“Seven years sober. I’m really grateful. It’s really lovely to be present in my life.”
There is a dangerous beast, a disease, an epidemic, making its way through the United States. This beast destroys families and careers, friendships and futures, minds and bodies. To fight this disease, we must be constantly on the lookout. We must know the signs that this beast is making a home in ourselves or our loved ones.
And it is then that we can get help. It is then that we can repair the damage done by the monster.
This monster is addiction.
Celebrities and blue collar workers, young and old, men and women: all can fall prey to addiction and substance abuse. The disease knows no bounds. But for many, addiction is an unknown danger.
Can’t recognize the signs of substance abuse in yourself or those around you? You’re leaving those you love more susceptible to the eventual consequences of substance abuse. These eventual consequences include physical, societal, social, emotional, and mental problems. Often, the final consequence is death.
Here, we provide you with the information you need to keep addiction from commandeering your life or the life of someone you know. We hope that with this information, you can identify addiction and find help for its victims. And we hope that eventually, you can recover and enjoy your life free from the threat of drugs and alcohol.
Below, we’ll dive into the answers of these frequently asked questions about substance abuse and addiction, including:
We hope we can help. If you’re already an addict or abuser, there is hope. You’re not alone in your recovery. The first step to reclaiming your life is to learn more.
It isn’t enough to simply know that substance abuse and addiction are problems. Both are multi-faceted issues and can manifest themselves in many different ways. Each term must be broken down further and defined to truly know what the problem is.
Some of the most common terms thrown around are substance abuse, addiction, and dependence. These are all actually different conditions. All are problematic. However, they’re characterized by different symptoms and even different resulting health problems.
According to the World Health Organization, substance abuse is the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. However, the definition of substance abuse differs between sources. Based on other definitions, it is also possible to abuse drugs that are legal. This happens if the user takes them outside of their specific instructions or purposes.
Not everyone who is abusing a substance is addicted to or dependent on it. Many truly could stop whenever they wanted.
Substance abuse covers a wide variety of behaviors. Some examples of such behaviors include:
There are, of course, many other ways to abuse substances. There are also many substances that can be abused. Even common substances can be abused by those who use them improperly and for the wrong reasons.
In many cases, substance abuse leads to addiction or dependence.
According to the National Institute on Drug Abuse, substance dependence is the state in which an organism functions normally only in the presence of a drug. This is characterized physically by distress when the substance is removed. In other words? Withdrawal symptoms.
Someone who is physically dependent on a substance has used the substance enough that their body can’t figure out what to do without it if they stop using. This could be someone who can’t sleep without their sleeping meds. It could also be someone who can’t relax or feel happy without alcohol. It could be someone who is shaky, irritable, and disoriented without an opioid fix. it could be someone who gets cranky or has other symptoms when they try to stop smoking.
A huge part of identifying substance dependence is identifying the symptoms of withdrawal in those who haven’t used for some time.
Withdrawal is simply the body’s way of reacting to the absence of the substance. Withdrawal will look different for those withdrawing from different substances. In general, though, the signs of withdrawal can often include:
If any of these symptoms appear when the abuser doesn’t take their substance of choice, they are likely beginning withdrawal. This is a sure sign of substance dependence. Withdrawal can be unpleasant and incredibly dangerous, so it’s important to enlist professional help.
The American Society of Addiction Medicine defines addiction as:
“Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
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. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”
This definition is weighty and has multiple parts, so we’ll break it down here:
Obviously, addiction doesn’t happen all at once. The process of developing an addiction is an extended one. However, it occurs in stages. Consider these six stages of addiction.
The first stage of addiction is the first time an individual uses the substance in question. This could be a teenager drinking alcohol for the first time. This could be a young adult trying a friend’s Adderall during finals week. This could be a harried businesswoman popping a prescribed benzodiazepine to handle stress. This could be a man taking Oxycontin for chronic back pain after an accident.
This first use of the substance isn’t necessarily problematic. It could be completely legal and necessary. What leads to the further, problematic steps is a combination of personal temperament, genetics, and context.
