While each drug of abuse produces different physical effects, all abused substances share one thing in common: they hijack the brain’s normal “reward” pathways and alter the areas of the brain responsible for self-control, judgment, memory, motivation, emotional regulation, and learning. Whether a person is addicted to nicotine, alcohol, heroin, Valium or speed, the effect on the brain is the same: an uncontrollable craving to use that is more important than anything else, including family, friends, employment, education and your own health and happiness. This type of uncontrollable craving to use can be linked with a drug dependence, which is described by the Diagnostic and Statistical Manual of Mental Health Disorders, Criteria for Drug Abuse and Dependence:
Drug Abuse: A maladaptive pattern of drug use leading to impairment or distress, presenting as one or more of the following in a 12-month period:
- recurrent use leading to failure to fulfill major obligations
- recurrent use which is physically hazardous
- recurrent drug-related legal problems
- continued use despite social or interpersonal problems
Drug Dependence: A maladaptive pattern of drug use, leading to impairment or distress, presenting as three or more of the following in a 12-month period:
- tolerance to the drug’s actions
- withdrawal
- drug is used more than intended
- there is an inability to control drug use
- effort is expended to obtain the drug
- important activities are replaced by drug use
- drug use continues despite knowledge of a persistent physical or psychological problem
Dependence can occur with or without physiological dependence
There is evidence that genetic factors play a role in both dependence and abuse. Other theories involve the use of substances as a means to cover up or get relief from other problems (e.g., psychosis, relationship issues, stress), which makes the dependence or abuse more of a symptom than a disorder in itself.
Treatment: Research suggests that no treatment method is superior, but that social support is very important. An openness to accept the abuse is also paramount in successfully treating the illness. Organizations such as AA and NA have had better than average success in reducing relapse.
Source: Adapted from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
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