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What is an addiction?

Addiction is a condition that results when a person ingests a substance (e.g., alcohol, cocaine, nicotine) or engages in an activity (e.g., gambling, sex, shopping) that can be pleasurable but the continued use/act of which becomes compulsive and interferes with ordinary life responsibilities such as work, relationships, or health. Users may not be aware that their behavior is out of control and causing problems for themselves and others.
People with an addiction do not have control over what they are doing, taking or using. Their addiction may reach a point at which it is harmful. Addictions do not only include physical things we consume, such as drugs or alcohol, but may include virtually anything. In other words, addiction may refer to a substance dependence (e.g. drug addiction) or behavioral addiction (e.g. gambling addiction). Knowing that one has an addiction and the inability to take control of self can lead to feelings of guilt, shame, hopelessness, despair, failure, rejection, anxiety and/or humiliation which may lead to further isolation.

How can I determine if myself, a friend, or family member has an alcohol or drug addiction?

Drug addiction and/or alcoholism progresses from problem substance use to developing a chemical dependency. Complete the following questionnaire to assist in determining if you, a friend or family member may have developed a chemical dependency to alcohol and/or drugs.

  • Has anyone ever suggested you quit or cut back on your drug/alcohol use?
  • Has drinking or using affected your reputation?
  • Have you made promises to control your drinking or using and then broken them?
  • Have you ever switched to different drinks or drugs or changed your using pattern in an effort to control or reduce your consumption?
  • Have you ever gotten into financial, legal, or marital difficulties due to using?
  • Have you ever lost time from work because of using or drinking?
  • Have you ever sneaked or hidden your use?
  • On occasion, do you feel uncomfortable if alcohol or your drug of choice is not available?
  • Do you continue drinking or using when friends or family suggest you have had enough?
  • Have you ever felt guilty or ashamed about your drinking or using or what you did while under the influence?
  • Has your efficiency decreased as a result of your drinking or using?
  • When using or drinking, do you neglect to eat properly?
  • Do you use or drink alone?
  • Do you use or drink more than usual when under pressure, angry, or depressed?
  • Do you continually have to increase alcohol/drug intake to achieve the same effect?
  • Have you lost interest in other activities or noticed a decrease in your ambition as a result of your drinking or using?
  • Have you had the shakes or tremors following heavy drinking?
  • Do you want to drink or use at a particular time each day?
  • Do you go on and off the wagon?
  • Is drinking or using jeopardizing your job?

If you answer “yes” to one or more of the above questions, you may have a problem with alcohol or drug use.

What to look for - signs and symptoms:

WARNING SIGNS
The use and abuse of alcohol and drugs are serious issues that should not be ignored or minimized and we should not sit back and hope they just go away. If left untreated, use and abuse can develop into drug dependence or alcoholism. As a result, it is important to recognize the signs and symptoms of alcohol and drug abuse early. If you’re worried that your spouse, son, daughter or a friend might be abusing alcohol or drugs, here are some of the warning signs to look for:

  1. Physical and health warning signs of drug abuse
    • Eyes that are bloodshot or pupils that are smaller or larger than normal.
    • Frequent nosebleeds could be related to snorted drugs (meth or cocaine)
    • Changes in appetite or sleep patterns. Sudden weight loss or weight gain.
    • Seizures without a history of epilepsy
    • Deterioration in personal grooming or physical appearance.
    • Impaired coordination, injuries/accidents/bruises that they won’t or can’t tell you about- they don’t know how they got hurt
    • Unusual smells on breath, body, or clothing.
    • Shakes, tremors, incoherent or slurred speech, impaired or unstable coordination.
  2. Behavioral signs of alcohol or drug abuse
    • Skipping class, declining grades, getting in trouble at school
    • Drop in attendance and performance at work- loss of interest in extracurricular activities, hobbies, sports or exercise- decreased motivation
    • Complaints from co-workers, supervisors, teachers or classmates
    • Missing money, valuables, prescription or prescription drugs, borrowing and stealing money
    • Acting isolated, silent, withdrawn, engaging in secretive or suspicious behaviors
    • Clashes with family values and beliefs
    • Preoccupation with alcohol and drug-related lifestyle in music, clothing and posters
    • Demanding more privacy, locking doors and avoiding eye contact
    • Sudden change in relationships, friends, favorite hangouts, and hobbies.
    • Frequently getting into trouble (arguments, fights, accidents, illegal activities)
    • Using incense, perfume, air freshener to hide smell of smoke or drugs
    • Using eye-drops to mask bloodshot eyes and dilated pupils
  3. Psychological warning signs of alcohol or drug abuse
    • Unexplained, confusing change in personality and/or attitude.
    • Sudden mood changes, irritability, angry outbursts or laughing at nothing.
    • Periods of unusual hyperactivity or agitation.
    • Lack of motivation; inability to focus, appears lethargic or “spaced out.”

