Addictions: An Overview
What is addiction?
Addiction is a chronic (lifelong) disease. People who suffer from an addiction have an uncontrollable urge and compulsion to use dangerous substances or to engage in harmful activities despite knowing the negative consequences these may have on their lives. They’re physically or mentally unable to stop even when they try to do so.
Without treatment, addiction can damage relationships, cause problems at work and lead to financial and legal problems. Excessive drug and alcohol use can cause a range of serious health issues, and it can be fatal. Treatment for addiction includes rehabilitation, therapy and medication.
How common is addiction?
Addiction is unfortunately very common. Around 20 million people in the United States suffer from a substance use disorder. A substance use disorder often refers to substances that unnaturally increase dopamine levels in the reward pathway. These substances include prescription painkillers, illicit substances, nicotine or alcohol (alcoholism). Substance addictions are the most well-known form of addictions but people can also suffer from behavioral addictions which include the following:
- Exercising or dieting.
- Shoplifting or other risky behaviors.
- Having sex or viewing pornography.
- Video gaming and the internet.
Who is likely to develop an addiction?
Anyone can develop a substance use disorder, but people with a family history of addictions are at higher risk. People who have mental health disorders including depression or post-traumatic stress disorder (PTSD) are more likely to have co-morbid substance use disorders as well. Noteworthy, gay, lesbian, bisexual or transgender populations are also vulnerable to substance use disorders because they experience significantly more psychiatric issues than the heterosexual population. Factors in these experiences include things like discrimination and issues of family dynamics.
Symptoms and Causes
What are the symptoms of addiction?
Symptoms of addiction vary from person to person. Some people with addiction function well in daily living. They hide their activities or substance use from others. Other people have severe symptoms, including:
- Inability to stop using: People may use a substance or engage in harmful addictive behavior even if they want to stop. They may have tried multiple times to cut down on or stop use but can’t.
- Increased tolerance: Over time, they may need more alcohol, drugs or nicotine to feel the same euphoric effects as they did before. They also may need to continue using the same amount to cope with physiological and psychological withdrawals that they can experience with cessation or even reduction of substance use. This is because their bodies have built up a tolerance to the substances.
- Intense focus on substances or behaviors: People with addictions become pathologically preoccupied with drugs, alcohol, or harmful behaviors. They may feel that the addiction has taken over their lives, as they spend more and more time craving, obtaining and thinking of their choice of addiction.
- Lack of control: They may feel like they have lost complete control over their substance use and often feel helpless. They often feel guilty, depressed and/or overwhelmed over their addiction and how it’s impacted their lives.
- Personal problems and health issues: Their addiction often impacts all aspects of their lives including their medical health, mental health, personal relationships and their careers. Often they are unable to pay their bills and purposely isolate themselves from their friends and family. They often have negative experiences with the legal system including being arrested for operating a vehicle impaired. Again, despite knowing the detrimental effects their addictions are having on them, they can’t stop use.
- Withdrawal: People with addiction experience emotional and physical withdrawal symptoms when they stop using. Physical symptoms include shaking, sweating or throwing up. They may also become anxious, sad or angry.
What are the risk factors for addiction?
There isn’t one specific cause of addiction. Many factors contribute to a person’s risk, and anyone can develop a substance use disorder.
Certain factors increase the risk, including:
- Genetics: Substance use disorders can be inherited (passed down through families). If you have a family history of addiction, you are at a higher risk of developing a substance use disorder. However, it doesn’t necessarily mean you will. For example, novelty seeking and impulsivity are inherited traits often seen in individuals with substance use disorders but that doesn’t mean that you will develop a substance use disorder if you have these traits.
- Environmental factors: A combination of lifestyle and environmental factors also contribute to developing an addiction. These factors include violence, poverty, having access to substances, taking drugs during adolescence and extreme stress or trauma.
- Drug use: All addictive substances (including opioids) cause changes in the brain’s “reward center.” These changes make the person crave more and more drugs to keep feeling pleasure. The cravings can be so strong that drugs become the main focus. Some individuals are affected by these substances more so than others for a variety of reasons. You may ignore relationships, job responsibilities and other obligations.
