Addiction as a Disease: Those Who Suffer From It
Addiction as a Disease:
Those Who Suffer From It
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Addiction as a Disease
People feel pleasure when basic needs such as hunger, thirst & sex are satisfied. In most cases, these feelings of pleasure are caused by the release of certain chemicals in the brain. Most addictive substances cause the brain to release high levels of these same chemicals that are associated with pleasure or reward.
Over time, continued release of these chemicals causes changes in the brain systems involved in reward, motivation & memory. When these changes occur, a person may need the substance to feel normal. The individual may also experience intense desires or cravings for the addictive substance & will continue to use it despite the harmful or dangerous consequences.
The person will also prefer the drug to other healthy pleasures & may lose interest in normal life activities. In the most chronic form of the disease, addiction can cause a person to stop caring about their own or other’s well-being or survival.
These changes in the brain can remain for a long time, even after the person stops using substances. It is believed that these changes may leave those with addiction vulnerable to physical & environmental cues that they associate with substance use, also known as triggers, which can increase their risk of relapse.
Is Addiction a Chronic Disease?
A chronic disease is a long-lasting condition that can be controlled but not cured.
About 25-50% of people with a substance use problem appear to have a severe, chronic disorder. For them, addiction is a progressive, relapsing disease that requires intensive treatments & continuing aftercare, monitoring & family or peer support to manage their recovery.
The good news is that even the most severe, chronic form of the disorder can be manageable & reversible, usually with long term treatment & continued monitoring & support for recovery.
Why is Will Power Often Not Enough?
The initial & early decisions to use substances reflect a person’s free or conscious choice. However, once the brain has been changed by addiction, that choice or willpower becomes impaired. Perhaps the most defining symptom of addiction is a loss of control over substance use.
Are People with Addiction Responsible for Their Actions?
People with addiction shouldn’t be blamed for suffering from the disease. All people make choices about whether to use substances. However, people don’t choose how their brain & body respond to drugs & alcohol, which is why people with addiction can’t control their use while others can. People with addiction can still stop using – it’s just much harder than it is for someone who hasn’t become addicted.People with addiction are responsible for seeking treatment & maintaining recovery. Often they need the help & support of family, friends & peers to stay in treatment & increase their chances of survival & recovery.
Why Some People Say Addiction is Not a Disease
Some people think addiction can’t be a disease because it is caused by the individual’s choice to use drugs or alcohol. While the first use (or early stage use) may be by choice, once the brain has been changed by addiction, most experts believe that the person loses control of their behavior.Choice doesn’t determine whether something is a disease. Heart disease, diabetes & some forms of cancer involve personal choices like diet, exercise, sun exposure, etc. A disease is what happens in the body as a result of those choices.
Others argue that addiction isn’t a disease because some people with addiction get better without treatment. People with a mild substance use disorder may recover with little or no treatment. People with the most serious form of addiction usually need intensive treatment followed by lifelong management of the disease.
However, some people with severe addiction stop drinking or using drugs without treatment, usually after experiencing a serious family, social, occupational, physical, or spiritual crisis.
Others achieve sobriety by attending self-help (12-step or AA) meetings without receiving much, if any, professional treatment. Because we don’t understand why some people are able to stop on their own or through self-help meetings at certain points in their life, people with addiction should always seek treatment.
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The Disease Model of Addiction
Addiction is defined as a disease by most medical associations, including the American Medical Association & the American Society of Addiction Medicine.Like diabetes, cancer & heart disease, addiction is caused by a combination of behavioral, environmental & biological factors. Genetic risks factors account for about half of the likelihood that an individual will develop addiction.
Addiction involves changes in the functioning of the brain & body. These changes may be brought on by risky substance use or may pre-exist.
The consequences of untreated addiction often include other physical & mental health disorders that require medical attention. If left untreated over time, addiction becomes more severe, disabling & life threatening.
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Methamphetamine (Meth)
Excerpts
from:
Source: National Institute on Drug Abuse;
National Institutes of Health; U.S. Department of Health & Human Services.
Methamphetamine is a powerful drug. It acts by changing how the brain works. It also speeds up many functions in the body. Methamphetamine has a chemical structure that is similar to another drug called amphetamine. Methamphetamine can cause lots of harmful things, including inability to sleep, paranoia, aggressiveness, & hallucinations.
Methamphetamine
Changes the Brain
Usually neurons recycle dopamine.
