Addiction: A Complex Illness

This is a disease caused by long habitual use of drugs and other substances of abuse. It is a progressive illness that is not completely curable but is manageable. It’s characterized by a pattern of repeated self-administration of the drug of choice which results in tolerance, dependence and compulsive drug taking.

a). The Illness Description

It is the alcoholic’s compulsion to drink manifested in drinking habits that are inappropriate, unpredictable, excessive and constant. His behavior oscillates to extremes, so that people around him are confused and bewildered. He might be good at hiding the compulsion but it is always there.

He might say: “compulsion means that you just have to have a drink. I am obviously not like that. I always decide whether or not I am going to drink… so, I cannot possibly be an alcoholic!” to an objective outside observer, it becomes obvious that sooner or later the decision is always the same…. To drink.

b). The Course of the Illness is Predictable and Progressive

It will get worse; it is a simple as that. Sometimes there are plateaus where the drinking behavior seems to remain constant for months. Occasionally, some even will trigger what seems to be spontaneous improvement. But over a period of time, the course of the disease is inevitably towards greater and more serious deterioration. The disease can be physical, mental, and spiritual.

c). The Disease is Primary

For a long time, most medical and psychiatric professionals stated from a false premise: they treated alcoholism as though it were only a symptom of emotional or psychological disorders.

“Let us find out what is really wrong with you, then, you will have no need to drink.” This does not work.

Alcoholism is what causes mental, emotional and physical problems. Other problems which the victim may have cannot be treated effectively until the alcoholism is treated first.

d). The Disease is Permanent

Once you have it, you have it. Trying to learn “to drink like a lady or a gentleman” just won’t work. The only solution is to seek help to permanently arrest the disease- the earlier the better. It has been said that to find sobriety, “go straight to hell and make a 180 degree turn,” before you reach hell.”

e). The Disease is Terminal if Unchecked

If you have this disease, and you do not successfully arrest it you will die from it in some way or another: fatal accidents, cirrhosis... Etc. Death certificates from hospitals use a lot of euphemisms for alcoholism but the result is the same- the victim is dead. Whether the chemical complicated a heart condition, high blood pressure, bleeding ulcers or precipitated a suicide, it is still the same agent that caused the death.

Path to Drug Addiction

The path to drug addiction begins with the act of taking drugs. Over time, a person’s ability to choose not to take drugs is compromised. This in large part is a result of the effects of prolonged drug use on brain functioning, and thus on behavior.

Addiction, therefore, is characterized by compulsive, drug craving, seeking, and use that persists even in the face of negative consequences. Addiction-a bio-psycho-social-spiritual disease that is cunning, powerful and baffling. A brain disease marked by senseless usage despite adverse negative consequences. Entails disorder of the whole person.

Tolerance

• A state in which increased amounts of drug of choice are required to achieve the same effect initially experienced at first time use.

Dependence

• A psychological and physical state in which the drug user relies on the drug for day to day functioning.

• Characterized by a compulsion to take the drug despite the negative effects

Types of Dependence

 Physical dependence

A state of physical adjustment with increase in level of tolerance coupled with withdrawal symptoms

 Behavioral dependence

The person feels incompetent or unable to function appropriately without the drug of choice.

 Social dependence

Marked by a drug related lifestyle; The abuser adjusts his life to ensure access to drugs; Individual cannot function socially without drugs; Relationships change to allow and support use and provide protection from consequences of drug use.

Detoxification

• First step in addiction treatment where medication is given to:

 Remove the substances from the body system

 To reduce the discomfort of withdrawal symptoms

Manifestations

Physical deterioration from persistent use, e.g. skin rash, liver damage, cognitive damage, strong subjective drive to use substance in larger amounts over longer periods. Persistent desire to cut down on amounts of use. Virtually all of the person’s daily activities revolve around the substance.

Sense of guilt, irritability or annoyance over family and friends’ expressed concerns about use. Waste of a great deal of time seeking to obtain the substance or recovering from their effects. Withdrawal from healthy hobbies, friends and family in order to use the substance. ‘Raising’ money through dubious means like theft, prostitution etc. to sustain procurement.

Hence, drug addiction is characterized by:

 An obsession-always thinking about the ‘positive’ effects of using drugs, actively planning and looking forward to using them.

 A compulsion-an irrational urge or craving to use the drug or substance for anticipated positive effects even though the user knows it will hurt in the long run. Emotional logic works to satisfy the urgency and compulsion to use drugs.