The second stage of addiction is when a first use goes farther. The individual is no longer simply using the substance once or under a doctor’s orders. They begin to get creative. Usually, this means that the individual will begin to use the substance in excess. They may begin to use it only in specific situations.
This could mean a father drinks heavily on weekends after a long week at work. This could mean a high school student buys Adderall from a friend before every exam. This could be a woman deciding that two pills will likely do the trick twice as well, so she should probably take them two at a time.
This third stage is the period in which use of the substance becomes normal. It is during this time that the body begins to adjust to the substance, though not yet completely. This stage is when the individual’s use becomes a normal part of life. It is also often during this stage that individuals begin to use their substance alone, or perhaps secretively. That could be a sign that something is going wrong.
This could refer to the teenager who begins to drink alcohol from an opaque water bottle at school. This could be a woman who begins to snort cocaine even when she isn’t partying with friends. This could refer to a man who has regularly taken more of his opioid prescription than he was supposed to.
At this fourth stage, use of the substance has become dangerous and has negative consequences. Additionally, more for the substance is required to produce the same effect. The body is becoming more accustomed to the presence of the drug, so it requires more.
This stage envelopes those who switch from Oxycontin to heroin to get more of the drug for cheaper, those who opt for three glasses of wine because they don’t feel any effects after one or two, and those who are constantly popping anti-anxiety meds because taking them on a schedule simply doesn't do it for them anymore.
This stage also includes those taking substances despite the consequences. Examples of this include a woman continuing to drink after being fired for repeatedly showing up to work hungover, a man who continues to smoke marijuana after his wife leaves because of his behavior while high, or a student who continues to use benzodiazepines after failing several classes for sleeping through.
In this fifth stage, the user can no longer control their use. They are dependent on the substance. They begin to go through withdrawals if they don’t use. They desperately crave the substance. They have already chosen to keep using after experiencing broken relationships and/or other negative consequences. This stage is serious.
Those in stage five may get shaky if they go too long without a drink or develop flu-like symptoms when they miss a dose of their benzodiazepines. They could start sweating profusely or experiencing muscle pains when they don’t use heroin, or they could begin to stumble around and slur their words when they haven’t had an opioid.
The sixth stage is the one that should bring hope and encouragement if you or someone you love is an addict. In this stage, the individual has recognized that there is a problem. Perhaps they’ve hit rock bottom, or perhaps a friend has helped them see the truth. Regardless, the individual is ready to get clean and sober.
We’ll talk more about the different parts of recover below. However, this can look like someone attending an AA or NA meeting, checking into a detox program, moving into a sober living home, or even just reaching out to their doctor to ask for help.
This stage takes the most courage, but is the most instrumental in rebuilding a crumbling life.
Experts agree that addicts’ brains are inherently different from the brains of those who are not addicted. Because of this, the style and process of thinking looks different for addicts than for others. In fact, without outside involvement, an addict’s brain could lead them to engage in the same cycle of addictive behavior over and over.
This cycle isn’t impossible to break, but is likely difficult. An addict can expect to go through this cycle, perhaps multiple times. Consider the following stages in the addiction cycle.
Frustration is the stage of the cycle where use starts, either for the first time or again. In this stage, the individual feels some sort of pain or anxiety and desires relief from these feelings. This is a precursor to actual use, but is a major cause of use.
This frustration could be a physical pain or an emotional one. It could even be brought on by big life events, such as a breakup, an accident, losing a job, or a flare-up of an old injury.
Whatever the reason, the individual in question begins to think about how to heal this hurt: using the substance in question.
In this fantasizing stage, the individual has thought about how drugs or alcohol could help to fix their pain, frustration, or problem. They imagine that if they just used, even once, things could get better. They imagine how much easier life would be if they were to use or drink.
This daydreaming is even dangerous, but likely doesn't feel like a problem yet. This could be someone glancing wistfully at the liquor store as they walk past or remembering how nice it felt to be pain free back when they were taking Percocet every day.