Common Signs and Symptoms of Alcohol Abuse include:
Alcohol abuse is a pattern of drinking that results in harm to one’s health, interpersonal relationships, or ability to work including:

  • Repeatedly Neglecting Responsibilities: Because of drinking, repeatedly neglecting responsibilities at home, work, or school. For example, neglecting the children, performing poorly at work, poor or failing grades in school, or skipping out on work, school, personal or social commitments because you’re hung over.
  • Alcohol Use in Dangerous Situations: The use of alcohol in situations where it can be physically dangerous, such as drinking and driving, drinking in a bad neighborhood, mixing alcohol with prescription medication against the advice of your doctor or operating machinery while drinking.
  • Legal Problems Due to Drinking: If, due to drinking, you are experiencing repeated legal problems. For example, getting arrested for fights, drunk and disorderly conduct, domestic disputes, driving under the influence.
  • Continued Drinking Despite Relationship Problems: Alcohol is causing or making problems worse in your relationships with your friends, family or spouse, and you continue to drink. For example, fighting with your family because they don’t like how you act when you drink or going out and drinking with your buddies even though you know your wife will be very upset.
  • Drinking to De-Stress: Many drinking problems start when people use alcohol to relieve stress. Because alcohol is a sedative drug, over time, you will need more alcohol to have the same effect. Getting drunk after a very stressful day more often, for example, or reaching for a bottle after you have an argument with boss, a friend or your spouse more frequently.

How effective is drug addiction treatment?

In addition to stopping drug abuse, the goal of treatment is to return people to productive functioning in the family, workplace, and community. According to research that tracks individuals in treatment over extended periods, most people who get into and remain in treatment stop using drugs, decrease their criminal activity, and improve their occupational, social, and psychological functioning. For example, methadone treatment has been shown to increase participation in behavioral therapy and decrease both drug use and criminal behavior. However, individual treatment outcomes depend on the extent and nature of the patient’s problems, the appropriateness of treatment and related services used to address those problems, and the quality of interaction between the patient and his or her treatment providers.

How long does drug addiction treatment usually last?

Individuals progress through drug addiction treatment at various rates, so there is no predetermined length of treatment. However, research has shown unequivocally that good outcomes are contingent on adequate treatment length. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive outcomes.
Good outcomes are contingent on adequate treatment length.
Treatment dropout is one of the major problems encountered by treatment programs; therefore, motivational techniques that can keep patients engaged will also improve outcomes. By viewing addiction as a chronic disease and offering continuing care and monitoring, programs can succeed, but this will often require multiple episodes of treatment and readily readmitting patients that have relapsed.

Where can family members go for information on treatment options?

Trying to locate appropriate treatment for a loved one, especially finding a program tailored to an individual's particular needs, can be a difficult process. However, there are some resources to help with this process. For example, NIDA’s handbook Seeking Drug Abuse Treatment: Know What to Ask offers guidance in finding the right treatment program.

How can the workplace play a role in substance abuse treatment?

Many workplaces sponsor Employee Assistance Programs (EAPs) that offer short-term counseling and/or assistance in linking employees with drug or alcohol problems to local treatment resources, including peer support/recovery groups. In addition, therapeutic work environments that provide employment for drug-abusing individuals who can demonstrate abstinence have been shown not only to promote a continued drug-free lifestyle but also to improve job skills, punctuality, and other behaviors necessary for active employment throughout life. Urine testing facilities, trained personnel, and workplace monitors are needed to implement this type of treatment.

What role can the criminal justice system play in addressing drug addiction?

It is estimated that about one-half of State and Federal prisoners abuse or are addicted to drugs, but relatively few receive treatment while incarcerated. Initiating drug abuse treatment in prison and continuing it upon release is vital to both individual recovery and to public health and safety. Various studies have shown that combining prison- and community-based treatment for addicted offenders reduces the risk of both recidivism to drug-related criminal behavior and relapse to drug use—which, in turn, nets huge savings in societal costs. A 2009 study in Baltimore, Maryland, for example, found that opioid-addicted prisoners who started methadone treatment (along with counseling) in prison and then continued it after release had better outcomes (reduced drug use and criminal activity) than those who only received counseling while in prison or those who only started methadone treatment after their release.

Where do 12-step or self-help programs fit into drug addiction treatment?

Self-help groups can complement and extend the effects of professional treatment. The most prominent self-help groups are those affiliated with Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Cocaine Anonymous (CA), all of which are based on the 12-step model. Most drug addiction treatment programs encourage patients to participate in self-help group therapy during and after formal treatment. These groups can be particularly helpful during recovery, offering an added layer of community-level social support to help people achieve and maintain abstinence and other healthy lifestyle behaviors over the course of a lifetime.

Can exercise play a role in the treatment process?

Yes. Exercise is increasingly becoming a component of many treatment programs and has proven effective, when combined with cognitive-behavioral therapy, at helping people quit smoking. Exercise may exert beneficial effects by addressing psychosocial and physiological needs that nicotine replacement alone does not, by reducing negative feelings and stress, and by helping prevent weight gain following cessation. Research to determine if and how exercise programs can play a similar role in the treatment of other forms of drug abuse is under way.