risk factors that increase your statistical likelihood of developing an addiction:

  • Biological/Genetic: Individuals with a family history of addiction are approximately twice as prone to developing an addiction themselves. In addition to environmental influences, frequently intertwined with addiction, recent research validates the existence of a genetic predisposition associated with a mutation in the COMT gene, responsible for regulating dopamine levels. This genetic variant renders certain individuals more susceptible than others to addiction development.
  • Age of exposure: The brain undergoes full development around the mid-twenties. Early exposure to addictive substances biologically heightens the probability of addiction development.
  • Trauma: Encounters with violence, prolonged periods of poverty, trauma, and significant stress significantly elevate the chances of developing an addiction.
  • Membership in a minority group: Belonging to the LGBTQI community or another marginalized or discriminated minority group.
  • Co-occurring mental health difficulties: Depression, anxiety, and bipolar disorder frequently coexist with addiction. Substance abuse typically worsens preexisting mental health issues, while mental illness tends to fuel substance abuse. The term “dual diagnosis” refers to the concurrent presence of both a mental health disorder and a substance use disorder (SUD).

Diagnosis

For diagnosing addiction, your healthcare provider typically conducts both physical and psychological assessments of your health, behavior, and lifestyle. You might receive a referral to a substance use clinic, addiction psychologist, or another mental health specialist with expertise in Substance Use Disorder.

Your healthcare provider might require a blood test or urine sample, which aids in diagnosing and managing any underlying health issues that may have emerged concurrently with or occasionally resulting from your substance use.

Treatment

Your healthcare provider will explore available options with you and offer recommendations tailored to your unique needs and situation. Treatment options may vary depending on the type and severity of your addiction, as well as your personal preferences. Treatment may include:
  • Rehabilitation in a residential community or at home in an Intensive Outpatient Program (IOP).
  • A sober living house can be a step between rehabilitation and full independence.
  • Cognitive Behavioral Therapy (CBT) or other talk therapies.
  • Referral to a peer addiction support group (Alcoholics Anonymous, Narcotics Anonymous, or other 12-step groups).
  • Medication.
    • Naltrexone, disulfiram, and acamprosate are medications often used to support recovery from alcohol abuse.
    • Buprenorphine, extended-release naltrexone, and lofexidine may be prescribed to support recovery from addictions to opioids. 

While acknowledging an addiction and seeking assistance may seem intimidating, it’s crucial to recognize that support services are accessible. You might discover it more manageable to involve a trusted friend or family member to accompany you to appointments, offering emotional and practical assistance when required. Remember, you don’t have to navigate this journey alone.

If you are ready to take charge of your addiction and begin your healing journey, reach out today – fill out the contact form below and click Send.

Related information and references

Chen, S., Yang, P., Chen, T., Su, H., Jiang, H., & Zhao, M. (2020). Risky decision-making in individuals with substance use disorder: A meta-analysis and meta-regression review. Psychopharmacology, 237, 1893 – 1908.

Lovallo, W. R., Cohoon, A. J., Sorocco, K. H., Vincent, A. S., Acheson, A., Hodgkinson, C. A., & Goldman, D. (2019). Early‐life adversity and blunted stress reactivity as predictors of alcohol and drug use in persons with COMT (rs4680) Val158Met genotypes. Alcoholism: Clinical and Experimental Research, 43(7), 1519-1527.

NIDA. 2022, March 22. Treatment and Recovery. Retrieved from https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery on February 16, 2023.