In this stage, the fantasizing has become more compulsive and less healthy. The individual is now fixated on treating their problem with drugs or alcohol. They have likely already begun to plan: how to contact their dealer, how to pay for the substance, when they could use it, how much they should use, and every other detail.
At this stage, they’ve likely been playing out the details of how much better their life will be after they use. They have decided that using drugs or drinking alcohol is the cure for their pain or difficulty.
The individual has probably become secretive or moody. They likely hide their plans from others who would discourage them from using. They may have a sudden upswing in mood now that they’ve decided on a course of action.
In this stage, the user acquires the substance and begins to use, either again or for the first time. They feel in control of their use, and are using specifically to avoid the pain, frustration, or problems that they were having in the first stage of the cycle.
Use of the substance may still be a secret, or they could use publicly and it could appear to not be problematic at all. In fact, the person may seem particularly healthy because they feel better after “fixing” the problem.
This stage encompasses the first bottle of beer drunk after someone’s been sober for a while, the first bit of fentanyl used for the first time, or the first Klonopin downed upon filling a prescription.
Some time after the first use, the individual loses control of their use. They’ve slid back into old ways or fallen quickly into new habits. They can no longer decide that they need just one drink or just one pill or just one hit.
At this point, the individual isn’t using to solve a problem, but because they have a problem. They no longer get to decide that they’re using, because they can’t stop. Even if they’ve run out of money or are making matters worse with their use, they’ll continue to find and use the substance.
In this stage, the individual has realized that they have a problem. They feel bad about losing control and guilty for relapsing, causing problems, or using in the first place. They may now recognize that using the substance wasn’t the best way to deal with their pain or frustration.
They may take further efforts to hide their use at this stage, or they may reach out and admit to others what they’ve done.
This stage is where the individual decides or promises to stop using. They may make this promise to themself or to another person, but they’ve realized that their substance use helps nothing and they mean to keep themselves under control in the future.
This decision to stop could last a few hours or several years. The cycle begins again once the individual begins to feel a pain, frustration, or difficulty arising. Because the process is a cycle, many people end up continuing through the cycle and using again and again.
Fortunately, there is a way to break the cycle at any stage. The best way to prepare oneself to truly stop using is to enlist professional outside treatment and recovery help. We’ll discuss this more below. However, this will likely include detox, rehab, and continuing care, perhaps for the rest of the individual's life. It takes a lot of work and a strong support system to break the cycle, but it is possible.
We’ve mentioned above that professional intervention is almost always necessary to truly recover from addiction or substance abuse. The recovery process itself looks different for each individual. The process changes based on the substance in question, how long someone’s been using, personal biological and genetic factors, and other related facts.
In general, however, the recovery process is usually comprised of three parts: detox, rehab, and continuing care.
Detox is the first part of recovery. During detox, the addict recovers from their physical dependence on the substance in question. The process involves removing the substance completely from the individual’s system and body. It takes different amounts of time to remove different substances.
Essentially, detox is the same process as withdrawal. The main difference between the two is that detox tends to imply that the symptoms of withdrawal are managed or treated. In a professional rehab center, this can mean a few different things.
A holistic rehab center will try to decrease the symptoms of withdrawal by increasing the overall health of the patient. A balanced and nutritious diet, solid hydration plan, good sleep schedule, and physical activity are all parts of a holistic detox program.
Other rehab centers may choose to aid in recovery using medications. There are three main kinds of medications used during recovery. They include:
You may have seen or heard of at-home detox kits that you can find at the store or online. None of these have been approved by the FDA. That means that there is no guarantee that they are safe or that they work at all. It is always better to enlist professional detox help.
For many people, the psychological side of addiction is just as strong and just as difficult to overcome as the physical dependence. Many addicts have become accustomed to turning to drugs or alcohol to cope with problems, have fun, or relax. In a professional treatment program, professionals can help recovering addicts learn to live their lives without abusing a substance.
During rehab, patients will meet with therapists and possibly other patients as they attempt to learn what to do instead of abusing a substance. The goal of therapy is always to learn to cope without drugs or alcohol. There are different styles of rehab that work towards this goal in different ways.