- Mental health disorders: Bipolar disorder, PTSD and depression often occur along with substance use disorders. People with mental health disorders have an increased risk of developing substance use disorders.
- Being a member of the LGBTQ community: Lesbian, gay, bisexual and transgender people have a higher risk of developing a substance use disorder. Many LGBTQ individuals may use drugs or alcohol to cope with discrimination and violence.
Diagnosis and Tests
How are addictions diagnosed?
To diagnose addiction, your provider may refer you to a psychiatrist, psychologist or a drug and alcohol counselor. Your healthcare provider will ask you (and possibly your loved ones) questions about your activities and patterns of substance use. Tell your provider if you’ve tried to stop drinking or doing drugs, and why. Share whether you’ve had physical or psychological withdrawal symptoms whenever you have tried to stop.
Your provider will do a physical exam and may obtain a blood and urine test from you. These tests give your provider information about your overall health. They can also help rule out underlying health conditions.
Management and Treatment
Can addictions be treated?
Treatments for addiction can help. Your healthcare provider may recommend a combination of treatment options. They include:
- Detoxification (detox): For severe addiction, a process called detox can help alleviate and treat withdrawal symptoms. During detox, your provider cares for you while drugs or alcohol leave your system. Your provider may give you medications and other therapies to ease withdrawal symptoms.
- Medications: Your provider may give you medications to reduce urges, cravings and ongoing withdrawal symptoms. If you have another mental health disorder (such as bipolar disorder or depression), your provider may treat those with medications as well.
- Rehabilitation (rehab): Providers offer structured counseling, education, support and encouragement during rehab. You may live at a rehab facility (inpatient rehab) or visit one for scheduled sessions (outpatient rehab). Rehab services focus on helping you manage addiction long term and live a healthier life.
- Therapy: Several types of therapy help people with addiction gain new perspectives and change their behavior. Your provider may recommend types of cognitive behavioral therapy or biofeedback therapy. You may also improve with psychotherapy (talk therapy).
- Support groups: Many people manage addiction with the help of a support group, such as Alcoholics Anonymous or Narcotics Anonymous. Groups like Al-Anon support family members and friends of people with substance use disorders. These groups offer people the opportunity to share experiences and find ongoing encouragement.
Can I avoid developing an addiction?
You can reduce your risk of developing an addiction by making certain choices. To reduce your risks, you should:
- Avoid illegal drugs: Never take illegal drugs, and always follow your provider’s orders for prescription drug use.
- Know your family history: If you have a family history of substance use disorders, you may be more vulnerable. Talk to your healthcare provider about ways to lower your risk.
- Seek counseling: If you have a mental health disorder or history of trauma or abuse, talk to your provider about therapy. An experienced therapist can help you manage emotions and stress in a healthy way which will reduce your chances of developing an unhealthy relationship with alcohol and drugs for coping.
Outlook / Prognosis
What is the outlook for people who live with addiction?
With treatment, many people manage addiction and live full, healthy lives. But recovering from substance use disorders is not easy. It takes self-discipline and a strong commitment on a daily basis. Supportive friends, family members and healthcare providers play an essential role in effective treatment as well.
Without treatment, addiction can cause serious health problems, even death. It can damage personal relationships, lead to financial difficulties and cause legal problems. Untreated addiction also harms family members, and the effects can last for generations.
When should I see my healthcare provider about addiction?
Addiction is a serious disease. If you or someone you care about has a problem with addiction, talk to your provider right away. Treatments and support groups can help.
A note from Cleveland Clinic
If you or someone you know is living with addiction, you may feel overwhelmed and out of control. But there is hope. Addictions are treatable. Through hard work and commitment, millions of people have overcome substance use disorders to live happy, healthy lives. Talk to your provider about a treatment plan that works for you. Don’t get discouraged if you have setbacks along the way. It is possible to overcome this, and you are not alone.
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