Addiction

Known as a lifelong disease, the word “addiction” can mean a variety of things to people suffering from it. To some, addiction may seem untreatable which can easily dissuade them from seeking treatment. To others, it may seem like a challenge, one that motivates the addict to beat their addiction. To all, however, addiction is a dangerous disease.

When treating drug addiction, every case is different. Knowing the different treatment options, side effects, withdrawal effects, and anything else relating to addiction treatment can play a huge role in whether or not someone who suffers from drug addiction can achieve sobriety.

Drug addiction is defined as a chronic brain disease involving compulsive drug use despite the negative drawbacks. While the definition does give some insight into how to treat addiction, the first step in fully understanding how to treat addiction is knowing what the causes of addiction are. Similar to a garden weed, addiction can become a nasty problem if you do not trace it back to its roots and target the source of the problem.

Causes of Addiction

Although it may sound like a simple question, ask yourself, “Why do people do drugs when they are so obviously bad for you?” It is not a trick question, don’t worry, and the answer is surprisingly just as simple: pleasure. Pleasure is everyone’s motivation, and the pursuit of happiness is pretty much how we manage our everyday lives. We surround ourselves with things that make us happy, and we avoid things that make us unhappy.

Happiness is caused by dopamine being released to the brain, rewarding the person with feelings of happiness. The brain begins to train you to seek out the dopamine-rewarding activities in the future. 

Think of it as a puppy learning new tricks. You say sit, he sits, and you give him a treat. The puppy associates sitting with rewards, and thus sits every time he wants to be rewarded. Your brain associates a certain activity or substance with happiness, and every time you want to feel happy, your brain encourages you to do the same activity or substance as you did before. This is known in psychology as classical conditioning.

In the case of drug addiction, that “certain substance” is replaced with drugs. In a normal-functioning brain, the surge of dopamine is reabsorbed and dopamine levels return to normal. However, in the case of drug use, the chemical functionality of the entire brain is changed and reprogrammed.

The dopamine reabsorption is blocked and the euphoric and pleasurable sensations are extremely powerful and long-term as a result. Because of this, once enjoyable activities become dull and boring in comparison to the substance. This drives people to keep abusing drugs until it slowly turns into an addiction. It is an addiction when the brain becomes so hooked on the drug that not taking it

causes severe discomfort, and the person starts to lose control over intake and the means to obtain the drug.

Knowing how addiction works is a very useful tool when it comes to treating addiction. However, you still do not know the specific roots of addiction. What causes someone to start taking drugs as opposed to doing the “normal” things that would’ve made them happy before? There are many factors that may contribute to the development of drug addiction, and addiction vulnerability differs from person to person. The two main factors that contribute to the development of an addiction are environmental factors and biological factors.

Environmental Factors

Depending on someone’s environment, the risk of drug use and addiction can vary from very little to almost guaranteed. Environmental factors refer to the different outside forces that the user is exposed to that may influence his or her risk of addiction.

Home and family, for example, are two of the main environmental factors that can greatly increase or decrease the probability of drug addiction. For instance, studies have shown that people exposed to drugs or alcohol at a young age, such as having an alcoholic parent or an addicted family member, are at a significantly higher risk of developing an addiction.

Other environmental factors worth considering are school/work and the people that someone at risk for addiction surrounds themselves with. During adolescence and adulthood both, people are easily influenced by those around them through peer pressure. Failure at work or school, as well as lack of a friend group, can also put a child at risk for addiction, so it is important to stay vigilant in looking out for early signs.

Biological Factors

While not tested or applied to every single type of addiction, biological models of addiction are currently being studied and can be applied to some addictions. These models suggest that genetics and brain development/functionality play a large role in determining whether or not someone becomes addicted.

While there are no specific genes that directly cause someone to be addicted, there are some that contribute to the likelihood of addiction occurring. For example, when it comes to alcohol addiction development, there are genes that we do know of that can negate the effects of a hangover whilst also boosting the effects of alcohol. For obvious reasons, these genes can contribute largely to whether or not someone can become addicted.