Inpatient rehab is probably what you picture when you hear the word rehab. This treatment style involves the recovering addict moving into a treatment center while they recovery. They will sleep, eat, and attend therapy sessions all in one place.
Outpatient rehab is different. For outpatient treatment, the recovering alcoholic still attends therapy and other activities. Meanwhile, they live at home, away from the rehab facility.
Overall, inpatient addiction treatment is usually most effective. This means that of all recovering addicts who complete a treatment program, those who opted for an inpatient program are least likely to relapse. However, both kinds of treatment can be successful for different people. It’s important to think about what’s right for you and your addiction before deciding which to take part in.
Consider the pros and cons of each kind of treatment.
The pros of inpatient treatment are:
The pros of outpatient treatment are:
The potential cons to inpatient rehab can include:
The potential cons to outpatient treatment can include:
Outpatient treatment can be broken down even further, too. Intensive Outpatient Programs, or IOPs, are outpatient programs that require the patient to spend much more time on campus than traditional outpatient programs.
Unfortunately, the disease of addiction isn’t easily beaten. Most addicts will continue to struggle against their desire to use for the rest of their lives. For some, this is easier than others. But for everyone, this is a daily decision.
Thankfully, there are a few ways that those who have completed professional detox and recovery programs can continue to hold themselves accountable for sobriety.
Many people leaving professional rehab programs choose to live in sober living homes. These houses are transitional living spaces for those recovering from an addiction. They are democratically run homes that function according to an agreed-upon set of rules. These rules usually include a ban on all drugs and alcohol as well as a curfew. Normally, the residents of each house attend group therapy together. Many recovering addicts find transitional living homes very beneficial.
Others will find support via groups such as Alcoholics Anonymous or Narcotics Anonymous. These groups bring recovering addicts together to talk through struggles and hold each other accountable. The group helps participants work their way through the 12 steps to recovery, guided by a mentor.
The goal is that eventually, participants become mentors to newer members. This way, those new to recovery are always guided by someone who’s been around longer.
As equally as important to these groups are those geared towards those who love addicts or alcoholics. The two most common of these groups are Al Anon and Alateen.
Al Anon is a support group for the friends and families of alcoholics. Al Anon groups meet regularly and discuss topics such as healthy coping mechanisms, the difference between supporting and enabling, and other important things. Al Anon works to help participants know that a loved one’s alcoholism isn’t their fault.
Alateen is an offshoot of Al Anon, and is very similar. However, Alateen is designed with older children and teenagers in mind. Alateen groups can help them learn to acknowledge and address a loved one’s problem. They usually cover similar topics to those covered by Al Anon. There is also a great emphasis based on learning methods to help break generational cycles of addiction. This works to keep the children of addicts from becoming addicts themselves.
“The mentality and behavior of drug addicts and alcoholics is wholly irrational. . . and unless they have structured help, they have no hope.”
~ Russell Brand
Like so many others, Russell Brand knows the destruction and pain that are inherent in the life of an addict. He also knows the hope and renewal that are inherent in recovery. Which of those would you rather know - addiction or recovery?
According to the National Council on Alcoholism and Drug Dependence, some of the signs of addiction include:
Have you noticed any of the above since you began using drugs or alcohol? Have you noticed them in a friend or family member? If you have, it is a good indicator that there is a problem that needs to be treated.
Perhaps in reading this, you’ve realized that you or someone you know has a problem. Maybe you need help to achieve a lasting recovery. If you still aren’t sure, consider taking one of our addiction quizzes.
If you want help, we want to provide it.
Ashwood Recovery is a high-quality intensive outpatient program. Our staff work with our patients to tailor treatment to their specific needs. We are located in Boise/meridian, Idaho area. We treat both adults and adolescents.
How long has it been since your addiction took over your life? Some people suffer with their addictions for years. They never do anything about them for a number of reasons. They may:
Want to find out more about intensive outpatient treatment at Ashwood Recovery? Please contact us today.