But Methamphetamine is able to fool neurons into taking it up just like they
would dopamine. Once inside a neuron, Methamphetamine causes that neuron to
release lots of dopamine. All this dopamine causes the person to feel an extra
sense of pleasure that can last all day.
What
Happens If a Person Uses Methamphetamine for a Long Time?
But eventually these pleasurable
effects stop. They’re followed by unpleasant feelings called a
"crash" that often lead a person to use more of the drug. If a person
continues to use Methamphetamine, they’ll have a difficult time feeling
pleasure from anything. Imagine no longer enjoying your favorite food or an
afternoon with your friends.
Methamphetamine
Has Lots of Other Effects
Because it is similar to dopamine,
Methamphetamine can change the function of any neuron that contains dopamine.
And if this weren't enough, Methamphetamine can also affect neurons that
contain 2 other neurotransmitters called serotonin & norepinephrine. All of this means that Methamphetamine can
change how lots of things in the brain & the
body work.
Even small amounts of
Methamphetamine can cause a person to be more awake & active, lose their appetite, & become
irritable &
aggressive. Methamphetamine also causes a person's blood
pressure to increase &
their heart to beat faster.
What
Happens If a Person Uses Methamphetamine for a Long Time?
Scientists are using brain imaging
techniques, like positron emission tomography (called PET for short), to study
the brains of human Methamphetamine users. They have discovered that even 3
years after long-time Methamphetamine users had quit using the drug, their dopamine
neurons were still damaged.
Scientists don't know yet whether
this damage is permanent, but this research shows that changes in the brain
from Methamphetamine use can last a long time. Research with animals has shown
that the drug Methamphetamine can also damage neurons that contain serotonin.
This damage also continues long after the drug use is stopped.
These changes in dopamine & serotonin neurons may explain some of the effects of
Methamphetamine. If a person uses Methamphetamine for a long time, they may
become paranoid. They may also hear & see
things that aren't there.
These are called hallucinations. Because
Methamphetamine causes big increases in blood pressure, someone using it for a
long time may also have permanent damage to blood vessels in the brain. This
can lead to strokes caused by bleeding in the brain.
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Opiods
Source: National
Institute on Drug Abuse; National Institutes of Health; U.S. Department of
Health & Human Services.
You
might not realize this, but if you have had a sports injury, dental work, or
surgery, it is possible your doctor gave you a pain reliever that was actually
an opioid medication. While opioids can be very effective at treating pain,
they can be very addictive & should only be used under a doctor’s careful
watch.
In
addition to opioids given to you by a doctor, there is another kind of opioid
you have probably heard about called heroin. Heroin is a very dangerous drug
that is usually used by injecting it directly into a vein with a needle.
The
chemical makeup of heroin is the same as that of pain relievers & both can
be very addictive & cause deadly opioid overdoses. In fact, 2.14 million
people ages 12 & older had an opioid use disorder in 2016, including
153,000 12- to 17-year-olds.1
Opioid Overdose Deaths
The
increase in opioid overdose deaths has resulted in a national crisis. After marijuana,
prescription drugs are the most commonly misused drugs in the country. Every
day, 115 Americans die from an opioid overdose.2
In 2016, the number of opioid overdose deaths, including prescription medicines
& heroin, was 5 times higher than it was in 1999.3
This caused the government to declare a public health emergency. People in
every community in every state have been affected by this crisis.
Brain Damage
Daily Life
Opioid
use can affect every area of your life. Using drugs, especially early in life,
can lead to poor grades, worse performance in sports, & bad relationships
with friends & family. Opioids also alter judgment which can cause you to
do risky things you wouldn’t ordinarily do, like having unprotected sex or
getting into a car crash because you drove while under the influence of
opioids.4–6
Addiction
Opioid
misuse can cause addiction. Opioids are among the most addictive drugs.
When addiction occurs, the body feels a strong need for the opioids. This is
like when you’re really hungry because you haven’t eaten in a long time. This
strong desire, together with a loss of control over the urges to take the drug,
is why some people continue to use opioids despite negative consequences.
What are the most commonly used opioids?
The
most commonly used prescription opioids are oxycodone (OxyContin®),
hydrocodone (Vicodin®), codeine, & morphine. Heroin is an
opioid, but it isn’t a medication. Fentanyl is a
powerful prescription pain reliever, but it is sometimes added to heroin by
drug dealers, causing doses so strong that people are dying from overdoses.
