What is Addiction?

Addiction is a complex condition in which there is uncontrolled use of a substance despite the harmful consequences. People with addiction have an intense focus on using a certain substance(s) such as alcohol, tobacco, or illicit drugs, to the point where the person’s ability to function in day to day life becomes impaired. People keep using the substance even when they know it is causing issues in their life.

People can develop an addiction to:

  • Alcohol

  • Marijuana

  • PCP, LSD and other hallucinogens

  • Inhalants, such as, paint thinners and glue

  • Opioid pain killers, such as codeine and oxycodone, heroin,and fentanyl

  • Sedatives, hypnotics and anxiolytics (medicines for anxiety such as tranquilizers)

  • Cocaine, methamphetamine and other stimulants

  • Tobacco

People with a substance use disorder may have distorted thinking and behaviors. Changes in the brain’s structure and function are what cause people to have intense cravings, changes in personality, abnormal movements, and other behaviors. Brain imaging studies show changes in the areas of the brain that relate to judgment, decision making, learning, memory, and behavioral control.

Repeated substance use can cause changes in how the brain functions. These changes can last long after the immediate effects of the substance wears off. Or in other words, after the period of intoxication. Intoxication is the intense pleasure, euphoria, calm, increased perception and sense, and other feelings that are caused by the substance. Intoxication symptoms are different for each substance.

When someone has a substance use disorder, they usually build up a tolerance to the substance, meaning they need larger amounts to feel the effects.

According to the National Institute on Drug Abuse, people begin taking drugs for a variety of reasons, including:

  • to feel good — feeling of pleasure, “high” or "intoxication"

  • to feel better — relieve stress, forget problems, or feel numb

  • to do better — improve performance or thinking

  • curiosity and peer pressure or experimenting

In addition to substances, people can also develop addiction to behaviors, such as gambling.  

People with substance use and behavioral addictions may be aware of their problem but not be able to stop even if they want and try to. The addiction may cause physical and psychological problems as well as interpersonal problems such as with family members and friends or at work. Alcohol and drug use is one of the leading causes of preventable illnesses and premature death nationwide.

Symptoms of substance use disorder are grouped into four categories:

  • Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use

  • Social problems: substance use causes failure to complete major tasks at work, school or home; social, work or leisure activities are given up or cut back because of substance use

  • Risky use: substance is used in risky settings; continued use despite known problems

  • Drug effects: tolerance (need for larger amounts to get the same effect); withdrawal symptoms (different for each substance)

Many people experience substance use disorder along with another psychiatric disorder. Oftentimes another psychiatric disorder precedes substance use disorder, or the use of a substance may trigger or worsen another psychiatric disorder.

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Alcoholism

Recognizing the symptoms of alcoholism can make a tremendous difference in getting proper treatment and heading down the path to recovery. Some warning signs include:

  • Drinking more than planned or intended

  • Failing to fulfill obligations at school, work or home (making drinking a priority, despite responsibilities, leading to missed school or work)

  • Continuing to use despite negative impacts on relationships, financial situation or health

  • Using in situations that could be physically hazardous, like drinking and driving

  • Showing an increased tolerance to alcohol (drinking more in order to achieve the same desired effect). Because the brain changes with alcohol abuse, one of the first physiological signs of addiction is building up a tolerance.

  • Experiencing physical or psychological withdrawal symptoms when attempting to stop drinking (anxiety, depression, insomnia, nausea, sweating, hand tremors/"the shakes," confusion, seizures and visual hallucinations)

  • Losing interest in once-enjoyed activities or becoming socially isolated

  • Becoming dishonest or secretive, aggressive, moody, or temperamental—people who have an alcohol addiction will try to hide it.

