The San Francisco Veterans Affairs Medical Center is administering ketamine to veterans with post-traumatic stress disorder and depression.
Tobias Marton, the director of the ketamine infusion program at the center, said that since the program first launched two years ago, they have treated about 40 patients who had virtually exhausted all other options.
“They’ve done everything we’ve asked them to do and they remain with very severe symptoms and with a poor or impaired quality of life,” he said. “Despite (past treatments), there remains a high risk of suicide (with some veterans).”
While it was not clear where the 40 patients are from, the option is something that is available to Humboldt County veterans who are suffering from PTSD or depression.
Marton said that in general, about a third of people diagnosed with depression don’t respond to first, second and third lines of treatment.
In contrast, ketamine infusion has yielded “impressive outcomes.”
Many people know of ketamine as a party drug, often referred to as Special K, but it is mainly used medically for anesthesia or pain treatment.
Miracle of medicine
“We know ketamine has rapid and powerful anti-suicide properties,” he said. “To have another tool, a potentially powerful tool to have an impact on suicide rates is really exciting.”
While Marton is proceeding with “cautious optimism,” Boris Nikolov, the CEO of Neurosciences Medical Clinic in Miami, Florida, which has a ketamine clinic, believes the application might be a medical breakthrough.
“It’s one of the greatest discoveries in the field of depression,” he said. “This is one of the miracles in medicine.”
Nikolov’s clinic has treated 120 patients with ketamine, including his wife who has PTSD as a result of severe child abuse.
“Ketamine really helped her,” he said. “That was a really big part of her recovery.”
Nikolov said most medicines that treat depression take from two to four weeks to start working. Ketamine begins working within hours after it is administered, a process which usually involves an IV infusion over the course of about an hour.
“What’s most important is the strong and fast effect of ketamine in patients who are very seriously depressed, or want to hurt themselves,” he said. “When they finish treatment, they’re totally different people. There is no other medication that does that.”
Brad Burge, the director of strategic communication at the Multidisciplinary Association for Psychedelic Studies, or MAPS, said there has been “an explosion of treatment that’s outpaced research.”
“It means that people are going to have another option, an alternative to conventional medications,” he said.
According to Burge, MAPS believes the best form of ketamine infusion involves pairing with other forms of psychotherapy such as group or individual counseling.
While ketamine is an FDA-approved drug which has been used as an anesthetic as well as a pain reliever, it isn’t officially sanctioned by the FDA to be used for treating mental health disorders. However, Marton said that ketamine has been administered in this fashion for over 18 years now.
A company is currently in the process of trying to get an intranasal product approved by the FDA which would administer ketamine through the nasal passage, according to Marton. He expects the FDA’s decision to be announced sometime around March 2019.
If the product is approved, he said, VA clinics in rural communities like the one in Eureka would likely be able to start offering ketamine treatments as well.
For now, only the location in San Francisco is able to offer the treatment, but Marton said anyone within their service realm, which includes Humboldt County, is invited to consult with the VA about seeking treatment.
“We want to be as thoughtful as we can,” he said. “As we understand more about it … (we) might be able to start helping people who we haven’t been able to help despite throwing everything we have at them.”
There is a point between casual drug usage and troubling drug misuse that happens before addiction fully sets in that needs to be addressed. Recreational drug use has been a facet of society for as long as history has existed. Drugs of all kinds, from opioids to alcohol, have always found their way into the lifestyles of the upper-class, as well as those who are stricken by poverty. Just like addiction, drug misuse doesn’t belong to a particular “type” of person or demographic, even though some people may be predisposed to addiction or drug use based on genetics and their surrounding environment. The focus of drug misuse is the bridge between experimentation and continued use into eventual dependency and addiction. Recognizing troublesome misuse early on can potentially stop cases of addiction in their tracks which is why it’s important to be aware of the signs.
What Is Drug Misuse?
There are many different phrases when talking about the use of drugs but what is “misuse”?
The use of illicit drugs: Experimentation can quickly go from a one-time use to habitual use, even if it doesn’t occur every day. The recreational use of illicit substances is always a risk since there is no way to fully know what a person is ingesting when a drug is acquired “off the street.”
Incorrect use of medication: Even legal, prescription drugs can be a part of drug misuse, especially when the person taking these drugs is using them outside of medical reasons without a doctor’s discretion or in dosage amounts that exceed the doctor’s instruction. This also occurs when someone is taking medication that does not belong to them.
Overuse of legal drugs: For example, just because caffeine and alcohol are legal doesn’t mean they cannot be misused. Regular or binge use of these substances can pose serious health concerns and result in potentially fatal consequences once a level of dependency is reached.