Risk Factors

To be a cause of addiction, a factor must be directly influencing whether or not addiction can take root. Risk factors are not direct causes of addiction, but more direct correlations. For example, someone’s country of birth may be a risk factor when it comes to addiction, but it is not a cause.

When it actually does come to the development drug addiction, there are a few risk factors that are worth considering:

Mental Health Disorders

Depression, ADHD/ADD, PTSD, and many other mental health disorders are very strong influences when it comes to the likelihood of developing an addiction.

The Addictiveness of the Drug

Drugs like stimulants, opioids, sedatives, barbiturates, and benzodiazepines are very addictive, and even though addiction is not guaranteed, the type of drug plays just as strong a role as genetics. Others, such as inhalants and over-the-counter drugs may be less addictive but no less dangerous.

Lack of Family Interaction

Difficulty in communication with your family or the lack of family bonding can increase the risk of addiction, as well as lack of parental supervision.

Signs of Addiction

Here at Maryland House Detox, we again treat every addiction as a separate and unique case, and rightfully so. Although some drugs can share similar signs of addiction in a person, every case is different, and believing otherwise can be very dangerous. Because there are so many drugs, and all are different, we cannot fit every single addiction sign for every single drug on this page. However, the most common are as follows: alcohol, stimulants, sedatives, depressants, and opioids.

Signs of Alcohol Addiction

The signs of a possible addiction to alcohol range from physical to behavioral symptoms. Fortunately, this makes early detection of addiction much easier, though the symptoms may not be clear at first. The physical symptoms of alcohol addiction are:

• Nausea
• Vomiting
• Dizziness
• Sweating
• Blackouts
• Slurred speech or problems with coordination

The harder-to-spot psychological symptoms of alcohol addiction are:

• Anxiety
• Depression
• Agitation or over-aggressive behaviors
• Loss of interest in previously entertaining activities

Signs of Stimulant Addiction

The signs of a possible addiction to stimulants range from physical to behavioral symptoms, but the physical effects of long-term abuse are much different than the long-term effects of alcohol abuse. The physical symptoms of stimulant addiction are:

• Extreme exhaustion and fatigue
• Severe weight loss
• Short, shallow breathing
• Stroke
• Headache
• Seizure/loss of muscle control

The psychological symptoms of stimulant addiction are:

• Paranoia
• Delusions
• Severe anxiety
• Depression
• Suicidal thoughts

Signs of Depressant Addiction

The signs of a possible addiction to depressants (or sedatives) range from physical to behavioral symptoms and are noticeable by their sedative qualities. The physical symptoms of depressant addiction are:

• Incoordination
• Dizziness
• Shallow breathing
• Drowsiness

The psychological symptoms of depressant addiction include:

• Low attention span/difficulty concentrating
• Poor decision making
• Memory loss

The memory loss aspect of psychological depressant addiction is in reference to the addict doing actions that they will not remember later on. It is almost identical to sleepwalking in the way that the user will randomly become conscious in the middle or after a bizarre action.

Signs of Opioid Addiction

With the ongoing opioid epidemic, opioid abuse and addiction cases are becoming much more common. The signs of an addiction to opioids range from physical to behavioral symptoms, and knowing what the symptoms are can easily aid in the early detection of addiction. The physical symptoms of depressant addiction are:

• Weakened immune system
• Gastric problems (ranging in severity from constipation to bowel perforation)
• Shallow breathing
• Liver damage (prevalent in cases that combine opioids with acetaminophen)

The psychological signs of opioid addiction are:

• Mood swings
• Depression
• Anxiety
• Irritability
• Social isolation
• Restlessness

Addiction Treatment

The point of drug treatment is to help someone who may be suffering from addiction stop compulsive intake of a drug and to prevent future relapses, which is vital to successful treatment and lasting sobriety. As the National Institute on Drug Abuse states in a comprehensive research-based guide:

“Because drug addiction is typically a chronic disorder characterized by occasional relapses, a short-term, one-time treatment is usually not sufficient. For many, treatment is a long-term process that involves multiple interventions and regular monitoring.”

