Over 20 million Americans have at least one addiction. It is so common that almost everyone is either struggling with addiction or knows someone who is struggling with addiction. Yet in spite of addiction being so widespread, it is still treated as taboo and misinformation is rife.
The most common misconception is that addiction is a character flaw, rather than an illness like any other. People struggling with addiction are scared to talk about it and feel too much shame to ask for help. This leads to the troubling reality that only 10% of addicts receive treatment for it.
If we are to help ourselves and others beat addiction, it is important to clarify exactly what addiction is, who can become addicted to substances, and how we can treat it.
What is addiction?
Addiction refers to dependence on a substance or behavior. This dependence may be physical, emotional or, most often, both. Addiction occurs when a person experiences urges to use the substance or behavior that make it difficult or impossible to function normally on a day-to-day basis.
Most importantly, addiction is a mental illness. Contrary to the anachronistic belief, addiction is not simply a lack of willpower. You can’t “just say no,” and the idea that you can does nothing but downplay the seriousness of addiction.
How does addiction start?
Addiction can start through physical or mental means. Some people start using substances or addictive behaviors to numb or distract themselves from physiological or emotional pain. In these cases, the mental struggles come before the physical dependence.
Others start using substances in a recreational manner, which leads to physical and emotional dependence. Once the dependence develops, coping mechanisms which used to be strong are weakened and, even without the physical urges, the person turns to substances to cope.
What are the different types of addiction?
The most common addiction is alcoholism. Alcohol is easily accessible and alcohol use is socially acceptable. While alcohol can be enjoyed in moderation, alcohol abuse can quickly become a pattern.
Drug addiction is also extremely common. This includes illegal drugs such as cocaine and heroin, as well as legal, prescription drugs, such as benzodiazepines (tranquilizers) and opioid painkillers which are incredibly addictive.
There are a number of behavioral addictions, including gambling addiction, porn addiction, and shopping addiction. While these addictions are not generally considered to be physical addictions, they have similar effects on the brain as addictive substances.
There are also some “acceptable” addictions. These include smoking and caffeine addiction. It is possible to function normally while addicted to nicotine or caffeine, although it can have harmful and even fatal effects on your body.
Who can become addicted?
“When I got to rehab, I couldn’t believe how low I had fallen. Was I really like these other people?”
“I’m not a criminal or lowlife. How did I end up becoming a junkie?”
The above sentiments are shared by many people who become addicted to substances or behaviors. Because of an archaic way of thinking about addiction as a character flaw, many individuals struggle to see themselves as addicts. They think that they are “better” than that.
However, no one chooses to become addicted and everyone is susceptible. If you are struggling with mental health issues, you may turn to substances to help you cope. If you use alcohol and substances recreationally, you could become physically addicted before you know it. And, if a doctor prescribes addictive painkillers for you, you can become addicted despite having stayed away from alcohol and illegal substances.
One of the most important aspects of rehab is meeting other people who are struggling with addiction. You find that they are stronger than you expected. That they are sensitive people who want more for themselves and their loved ones.
And in seeing the good in them, you begin to see the good in yourself.
How is addiction treated?
Addiction is notoriously complex to treat and relapse is common. However, this does not mean that treatment is ever pointless or that success can only be measured over a lifetime. On the contrary, like any other illness, you can only appreciate achievements in the present. Future complications cannot negate today’s wellness.
There are a number of components to addiction treatment.
Detox
When a person is addicted to substances, they will need to detox before attempting any other treatments. Addiction causes your body to become dependent on the substance. It is incredibly difficult to stop on your own, and can be very dangerous.
Drug and alcohol detox should be done in an environment in which medical help is readily available. The individual should be monitored throughout, as the body struggles to adapt to functioning substance-free.
After detox is completed, you may still experience cravings for the substance, but your body will make do without it.
Inpatient rehab
Inpatient rehab is the gold standard for addiction treatment. Inpatient rehab is important because it takes the person away from the triggers in their life and makes it difficult if not impossible to get access to substances.
It also gives the person space to deal with their addiction away from their normal day-to-day duties and responsibilities. They get the time to focus solely on their health.
Inpatient rehab includes a range of different treatments, including non-addictive medications, individual and group therapy, family therapy, meditation, alternative holistic treatments, and more.
Addiction treatment is not a one-size-fits-all matter, and different approaches work for different people. While one or more of the available therapies in rehab may not be ideal for an individual, others certainly will.
Outpatient treatment
Addiction treatment does not end after rehab. Rather, the person continues to receive outpatient treatment. This may include individual and group therapy, support groups, sober coaching, psychiatry, and more.
As effective as rehab has been for the individual, it can only go so far as to prepare them for sober living in the real world. Outpatient treatment ensures they continue to get support as they adapt to getting back to normal day-to-day life.
The outlook
Addiction can have a devastating effect on a person’s life. Before treatment, many addicts feel incredibly helpless. However, addiction treatment is evolving every day, and the outlook is more positive than ever before.
Just as there is no one-size-fits-all approach to treatment, there is no one timeline for recovery. Everyone experiences the process according to their own circumstances.
It is important to remember that relapse does not negate previous success. In the same way that a recurrence of a cancer cannot retroactively destroy healthy and happy months and years, a relapse cannot retroactively taint happy, sober days, weeks, months, or years.
Addiction is more common that most people think. We need to start thinking about it as an illness rather than a character flaw, while dispelling many of the misconceptions, if more people are to get treatment.
References:
- National Institute on Drug Abuse. (2017). Trends & Statistics.
- Hasin DS, Fenton MC, Beseler C, Park JY, Wall MM. Analyses related to the development of DSM-5 criteria for substance use related disorders: 2. Proposed DSM-5 criteria for alcohol, cannabis, cocaine and heroin disorders in 663 substance abuse patients. Drug Alcohol Depend. 2012;122:28–37.
- CHANG, G., AND KOSTEN, T.R. Detoxification. In: Lowinson, J.H.; Ruiz, P.; Millman, R.B.; and Langrod, J.G., eds., Substance Abuse: A Comprehensive Textbook. 3d ed. Baltimore: Williams and Wilkins, 1997. pp. 377–381.
- Taylor & Francis. 2020. Psychosocial Occupational Therapy Interventions For Substance-Use Disorders: A Narrative Review.
- Boisvert, R.A., Martin, L.M., Grosek, M. and Clarie, A.J. (2008), Effectiveness of a peer‐support community in addiction recovery: participation as intervention. Occup. Ther. Int., 15: 205-220. doi:10.1002/oti.257
- McGovern, M., Xie, H., Segal, S., Siembab, L. and Drake, R., 2006. Addiction treatment services and co-occurring disorders: Prevalence estimates, treatment practices, and barriers. Journal of Substance Abuse Treatment, 31(3), pp.267-275.
- Center for Substance Abuse Treatment. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006. (Treatment Improvement Protocol (TIP) Series, No. 47.) Chapter 4. Services in Intensive Outpatient Treatment Programs. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64094/
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