questions and answers
"I've said it many times now, 'I didn't know what I didn't know.' Stigma and embarrassment played a big role in keeping me from asking honest questions. But there's so much more that's known now about addiction. That's one thing the current crisis has done. People are getting more educated on the subject."
doesn't addiction come
down to a choice?
Addiction is a brain disorder where a person compulsively uses a substance despite knowing it’s harming them and causing problems in their life. Addiction has been medically diagnosed as a disease because your body becomes dependent on the substance. You know you’ve become dependent when you need it to feel normal and function, where not using sends your body into withdrawal, making you very sick.
What's the science behind addiction?
From a science perspective, alcohol and drugs cause the release of a feel-good chemical called dopamine. When your brain gets used to that short-cut supply of dopamine, it can become hard-wired for survival and prioritize that feeling over everything else. Including family, friends and logic.
If addiction is a disease, why is there such a stigma around it?
Our culture can be quick to classify addiction as a "those people" problem. We're seeing a shift in understanding, but because addiction is linked to stealing, lying or manipulation, it can be equated to criminal behavior. As we do a better job of educating about the science behind addiction, we're seeing the kind of constructive conversations that lead to a more heart-centered desire to to help our neighbors.
Does all addiction look the same?
No. Every person experiences addiction differently. Someone who is in the early stages is going to look different than someone in the later stages of addiction. Two people will never experience addiction exactly the same way. Some people are “functioning addicts,” meaning that for much or all of the addiction, they're able to hold a job, pay their bills and so on. Others’ lives show little to no signs of manageability. Typically, the longer an addiction persists, the more unmanagable and out of control it becomes.
what's up with withdrawal?
Simply put, withdrawal is the cruel way the body's biology -- and the rewired brain -- requires the alcohol or the drug to simply feel normal; where stopping is more physically and mentally brutal than continuing to consume.
Someone who abruptly stops using a substance they're addicted to may experience withdrawal symptoms as soon as within a few hours of their last use.
Why is withdrawal from alcohol so dangerous?
When a person becomes addicted to alcohol, their body becomes physically dependent on the substance. As with addiction to other substances, we now know that the brain’s chemistry is changed.
With dependency developed during addiction, when a person decides to stop drinking, their brain and body suffer from Alcohol Withdrawal Syndrome. Depending on age, the length of addiction and other factors, basic withdrawal symptoms can include:
Dizziness Rapid heart rate
Muscle weakness Depression
The more serious indicators of withdrawing are called Delirium Tremens (also known as DT’s). These can lead to seizures and confusion. Dehydration and depletion of other vitamins and minerals in the body can lead to heart attack, coma and death. The real risk of these side effects can occur days after an alcohol-dependent person believes they’ve been through the worst of the alcohol withdrawal syndrome. Detoxing from alcohol should never be attempted without medical assistance.
What are the signs of opiate and heroin withdrawal?
A physically dependency means the individual no longer feels the level of euphoria they experienced when they first began using; they now must take it simply to feel normal, in typically increasing amounts. Where stopping means getting extremely sick -- also referred to as being "dopesick."
Signs of withdrawal may include flu-like symptoms such as a headache, nausea and vomiting, diarrhea, sweating, anxiety and the inability to sleep. The physical and mental effects of withdrawal can become excruciating and extreme.
Signs of potential drug
abuse in the home:
Missing shoe laces
Small plastic baggies
some signs of addiction
How do I know if I’m addicted to my pain reliever?
Here are some signs of addiction:
You’re not taking the drug for pain but because you feel like you need it.
When you don’t take it, you experience chills, nausea and/or headaches.
You’re using the drug to get the same effect you used to get.
You’re preoccupied with taking the drug.
You’re isolating yourself.
Your sleep patterns and/or personal hygiene habits have changed.
You’re not fulfilling obligations.
What are the active signs of opioid abuse?
Signs that a person may actively be high include:
“Nodding off” where a person may fall asleep or be unable to keep their eyes open, even in the middle of a conversation.
Pupils (the black part of the eye) will appear very tiny.
Signs that a person may be going through withdrawal include:
Flu-like symptoms such as a runny nose, body aches, sweating, feeling “clammy,” vomiting and diarrhea.
General signs that a person may be using drugs:
“Track marks” - puncture wounds, bruises or scabs that appear as dots on the skin, most commonly on the inside of the arms near the elbow crease. They may also appear on the wrists, inside the legs, on the neck and anywhere on the body that can be used as an injection site. Track marks are places on the body where a person has repeatedly injected a drug.
Wearing long sleeves in the summertime to cover track marks.
Social withdrawal, meaning the person no longer likes to associate with anyone or be in any situation where they cannot get high.
Stealing, lying, manipulating.
Acting confrontational or defensive when asked about their drug use.
Associating with others who are using.
Going to many different doctors, sometimes across state lines – this behavior is called doctor-shopping, where a person looks for multiple doctors who will prescribe opioids and other narcotics.
various drugs described
A drug is any chemical capable of changing the way a person thinks, feels or behaves.
What are prescription opioids?
Opioids are drugs derived from or chemically structured to mimic the make up of the opium plant, used to treat pain. Examples include oxycodone, hydrocodone, morphine, codeine, meperidine, Vicodin, Percocet and fentanyl.
What is the difference between an opioid and an opiate?
