Addiction and Substance Use Disorder

Millions of Americans struggle with addiction and substance use disorder. Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry” (ASAM, 2011). According to the Oregon Health Authority (2014), every day in the United States, 114 people die as a result of drug overdose, and another 6,748 are treated in emergency departments for the misuse or abuse of drugs.

Nearly 9 out of 10 poisoning deaths are caused by drugs. In 2017, there were over twenty million people who required drug and alcohol treatment, however only about nineteen percent received treatment. In 2012, Oregon had the highest rate of non-medical use of prescription pain relievers in the nation.

American Addiction Center (2019) reports more people die from prescribed opioid pain relievers than all illegal drugs combined annually. Emergency room visits doubled in the 6 year period from 2004-2009 due to prescription drug abuse. In 2012, there were over 33,000 unintentional drug overdose deaths; 53% were linked to pharmaceutical use and 72% of the deaths attributable to pharmaceuticals were related to opioids, indicating the tragic consequences of prescription misuse or abuse. Alcohol abuse is one of the most common and costly substance abuse disorders in the United States. Regular use of alcohol is extremely common with 71% of Americans who drank in the past year, and binge or heavy drinking rates are significant (24.6% and 7.1%). Alcohol-related deaths are the third leading preventable cause of death in the US. Nearly 88,000 people die every year from alcohol related causes.

Despite the dangers of misusing substances, many people often dismiss the underlying reasons for their addiction and continue to use. There are many reasons why someone uses substances which can lead to addiction. Some causes of addiction include environmental factors, including a family's beliefs and attitudes and exposure to a peer group that encourages drug use, seem to play a role in initial drug use. Drug addiction is more common in some families and likely involves genetic predisposition. If someone has a blood relative, such as a parent or sibling, with alcohol or drug addiction, they are at greater risk of developing a drug addiction. Once a person starts using a substance, the development into addiction may be influenced by inherited traits, which may delay or speed up the disease progression. Difficult family situations or lack of a bond with parents or siblings may increase the risk of addiction, as can a lack of parental supervision. If someone has a mental health disorder such as depression, attention-deficit/hyperactivity disorder (ADHD) or post-traumatic stress disorder, it is more likely to become addicted to drugs. Using drugs can become a way of coping with painful feelings, such as anxiety, depression and loneliness, and can make these problems even worse. Peer pressure is a strong factor in starting to use and misuse drugs, particularly for young people. Using drugs at an early age can cause changes in the developing brain and increase the likelihood of progressing to drug addiction. Some drugs, such as stimulants, cocaine or opioid painkillers, may result in faster development of addiction than other drugs. Smoking or injecting drugs can increase the potential for addiction. Taking drugs considered less addicting — so-called "light drugs" — can start a person on a pathway of drug use and addiction (Mayo, 2017).

Some people with substance use disorders may be cognizant about their addiction, however lack the ability to stop using. The American Psychiatric Association (2017) groups substance use disorders into four categories which include impaired control, social problems, risky use, and drug effects. A person who exhibits cravings, desires to quit, or have failed attempts to cut down or control substance use is in the category for impaired control. Substance use causes failure to complete major tasks at work, school, or home, and social, work, or leisure activities are given up or cut back. Some people begin using substances in risky settings and continue despite known problems.

There is a wide array of symptoms that are associates with addiction. The Mayo Clinic (2017) describes some symptoms as needing to use substances regularly, daily or even several times a day. Having intense urges for substances that block out any other thoughts. Over time, needing more of a substance to get the same effect. Taking larger amounts of the substance over a longer period of time than intended. Making certain to maintain a supply of the substances. Not meeting obligations and work responsibilities, or cutting back on social or recreational activities because of substance use. Continuing to use, even though it's causing problems in life or causing physical or psychological harm. Driving or doing other risky activities when under the influence of substances. Spending a good deal of time obtaining the substances, using or recovering from the effects. Failing in attempts to stop using, and eexperiencing withdrawal symptoms (Drug Addiction, 2017). People also face problems at school or work, have physical health issues, neglectful of their appearance, have changes in behavior, and money issues.
More in depth consequences from specific substances include methamphetamine, opiates and cocaine that are highly addictive and cause multiple short-term and long-term health consequences, including psychotic behavior, seizures or death due to overdose. GHB and flunitrazepam may cause sedation, confusion and memory loss. These so-called "date rape drugs" are known to impair the ability to resist unwanted contact and recollection of the event. At high doses, they can cause seizures, coma and death. The danger increases when these drugs are taken with alcohol. Ecstasy or MDMA can cause dehydration, electrolyte imbalance and complications that can include seizures. Long-term, MDMA can damage the brain.

Consequences from addiction can be mended with support from family and counselors. Addiction is treatable and can be successfully managed. Treatment approaches tailored to each patient’s drug use patterns and any co-occurring medical, mental, and social problems can lead to continued recovery. (National Institute on Drug Abuse, 2018) There are numerous ways that people who struggle with addictions can reach out and seek help. In some situations, there are parents who do not have many options for services because of their children and do not have providers to look after them. Parents are more likely to connect with an outpatient treatment facility and remain in treatment when there is support for themselves and their children. Providing parent-child workshops, wraparound service education sessions, resource workshops, and childcare would be beneficial in order for the parent to complete treatment.

References

1. American Psychiatric Association. (2017, January). What is Addiction? Retrieved from https://www.psychiatry.org/patients-families/addiction/what-is-addiction
2. American Society of Addiction Medicine. (2011, April 12). Retrieved from https://www.asam.org/resources/definition-of-addiction
3. Drug addiction (substance use disorder). (2017, October 26). Retrieved from https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112
4. Jackson, Valera (August 2004). "Residential Treatment for Parents and Their Children: The Village Experience." Science & Practice Perspectives. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851019/.
5. National Institute on Drug Abuse. (2018, June). Understanding Drug Use and Addiction. Retrieved from https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction
6. Oregon Health Authority (2014). Drug Overdose Deaths, Hospitalizations, Abuse & Dependency among Oregonians [PDF file]. Retrieved from https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/INJURYFATALITYDATA/Documents/oregon-drug-overdose-report.pdf
7. Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health. Retrieved from https://www.samhsa.gov/data/
8. Thomas, S. (2019, March 14). Statistics on Drug Addiction. Retrieved from https://americanaddictioncenters.org/rehab-guide/addiction-statistics

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