What are the health effects of opioids on the brain &
body?
In the short term, the release of
dopamine into your body can make some people feel really relaxed & happy. But it can also cause more harmful effects, like
extreme sleepiness, confusion, nausea, vomiting, & constipation.
Over time, opioids can lead to insomnia, muscle pain, heart infections,
pneumonia, &
addiction.
Heroin
Common
names for heroin include Big H, Horse, Hell Dust, & Smack.
What is the connection between opioids & heroin?
Heroin is a type of opioid. Prescription pain relievers & heroin are chemically similar & can produce similar effects.In some communities, heroin is cheaper & easier to get than prescription opioids. Because of this, people who are addicted to prescription opioids sometimes switch to using heroin instead. Four out of 5 new heroin users report misusing prescription opioids before trying heroin.8 You can overdose on both.
How many people use heroin?
What are the effects of heroin on the brain & body?
Long-term effects include insomnia, heart infections, liver & kidney disease, collapsed veins in people who inject heroin, depression, & addiction.
People
who inject drugs are at an increased risk of getting HIV or hepatitis C. Both
of these diseases are transmitted through blood & other bodily fluids. When
people share needles or other drug equipment, they can come in contact with
these fluids. HIV, & less often hepatitis C, are also spread through
unprotected sex, which drug use makes more likely.
I've heard about something called Fentanyl. What is that?
Are opioids addictive?
However, many people who take prescription opioids for pain become dependent, not addicted. Dependence means your body has gotten used to the drug, & it will hurt & feel uncomfortable if you suddenly stop. Patients using prescription opioids should ask their doctors how to safely stop using them.
A person can be dependent on a drug without being addicted. But sometimes dependence can lead to addiction, if you don’t make an effort to stop taking them.
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Inhalants
Although other substances that are
misused can be inhaled, the term inhalants refers to the
various substances that people typically take only by
inhaling. These substances include:
- solvents (liquids that become gas at room temperature)
- aerosol sprays
- gases
- nitrites (prescription medicines for chest pain)
Many inhalants have a strong smell. That's why they're called inhalants: Some people inhale the vapors on purpose.
Why would anyone do this? Because the chemicals in these vapors can change the way the brain works, & those changes can make people feel very happy for a short time. But inhalants can also do harm.
They
Don't Go Away When You Exhale
Inhalant vapors often contain more
than one chemical. Some leave the body quickly, but others are absorbed by
fatty tissues in the brain & nervous system.
They can stay there for a long time.
One of these fatty tissues is
myelin—a protective cover that surrounds many of the body's nerve cells
(neurons). Nerve cells in your brain & spinal
cord are sort of like "Command Central" for your body. They send & receive messages that control just about everything you
think & do.
If you picture nerve cells as your
body's electrical wiring, then think of myelin as the rubber insulation that
protects an electrical cord.
One problem with inhalant use over
the long term is that the chemicals can break down myelin. And if myelin breaks
down, nerve cells may not be able to transmit messages.
Beyond
the Brain
One reason scientists are so interested
in inhalants is that these chemicals affect the body in lots of ways. While
some effects are due to changes in the brain, others are direct actions on
other parts of the body, such as the circulatory system.
Did you know that some inhalants
directly increase the size of blood vessels, allowing more blood to flow
through? And some inhalants can make the heart beat faster. This can be a
serious problem, especially if someone inhales butane gas.
Butane, found in cigarette lighters & refills, makes the heart extra sensitive to a chemical that
carries messages from the nervous system to the heart. This chemical,
noradrenalin, tells the heart to beat faster when you're in a stressful
situation—like if something suddenly scares you.
If the heart becomes too sensitive
to noradrenalin, a normal jolt of it may cause the heart to temporarily lose
its rhythm &
stop pumping blood through the body. Some inhalant users die
this way. Inhalants can also cause death by suffocation. This occurs when the
inhaled fumes take the place of oxygen in the lungs & the brain. This is known as Sudden Sniffing Death.
Changes
in the Brain
Damage from long term use of
inhalants can slow or stop nerve cell activity in some parts of the brain.
This might happen in the frontal cortex,
the part of the brain that solves complex problems & plans ahead. Or if
inhalants get into the brain's cerebellum, which controls movement & coordination, they can make someone move slowly or clumsily.
Studies show that neurons in a part
of the brain called the hippocampus can also be damaged by inhalants. The
damage occurs because the cells don't get enough oxygen.