While all cases of addiction are viewed as unique, drug addiction treatment generally follows a certain path: medical detoxification, a treatment program (outpatient, inpatient, residential), and then aftercare.

Medical Detox

The point of medical detoxification is to eliminate any leftover residue or toxins in the body from prior substance abuse. Usually lasting between five and seven days, the medical detox phase of addiction treatment is the initial paving stone set for your path to sobriety and consequently, it’s the most difficult.

As the first step in drug treatment, the success of someone’s addiction treatment depends largely on medical detoxification—or detox for short. While in detox, a patient will be under 24-7 medical supervision and care to combat the withdrawal symptoms that will more than likely occur while detoxing off of a substance.

Unfortunately, many people disregard or forget about the withdrawal symptoms and attempt to detox at home by themselves, usually in the form of “cold turkey” detox.

While it may sound quick and efficient on paper, quitting cold turkey is dangerous. In the cases of nearly all drugs that can be physically addictive, quitting cold turkey cannot just be uncomfortable, but even counterproductive. The sudden absence of a substance that someone is dependent on can result in severe withdrawal symptoms and is extremely unhealthy for the body.

Cold Turkey

To avoid going through the minor inconvenience of seeking professional detox at a recovery center, many people attempt an at-home method of self-detox in the form of “going cold turkey”. What the term cold turkey refers to is the immediate cessation of all intake of a certain substance in order to self-detox. This is not advised, as withdrawal symptoms can sometimes be deadly.

Outpatient Programs

Outpatient treatment programs are a form of substance abuse treatment that involved living off of facility grounds, while still participating in treatment activities. Outpatient treatment activities can vary from partial hospitalization and intensive outpatient programs (IOP) to 12-step, one-on-one, and group meetings.

Intensive Outpatient

Similar to inpatient treatment in the way that the patient is accommodated for and serviced, people that are enrolled in IOP generally meet three days a week for around three hours a day. Intensive outpatient programs are usually tailored to work and school to best accommodate the patient.

IOP treatment is most effective in treating people that suffer from addiction, but have a stable living environment at home and are in good physical health. Intensive outpatient programs are the first level of treatment after detox if you are not going into an inpatient program that requires you to live at the facility during your treatment.

If you have been using a dangerous substance such as an opioid or benzodiazepine for an extended period of time and in high doses, inpatient treatment is usually recommended before outpatient.

Partial Hospitalization

More suited towards those who require constant medical surveillance and care, partial hospitalization includes meeting at a treatment center a bit more often than IOP: three to five days a week, for at least four to six hours per day. Partial hospitalization, although meant for more severe addictions, is still meant for those that have a stable living condition at home. If not, one should consider potential inpatient treatment.

Inpatient Programs

Because it is defined as a step in drug treatment that requires the patient to stay overnight, detox technically can be defined as an inpatient program. However, use of the term “inpatient” very rarely pertains to detox and more applies to the post-detox, long-term treatment in which the patient will live on site for an extended period of time.

When talking about inpatient programs, there are two main types of treatment options. The first one is for less intensive addictions and is called residential treatment. The second, more intensive and urgent treatment option is called intensive inpatient treatment.

Residential Treatment

Residential treatment is a unique approach to treatment and is used to treat addictions in which the cause of addiction is more psychological than physical. For example, while it is commonly thought of as “fake”, marijuana addiction is very real. Although it is not a physically addictive drug, one can easily build a psychological dependence and addiction to it. In these cases, a less intensive approach to treatment would be optimal, such as outpatient or residential.