Opiates are drugs derived from opium. At one time, “opioids” referred to synthetic opiates only (drugs created from artificial opium). Now the term “opioid” is used for the entire family of opiates, including natural, synthetic and semi-synthetic.
What is heroin?
Heroin is an opiate drug derived from opium poppy plant and processed into a white or brown powder or a black tar-like substance.
What is fentanyl?
Fentanyl is a synthetic opioid and is up to 50 percent more potent than heroin and up to 100 percent more potent than morphine. As little as two milligrams can be a lethal dose.
What is carfentanyl?
Carfentanyl is a synthetic opioid, 100 times more potent than the same amount of fentanyl, 5,000 times more potent than heroin and 10,000 times more potent than morphine.
What is meth?
Methamphetamine (meth) is a stimulant drug that is consumed as a white, bitter-tasting powder or a pill. Crystal methamphetamine, known as "crystal meth" is a form of the drug that looks like glass fragments or shiny, bluish-white rocks. Highly addictive, it is chemically similar to amphetamine, a drug used to treat attention-deficit hyperactivity disorder (ADHD).
What is crack?
Crack cocaine – also known as crack – is an derivative of cocaine that can be smoked. Crack offers a short, intense high to smokers. The Manual of Adolescent Substance Abuse Treatment calls it the most addictive form of cocaine.
What is cocaine?
Cocaine is a powerfully stimulant drug made from the leaves of the coca plant native to South America. Although healthcare providers can use it for valid medical purposes – such as local anesthesia for some surgeries – cocaine is an illegal drug. As a street drug, cocaine looks like a fine, white, crystal powder.
What is THC?
Tetrahydrocannabinol (THC) is the psychoactive chemical in marijuana that makes a person “high.” It may be smoked, vaped or eaten. Marijuana is now grown with the highest THC content in history. “Dabs,” “hash oil” or “honey” are all names for a high potency THC oil that may be up to 99 percent concentrated.
What is kratom?
Kratom is not currently an illegal substance and has been easy to order on the internet. It is sometimes sold as a green powder in packets labeled “not for human consumption.” It is also sometimes sold as an extract or gum. Kratom can cause effects similar to both opioids and stimulants and may cause similar dependence.
What are benzodiazepines?
Benzodiazepines – or “benzos” – are a prescription medicine used to treat anxiety. Commonly sold under the names Xanax, Klonopin or Valium, the medication is highly addictive. It is also dangerous to detox from "benzos" without medical supervision, as a person may have seizures.
Addiction is hard enough to understand without the rumors, assumptions and misinformation clouding things. Here are a few such myths, alive and well.
Addiction is predictable.
Addiction doesn't have a face. Substance use disorders impact whole families, work environments and friendships. They can occur regardless of age, gender, race, religion, background, or sexual orientation and can affect people all along the socioeconomic spectrum.
My family doesn't get addicted.
A person in a family can become addicted to alcohol and/or drugs, regardless of their genes, and in spite of having had a happy childhood and good parenting. Addiction happens to good people, all the time.
Most prescribed drugs aren’t dangerous.
Many legally prescribed medications and substances have side effects that can potentially lead to dependency or death if abused. Medications like opioids -- even when taken as directed -- can lead to dependence.
You bring it on yourself.
Individuals do not choose to become addicted; nor do individuals choose to die from addiction. Addiction is classified as the inability to stop doing something despite trying not to do it. There can be a physical, mental and genetic component to any addiction.
Addiction can be cured.
Addiction cannot be cured but it can be treated and put into remission. Drug addiction remission is known as active recovery and can become a sustained state of living in a healthy and satisfying substance-free life.
Relapse means failure.
Addiction is a chronically relapsing brain disease. Relapse is not abnormal. While some relapses are fatal, ideally a relapse can be foundational growth on a person's path to recovery.
Rehab doesn’t work.
Rehabilitation is a step in the journey to recovery. It works as a door to the continuation of treatment, and into eventual active recovery. According to the National Institute on Alcohol Abuse and Alcoholism, “research shows that about one-third of people who are treated for alcohol problems have no further symptoms one year later.” Rehabilitation can and does work.
alternative pain management
What are some alternatives to opioid pain relievers?
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen and aspirin help control pain and decrease inflammation and are available over-the-counter or in prescription strength.
Acetaminophen is another pain reliever used to treat acute pain and is available over-the-counter. Some steroids, antidepressants and anti-epileptics drugs are used to treat nerve and chronic pain. Some doctors will prescribe a combination of an NSAID pain reliever with acetaminophen.
All drugs have potential side effects and can be harmful when used in conjunction with other drugs, so naturally it’s important to consult with your doctor.
There are many non-drug treatment and alternative options to consider as well, including:
Cognitive behavior therapy
Meditation and mindfulness
Heat and cold treatments
Electoral nerve stimulation
hand-picked articles from around the web.
> "Alcohol's Damaging Effects On The Brain"
National Institute of Alcohol Abuse and Alcoholism
This Alcohol Alert reviews some common disorders associated with alcohol–related brain damage and the people at greatest risk for impairment. It looks at traditional as well as emerging therapies for the treatment and prevention of alcohol–related disorders and includes a brief look at the high–tech tools that are helping scientists to better understand the effects of alcohol on the brain.
Boston Globe | 4/18
Alternative pain treatments at this veterans hospital have replaced the stream of opioids that had hijacked his life….
Washington Post, 12/18
Mental well-being contributes to opioid addiction — fueling drug use, relapses and overdoses.