Since the hippocampus helps control
memory, someone who repeatedly uses inhalants may lose the ability to learn new
things, may not recognize familiar things, or may have a hard time keeping
track of simple conversations.
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Other Drugs
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Synthetic Cathinones ("Bath Salts")
Source: National Institute on Drug Abuse; National
Institutes of Health; U.S. Department of Health & Human Services.
Synthetic cathinones, more commonly known as "bath salts," are human-made stimulants chemically related to cathinone, a substance found in the khat plant. Khat is a shrub grown in East Africa & southern Arabia, where some people chew its leaves for their mild stimulant effects. Human-made versions of cathinone can be much stronger than the natural product &, in some cases, very dangerous.1
Synthetic
cathinones usually take the form of a white or brown crystal-like powder & are
sold in small plastic or foil packages labeled "not for human
consumption." They can be labeled as "bath salts," "plant
food," "jewelry cleaner," or "phone screen cleaner."
They’re introduced & reintroduced into the market in quick succession to dodge or hinder law enforcement efforts to address their manufacture & sale.
Synthetic cathinones are marketed as cheap substitutes for other stimulants such as methamphetamine & cocaine, & products sold as Molly (MDMA) often contain synthetic cathinones instead (see "Synthetic Cathinones and Molly").
People can buy synthetic cathinones online & in drug paraphernalia stores under a variety of brand names, which include:
- Bliss
- Cloud Nine
- Lunar Wave
- Vanilla Sky
- White Lightning
How do people use synthetic cathinones?
People typically swallow, snort, smoke, or inject synthetic cathinones.How do synthetic cathinones affect the brain?
Much is still unknown about how synthetic cathinones affect the human brain. Researchers do know that synthetic cathinones are chemically similar to drugs like amphetamines, cocaine, & MDMA.A study found that 3,4-methylenedioxypyrovalerone (MDPV), a common synthetic cathinone, affects the brain in a manner similar to cocaine, but is at least 10 times more powerful. MDPV is the most common synthetic cathinone found in the blood & urine of patients admitted to emergency departments after taking "bath salts."2
Synthetic cathinones can produce effects that include:
- paranoia—extreme & unreasonable distrust of others
- hallucinations—experiencing sensations & images that seem real but are not
- increased friendliness
- increased sex drive
- panic attacks
- excited delirium—extreme agitation & violent behavior
What are other health effects of synthetic cathinones?
Raised heart rate, blood pressure, & chest pain are some other health effects of synthetic cathinones. People who experience delirium often suffer from dehydration, breakdown of skeletal muscle tissue, & kidney failure.
The
worst outcomes are associated with snorting or needle injection. Intoxication
from synthetic cathinones has resulted in death.
Yes, synthetic cathinones can be addictive. Animal studies show that rats will compulsively self-administer synthetic cathinones. Human users have reported that the drugs trigger intense, uncontrollable urges to use the drug again. Taking synthetic cathinones can cause strong withdrawal symptoms that include:
- depression
- anxiety
- tremors
- problems sleeping
- paranoia
"Flakka" (alpha-PVP)
https://www.drugabuse.gov/drugs-abuse/other-drugsUse of a dangerous synthetic cathinone drug called alpha-pyrrolidinopentiophenone (alpha-PVP), popularly known as "Flakka," is surging in Florida & is also being reported in other parts of the country, according to news reports.
Alpha-PVP
is chemically similar to other synthetic cathinone drugs popularly called
"bath salts," & takes the form of a white or pink, foul-smelling
crystal that can be eaten, snorted, injected, or vaporized in an e-cigarette or
similar device. Vaporizing, which sends the drug very quickly into the
bloodstream, may make it particularly easy to overdose.
Like
other drugs of this type, alpha-PVP can cause a condition called "excited
delirium" that involves hyperstimulation, paranoia, & hallucinations
that can lead to violent aggression & self-injury. The drug has been linked
to deaths by suicide as well as heart attack. It can also dangerously raise
body temperature & lead to kidney damage or kidney failure.
___________________________
Substance Abuse & Mental Health Services Administration (SAMHSA)
You
can find treatment programs through findtreatment.samhsa.gov
provided by the SAMHSA. Also, you can call the SAMHSA Treatment Referral
hotline at 1-800-662-HELP. Treatment can help you, a friend, or someone you
love get back to the person you or they once were.
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