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Addiction (cont.)

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Common Characteristics of Destructive Addictions

The essence of addiction is drug craving, seeking, and use, in the face of negative health or social consequences. This is the basis for how the Institute of Medicine, the American Psychiatric Association, and the American Medical Association define addiction. Some common characteristics of addictions include the following:

  • The substance or activity that triggers addiction must initially cause feelings of pleasure and changes in emotion or mood.
  • The body develops a physical tolerance to the substance or activity, so people with addictions must take larger and larger amounts of a substance to feel the same effects.
  • Removal of the drug or activity causes painful withdrawal symptoms.
  • More than physical tolerance, an addiction involves physical and psychological dependence separate from the need to avoid the pain of withdrawal.
  • Addiction always causes physiological, chemical, and anatomical changes in the brain along with behavioral changes.
  • Addiction develops after an initial exposure to the addicting substance or activity. That initial exposure must occur for addiction to develop, but the exposure does not always lead to addiction.
  • Addictions lead to repeated behavioral problems, take a lot of time and energy, and are marked by a gradual obsession with the drug or behavior.
  • The cycle of quitting the addictive behavior, going through withdrawal, and relapsing may become self-reinforcing.

Common Characteristics of People with Addictions

  • People with addictions have the opportunity to obtain the substance or to engage in the activity that will addict them, and they have a risk of relapse no matter how successful their treatment is.
  • People with addictions tend to be risk takers and thrill seekers; the changes in brain circuitry lead drug abusers to expect a positive reaction to their addictive substance or activity before they use it or experience it.
  • Self-regulation and impulse control around the person's drug of choice are difficult for people with addictions. However, often these same people retain impulse control in most or all other areas of their life. This is more true with drugs like alcohol and less true with drugs like methamphetamine. Again, this difference is thought to be related to how stimulating the drug is to the reward circuits (dopamine tracts) in the brain. Methamphetamine is much more rewarding to the brain than alcohol.

When to Seek Medical Care for Addiction

  • Some people are able to recover from an addiction without help. However, it is thought that most people need assistance. Many times medical, psychiatric, or psychological assistance is needed. With treatment and support, many individuals are able to stop their drug abuse.
  • If there are known or suspected health problems related to substance abuse, it is wise to consult with a primary-care physician for a full history and physical exam. Examples include assessing for liver damage in advanced cases of alcohol addiction or dental damage due to methamphetamine abuse.
  • When talking with a loved one about addiction, having a third party present who is professionally trained and knowledgeable about addiction may be helpful. Being in a relationship with a drug abuser can change the relationship and lead to a decreased ability to communicate with each other.

Questions to Ask the Doctor

If you or a loved one is suffering from drug abuse, it can be hard to talk to a medical professional about it. It is helpful to find a doctor who is familiar and comfortable dealing with people who suffer from drug abuse. Unfortunately, some in the medical profession suffer from the same misperceptions and false ideas as many in the general public. However, most medical professionals do not have this prejudice and can direct you to local resources for help. After finding someone with whom you can work, some of the following questions may be helpful:

  • Can you test my liver or kidneys to assess for damage?
  • Are there other body systems that my drug use may have affected?
  • Are there any medications that may be helpful in treating my addiction?
  • Where can my family get support and information about drug abuse?
Medically Reviewed by a Doctor on 1/4/2016
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