Whether it involves abuse of alcohol or drugs (prescription or illegal), addiction can be a scary problem to face. It can also be complicated; symptoms of addiction vary widely from person to person, and determining the right treatment plan can be tough.
Addiction: Diagnosis of Substance Abuse
The common term "addiction" isn't entirely accurate. Most medical professionals diagnose patients who misuse substances with either "substance abuse" or "substance dependence," said Steven Shoptaw, PhD, a professor in family medicine and psychiatry at the David Geffen School of Medicine at the University of California, Los Angeles.
"Abuse would be a milder form of the disorder than substance dependence," Dr. Shoptaw said. To be medically classified as a substance abuser, patients must exhibit a recurrent pattern of substance use and meet at least one of the following criteria within a 12-month period:
Along with these criteria, the patient must also experience "clinical distress" over one or more of the above situations. A person who drives drunk once may not medically qualify as a substance abuser. "You don't get diagnosed by one bad thing that happens to you," Shoptaw said. "It needs to happen recurrently and cause distress."
Addiction: Diagnosis of Substance Dependence
Substance dependence is a more severe form of addiction. A patient must have a recurring pattern of substance use over a year's time and meet three of the seven following criteria:
Addiction: Effects on the Brain
A person's brain will change with repeated misuse of alcohol or drugs. Sometimes, the brain's dopamine transmitters, special nerves that send feelings of pleasure to the brain, stop working as well. This may leave the person feeling depressed when they stop using the substance, Shoptaw noted.
"I like to describe it as a cloudy day where the clouds won't lift," Shoptaw said. "It's common to people in recovery."
The brain's gray matter volume, which consists of valuable nerve tissue, may also be reduced. Additionally, damage can occur to the hippocampal region of the brain, affecting critical functions like short-term memory.
Some of these problems can persist for years after the patient has stopped misusing alcohol or drugs. "The whole process of recovery is not like a skinned elbow. The damaged brain recovers at a much slower rate [than other parts of the body]," noted Shoptaw.
Addiction: The Need for Treatment
While drug and alcohol dependence are lifelong disorders, Shoptaw said they can be managed by an effective treatment program. A good place to start is a 12-step program, such as Alcoholics Anonymous or Narcotics Anonymous. These programs, which consist of people with substance abuse or dependence helping others with the same problem, can work for many. "For every patient I see, that's the place I recommend they start," Shoptaw advised.
Other treatment methods can include:
Understandably, the loved ones of substance users may want to try an "intervention," an activity where friends and family members confront the user and strongly encourage medical treatment. Shoptaw, however, is skeptical about the efficacy of this method.
"For some people, it works," Shoptaw noted. "But for the person who says 'I'm outta here' that's a new situation you then have to deal with. It might have been easier to get them into the treatment process without the intervention."
If you or a loved one has a problem with substance abuse or substance dependence, it's important to understand that you are not alone and that there are worthwhile treatments available. Don't wait to talk with your doctor about resources that can help.