Addiction—dependence on a particular substance or activity—is one of the most important, difficult, and complex areas of mental health. Addiction can be difficult to treat, and there is a good deal of controversy surrounding the causes of addiction and the best approaches to treatment.
Drug and alcohol abuse or misuse—excessive or inappropriate use of a substance—can be difficult to define, and people’s opinions, values, and beliefs vary significantly on the topic. For some, any use of an illegal drug or any use of alcohol with the primary purpose of intoxication constitutes abuse. For others, abuse is indicated by recurring, negative consequences, such as:
Substance abuse can lead to substance dependence or addiction when both quantity and rate of use increase. People who experience drug or alcohol addiction feel unable to control the impulse to use, and they often experience withdrawal symptoms in the sudden absence of the substance. Alcoholism, for example, occurs when people become chemically dependent on alcohol, and those who are addicted may become ill if they suddenly stop drinking. People may also feel psychologically dependent on a substance and continue to use it, particularly under stressful circumstances or to alleviate other psychological problems. Some people are unaware or deny that they have a problem with addiction, and sometimes a person’s struggle with drug and alcohol abuse remains hidden from loved ones.
Signs of chemical dependence include:
There are a number of causes related to drug and alcohol abuse, including psychological, biological, social, and physiological reasons. A family history of substance abuse can make a person more vulnerable to addiction, and social factors, such as peer pressure and ease of availability can increase the likelihood of a person developing a problem with drugs or alcohol. In addition, once a person begins using heavily, physiological changes take place, and that person may then become physically dependent, requiring him or her to continually use the substance in order to avoid withdrawal symptoms.
Alcholism tends to run in families, although not all children of people addicted to alcohol become addicted themselves, and there is some debate among psychologists about the degree to which alcoholism is genetic. Some researchers are searching for an addiction or alcoholism gene, while others point out that simply witnessing a parent drink in response to stress increases a child’s likelihood of choosing to drink in response to stress.
Research indicates that the vast majority of people who are addicted to drugs or alcohol have an underlying mental health condition or significant emotional/psychological difficulty, and about half of people with mental health diagnoses will face challenges with drugs or alcohol at some point in their life, usually as a form of self-medication.
People who misuse drugs or alcohol often do so as a way of coping with experiences, memories, or events that emotionally overwhelm them. Whether they are equipped with appropriate coping strategies or not, people who misuse rely on the immediate gratification of the drugs and alcohol as an alternative to facing the issues at hand. In the long term, however, reliance on drugs and alcohol will almost surely worsen any emotional or psychological condition. Chronic self-medication may be a sign that therapy is warranted to address an underlying condition or difficulty.
Therapists who specialize in addiction recovery help people set achievable and empowering short-term goals. Once sobriety is achieved, healthy and adaptive skills can be developed, and the therapist and client can begin to explore the source of the addiction while employing the new coping strategies. Together, the client and therapist will work to set longer term goals that include rebuilding damaged relationships, accepting responsibility, and releasing guilt. A skilled therapist can help someone dependent on drugs or alcohol overcome their addiction and set them on the path of achieving the life they truly desire.
Several types of therapy are helpful in this process. In particular, cognitive-behavioral therapy and motivational interviewing therapy—a person-centered therapy that relies on a client’s inspiration to change—have demonstrated effectiveness in this arena. Sometimes therapy provides a supplemental form of support for someone who is attending a self-help group, such as Alcoholics Anonymous; in fact, some therapies are specifically geared toward facilitating 12-step programs.
People sometimes fear seeking help for drug addiction. Be advised that privacy and confidentiality in substance abuse treatment is mandated not only by professional ethical guidelines and, usually, state law (like all mental health treatment), but also by special federal laws.
Quitting the use of a chemical substance can be extremely difficult, and it can also be dangerous. Chronic users of alcohol and prescription drugs should not attempt to stop cold turkey without medical assistance. Many substances lead to physical sickness, temporary personality changes, loss of appetite, insomnia, nausea, mood swings, and other disturbances when quitting is attempted. Opiate withdrawal, for example, can be temporarily debilitating, but not fatal. Chronic alcohol abuse can cause a number of health conditions, including cirrhosis of the liver, heart and circulatory problems and premature death. Long-term alcohol abuse can also cause mental health problems and brain damage.
When a person’s dependence on drugs or alcohol is so severe that withdrawal symptoms may be life-threatening, an inpatient detoxification program in a hospital or treatment facility is essential for stabilizing the person. Medications may be used to help avoid potential withdrawal complications.
Fatal overdose is possible with many commonly abused drugs; in fact, pharmaceuticals such as opioid analgesics are the most common cause of drug overdose deaths. Marijuana is an exception, although misuse of marijuana is associated with a host of health issues, including diminished lung capacity, memory problems, and mood and cognition impairment, among others.
Last updated: 12-15-2014
Drug and Alcohol Addiction Articles