The level of care provided by residential treatment includes 24-hour

living support, with only around five hours of required clinical service per week. Due to the fact that residential treatment is meant for long-term psychological addictions, the residents in the program will explore the psychological aspects of their addictions such as the roots of addiction and the reasons why quitting may be so hard.

Intensive Inpatient Treatment

Similar to the 24-hour living support that is offered in residential treatment, intensive inpatient treatment offers 24-hour medical supervision and care but is more tailored towards severe addictions. With access to support groups and therapeutic sessions, a patient in an intensive inpatient program will live comfortably on site and be treated with the utmost care and precision.

Aftercare

Addiction does not simply stop as soon as treatment ends. Aftercare should immediately follow graduation from a treatment program. Aftercare generally follows shorter, intensive treatments such as partial hospitalization.

Relaxed and laid-back outpatient programs have been found to be very effective in relapse prevention, which is the main purpose of aftercare. After suffering from withdrawal symptoms, which are relatively common in drug addiction treatment, the chances of relapse skyrocket. If not treated properly, the long-term withdrawal symptoms from drug treatment can easily push someone to relapse.

Common Withdrawal Symptoms

Although every case is different, many of the withdrawal symptoms associated with drug addiction treatment are common between a significant amount of commonly-abused drugs.

These Symptoms can Include, But are Most Certainly Not Limited To:

• Anxiety
• Fatigue
• Sweating
• Vomiting
• Depression
• Nausea
• Seizures
• Hallucinations
• Change in appetite
• Insomnia

In the case of alcohol withdrawal, a series of severely amplified withdrawal symptoms called Delirium tremens (or DTs for short) manifest. DTs can be associated with involuntary shaking and shivering, irregular heart rate, sweating, vivid hallucinations, very high body temperatures, and seizures that can be ultimately fatal.

Withdrawal symptoms can easily cause discomfort and, even if they are not fatal, can quickly push a past-user to relapse. But what exactly is relapse and are withdrawals the only thing causing them?

Relapse

The first step in relapse prevention sounds quite obvious but is commonly overlooked: knowing what relapse actually is. To simplify its definition, relapse is when you use drugs again after a long period of abstinence. A common misconception is that relapse must involve becoming addicted again. However, a recovering addict may relapse in a short interval (known as a “slip”) or a binge that involves heavy use in a short amount of time.

Either way, relapse does not always lead back to full-blown addiction and someone who relapses can get back on the path to recovery. Many medical professionals refer to relapse not as a failure, but a chance to learn from past mistakes. Relapse sometimes even shows the user that the treatment may not be working as it should be.

The highest percentage rates of relapse occur in the first six months of treatment, accounting for roughly 66 percent to 80 percent of relapses. Because early detection plays such a crucial role in relapse 

prevention, it is imperative that a recovery patient devise a relapse prevention plan before treatment is completed.

Causes of Relapse

At Maryland House Detox, we understand that every case of addiction must be treated as a unique, individual case. When it comes to determining the cause of relapse, it would be wrong to say that all relapse cases are caused by the same things. For this reason, we came up with a list of common reasons for relapse, and while every case is different, many reasons for relapse derive from common factors:

• Mental or emotional health problems such as anxiety, depression, and any negative emotions are often high-risk triggers for relapse. In some cases, even boredom can push someone to begin using again.
• A factor that might trigger intense cravings that commonly leads to relapse is simply seeing or being around the substance that you went to treatment for. For example, if you went to addiction treatment for Alcohol Use Disorder, seeing alcohol is likely to bring cravings, in turn causing relapse.
• Although many reasons for relapsing have negative connotations, many positive situations can encourage relapse: more specifically celebratory events such as parties and concerts. Being exposed to a substance in such an adrenaline-filled event can easily bring unhealthy decisions, relapse being one of them. It is best to avoid these events altogether or to bring a trusted friend who can advise against your possibly relapse-inducing decision.

When it comes to avoiding relapse, seeking professional help when noticing the early signs and causes of relapse before it happens is crucial.