The term addiction is used when people talk about substance use disorders. “Addiction” is used in the right way when speaking about a person whose behavior changes due to their continued use of a substance. Continued use of a substance changes the brain of people who are addicted and because of this change, drug use becomes the most important thing in their lives. Even if the addicted person does not have the substance in their body, the drug can still control them.
Another term sometimes used when speaking about substance use disorders is physical dependence. A “physical dependency” refers to a person who physically needs the substance to feel like themselves. This means they have a tolerance for the substance, so if they try to cut back on their use or stop using, they will have physical withdrawal symptoms.
It is extremely important to understand the difference between physical dependence and addiction! A person may be physically dependent on a substance but not have an addiction. This is why some treatment plans include both medication and mental health counseling. The medication deals with a physical dependency, while the counseling deals with the actual addiction.
What are Physical Withdrawal Symptoms?
Physical withdrawal symptoms may look different for different people and different substances, but all have one thing in common: the symptoms come when the body does not have the substance in it. The most common symptoms for various substances can be explored below.
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Nicotine
Cravings (thinking about and wanting nicotine), depression, anxiety, irritability, problems with concentrating, and sleep problems.
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Alcohol
Cravings, anger, anxiety, sleepiness, loss of appetite, abdominal pain, vomiting, nausea, depression, heart palpitations, foggy brain, mood swings, high fever, hallucinations, and seizures.
These withdrawal symptoms can be life-threatening:
- Losing interest in activities they once enjoyed
- Bad grades
- Dropping old friends for a new group
- Acting sad, aggressive, or angry
- Sleeping more than usual
- Breaking rules
- Sudden physical changes like weight loss, frequent nose bleeds, bloodshot/watery eyes, shakes, and hand tremors
- Poor hygiene
- Secretive behavior
Signs of an addiction:
An easy way to remember the main signs of an addiction is by learning the “3 C’s of Addiction:”
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Compulsion
Intense and increasing urges to use a substance.
Examples include talking a lot about using, dreaming about using, planning the day around using. -
Loss of control
Once someone begins using the substance, they can’t get themselves to stop.
Examples include not being able to set limits on the amount used, saying “I’ll only have one hit or drink today” and not stopping after one, or not being able to perform daily tasks because of substance use. -
Consequences
Continuing to use despite the negative consequences.
Examples include continuing to use even after being told their health is at risk, getting into trouble with police, losing a job, or loved one because of their use.
Substances seen in substance use disorders can include legal and illegal drugs, alcohol, and other medications. The diagnosis of a substance use disorder can range from mild to moderate to severe.
How a substance use disorder is diagnosed:
For someone to be diagnosed with a substance use disorder, they have to show patterns of substance use that are negatively changing how they live. This has to go on within a span of 12 months.
Below is a list of the criteria used to diagnose a substance use disorder:
- Needing to take more of the substance over a longer period than planned.
- Wanting to cut back on substance use but is not successful.
- Spend a lot of time trying to get the substance, using, or recovering from use.
- Having urges or cravings to use the substance that is so strong it blocks out any other thoughts.
- Cannot keep promises at work, school, or home because of continued substance use.
- Continuing to use the substance even when use causes or worsens their relationships with family or friends.
- Activities that were once important are given up or reduced because of substance use.
- Continuing to use the substance even though they know it is harmful to their health.
- Continuing to use even knowing that substance use has caused or worsened a physical or psychological problem.
- There is a change in tolerance by either:
- Needing to use more of the substance over time to get the same effect
- Using the same amount of substance and not having the same effect as it once did
- There is a change in withdrawal by either:
- They experience withdrawal symptoms consistent with the substance they use.
- Using the substance to ease or avoid withdrawal symptoms
Someone with 2-3 of the criteria to be considered to have a “mild” substance use disorder.
Someone with 4-5 of the criteria to be considered to have a “moderate” substance use disorder.
Someone with 6 or more of the criteria to be considered to have a “severe” substance use disorder.
Addiction is a severe substance use disorder, and the word should only be used in cases where a person cannot control their impulse to use drugs even when there are negative consequences.
“Misuse” and “abuse” sound similar and are often used the same. However, using “substance abuse” should be avoided because it can add shame and stigma that already keeps people with substance use disorders from asking for help. To avoid shaming and increasing stigma, terms like misuse should be used instead of abuse.
Behavioral addiction is an addiction to non-substances like gambling or video games. Like any other addiction, people who are hooked depend on their behavior and crave it. Someone with a behavioral addiction needs to engage in their behavior of choice because it creates calming or euphoric effects.
Common behavioral addictions:
- Food
- Gaming
- Social media
- Gambling
- Internet
- Pornography
- Sex
- Shopping
- Plastic surgery
Myths and Facts about Substance Use
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People who are dependent on drugs made a wrong choice
MYTH -Research has found that many factors, such as genes, stress, and family/peer influence can affect a person’s chance of starting to use drugs and/or developing a substance use disorder.
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Addiction is just a bad habit, and if they have enough willpower they will stop using
MYTH – Addiction is much more than a bad habit. It is a lifelong disease and many people with addictions cannot simply “just stop” using. It has nothing to do with self-control and most people with an addiction need to go to one or more treatment programs to get the right care.
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Most people who use drugs have a substance use disorder
MYTH – Globally, about 5.5% or 271 million people use drugs, while only 35 million of these people develop a substance use disorder.
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Drugs and alcohol affect men and women the same
MYTH – The effects of a substance vary for men and women. Female and male bodies work very differently, so the effect of each drug and how the body absorbs and metabolizes the substance is different for each sex.
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Preventing substance use can start before a child is born
FACT – While most prevention is for teenagers, prevention focused on pregnant women can be effective in preventing a pregnant mother from using drugs and drinking which can be a risk factor for their child to develop a substance use issue in the future.
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Treatment does not work for people with substance use disorders, and they will never recover
MYTH – Many people who complete treatment go on to lead healthy and productive lives and while relapse is common, it DOES NOT mean that the treatment did not work or that the person who relapsed is a failure. It is sometimes just a part of the process.