  • Craving alcohol, such as drinking first thing in the morning

  • Spending an inordinate amount of time thinking about drinking, acquiring alcohol, and recovering from hangovers

 

Some Physical Signs and Symptoms of Alcohol Addiction

  • Rapid weight gain or loss

  • Slow or staggering walk

  • Inability to sleep or stay awake

  • Unexplained bruises or marks

  • Glazed or red eyes

  • Cold, sweaty palms or shaking hands

  • Puffy face, blushing or paleness

  • Nausea, vomiting or excessive sweating

  • Low or no energy

  • Depressed or anxious

  • Deterioration of personal appearance or hygiene

If you think a family member or loved one might be showing signs, signals or symptoms of alcoholism, know that it won't "go away" on its own. Their brain is changing—and without help, there can be serious long-term consequences. According to the National Institute on Alcohol Abuse and Alcoholism, "an estimated 88,000 people die from alcohol-related causes annually, making alcohol the third leading preventable cause of death in the United States." 

Opiates 

Opioids are a class of drug that includes both prescription pain medicines and illegal drugs such as heroin. Though opioids can be prescribed by a doctor to treat pain, their misuse may lead to a dependency or addiction (what is known in medicine as an “opioid use disorder”). Anyone prescribed an opioid should follow their doctor’s orders carefully, making sure to only take the medication as prescribed.

Opioid use disorder is a medical condition defined by not being able to abstain from using opioids, and behaviors centered around opioid use that interfere with daily life. Being physically dependent on an opioid can occur when someone has an opioid use disorder, and is characterized by withdrawal symptoms such as cravings and sweating. However, people can misuse opioids and not have physical dependence. When a person has physical dependence, it can be particularly hard to stop taking opioids, and that dependence can interfere with daily routines, including personal relationships or finances.

Opioid use disorder may be diagnosed by a doctor. Someone struggling with opioid use disorder may not display symptoms right away. However, over time, there may be some signs that they need help.

Common Signs of Opioid Addiction

  • The inability to control opioid use

  • Uncontrollable cravings

  • Drowsiness

  • Changes in sleep habits

  • Weight loss

  • Frequent flu-like symptoms

  • Decreased libido

  • Lack of hygiene

  • Changes in exercise habits

  • Isolation from family or friends

  • Stealing from family, friends or businesses

  • New financial difficulties

Methamphetamine

 

Methamphetamine misuse also has been shown to have negative effects on non-neural brain cells called microglia. These cells support brain health by defending the brain against infectious agents and removing damaged neurons. Too much activity of the microglial cells, however, can assault healthy neurons. A study using brain imaging found more than double the levels of microglial cells in people who previously misused methamphetamine compared to people with no history of methamphetamine misuse, which could explain some of the neurotoxic effects of methamphetamine.

Some of the neurobiological effects of chronic methamphetamine misuse appear to be, at least, partially reversible. In the study just mentioned, abstinence from methamphetamine resulted in less excess microglial activation over time, and users who had remained methamphetamine-free for 2 years exhibited microglial activation levels similar to the study’s control subjects. A similar study found that while biochemical markers for nerve damage and viability persist in the brain through 6 months of abstinence from methamphetamine, those markers return to normal after a year or more without taking the drug. Another neuroimaging study showed neuronal recovery in some brain regions following prolonged abstinence (14 but not 6 months).This recovery was associated with improved performance on motor and verbal memory tests. Function in other brain regions did not recover even after 14 months of abstinence, indicating that some methamphetamine-induced changes are very long lasting. Methamphetamine use can also increase one’s risk of stroke, which can cause irreversible damage to the brain. A recent study even showed higher incidence of Parkinson’s disease among past users of methamphetamine.

In addition to the neurological and behavioral consequences of methamphetamine misuse, long-term users also suffer physical effects, including weight loss, severe tooth decay and tooth loss ("meth mouth"), and skin sores. The dental problems may be caused by a combination of poor nutrition and dental hygiene as well as dry mouth and teeth grinding caused by the drug. Skin sores are the result of picking and scratching the skin to get rid of insects imagined to be crawling under it.

Long-term effects may include:

  • addiction

  • psychosis, including:

    • paranoia

    • hallucinations

    • repetitive motor activity

  • changes in brain structure and function

  • deficits in thinking and motor skills

  • increased distractibility

  • memory loss

  • aggressive or violent behavior

  • mood disturbances

  • severe dental problems

  • weight loss