Drug misuse is a willful act which, when done continuously, can lead directly to dependency and unintended addiction. When someone habitually disregards the negative effects of drug misuse it’s likely they have crossed from misuse into addiction. The following are signs that someone has reached the stage of drug misuse:
1) Making Drugs A Priority
When someone starts planning their days, evenings, or entire weekends about obtaining and consuming drugs, misuse is likely a factor. Typically this begins shortly after the first or second experimental experiences they’ve had with a drug and become curious to try more. This can also become somewhat of a ritual. Leisure time is no longer to relax; it begins to focus solely on using the drug of choice in excess until there is no more left or more needs to be acquired. When social outings or gatherings seem to be exclusively dependent on having the drug available, misuse is in play.
2) Drastic Changes in Social Circle
Sometimes people are exposed to drugs and begin to experiment as a way to get acquainted with new friends. Usually, this involves someone new entering a social circle that opens members to a particular drug where its use becomes more and more prevalent. When someone drastically changes their social habits and social circle to include only other people who participate in the use of that drug, it’s more than likely they are misusing the drug regularly. They are most likely associating with people who can give them access to more of the drug.
3) Decline in Health or Appearance
When someone misuses drugs, their body typically experiences neglect or mistreatment. If someone is showing signs of:
Other unusual outward behavior due to their excessive “partying”
it’s likely they are misusing drugs in their free time. People who are usually ‘put together’ may come stumbling into work or class looking disheveled or ill to hide a hangover or may be struggling through the “come down” from a high from the night before. Mysterious “illnesses” will also be a common excuse as to why they are frequently feeling sick from the misuse of drugs, or the effects that follow after a large dose.
4) Normalizing Drug Use
While some circles may treat recreational drug use lightly, the complete normalization of drug use every time someone goes out or socializes could be a sure sign of drug use. When people no longer attempt to hide the frequency of their consumption of drugs and begin to use them freely around other people, they have completely normalized the misuse of these drugs. Speaking fondly of the drug and their many adventures while using the drug can also be a sign that their use is has moved past the experimental or recreational phase into more serious use. If someone grew up in a household where drug misuse was frequent, this puts them at a much higher risk of drug misuse.
5) Facing Negative Consequences
When wild, drug-fueled events or nights out start leading to unwanted ramifications like constantly being late for work, receiving bad grades, or ruining close relationships, misuse is likely at the source. When people begin to take bigger and bigger risks to consume their drug of choice, it’s likely that their misuse has become full-fledged and they are now starting to see consequences of their decision-making. When someone starts dealing with constant social problems that are a direct result of their drug use, it may lead them to rethink their actions, but those who are misusing drugs at a constant rate may be lacking the self-awareness to correct their behavior.
Without addressing misuse, we cannot effectively make efforts stop addiction in its early phases. There is a period between experimentation and addiction that is the cornerstone of how people develop a substance use disorder. No matter what drug is being misused, the behaviors and subsequent consequences that result in misuse are what can turn a healthy, vibrant person into a shell of their former selves. We cannot ignore the fact that the attitude towards recreational drug misuse in society is troubling and sending the wrong message. While we fail to address misuse, people who fall victim to substance use disorders that once started as occasional misuse will still have to deal with the awful stigma attached to addiction. We can’t ignore something until it becomes an uncontrollable problem while blaming those who have succumbed to it. Prevention can and will help many if the message is clear. Discussing topics like misuse could potentially save many lives before they ever begin to experiment with addictive substances.
Explore the links below for more information, resources and support:
According to SAMHSA, in 2016, 28.6 million people aged 12 or older used an illicit drug in the past 30 days, which corresponds to about 1 in 10 Americans overall (10.6%) but ranges as high as 1 in 4 for young adults aged 18 to 25. An estimated 11.8 million people misused opioids in the past year, including 11.5 million pain reliever misusers and 948,000 heroin users. Additional information is gathered in NSDUH for the misuse of pain relievers in the past year. Among people aged 12 or older who misused pain relievers in the past year, about 6 out of 10 people indicated that the main reason they misused pain relievers the last time was to relieve physical pain (62.3%), and about half (53.%) indicated that they obtained the last pain relievers they misused from a friend or relative.
With recreational drug use in America on the rise, it’s important to understand the risks involved with drugs that can lead to addiction. There is a very short amount of time between the experimental phase of recreational drug use and the next steps towards losing control. Based on statistics, recreational drug use is common among a wide range of ages and socioeconomic classes because addiction does not discriminate. Knowing the potential dangers of drug misuse can help educate others to prevent them from using drugs that could lead them down a dark path.
Drug Use that Leads to Addiction
While growing up, many of us are exposed to scare tactics that are used by school programs to help steer us away from drugs and alcohol. While their intentions are good, curiosity, peer pressure, and underlying risk factors that make people prone to addiction tend to override these measures. According to the National Institute on Drug Abuse (NIDA), about 24% of 12th graders have used illicit drugs in the last month. While the general attitude towards teenagers is that we expect them to rebel, drug misuse at an early age can severely affect young developing brains. The prefrontal cortex controls the flow of dopamine in their brains, helping with logical decision making. This area doesn’t fully develop until mid-to-late 20s. When a young person has access to drugs during these developmental stages, it can acutely increase their risk of drug use disorder. The most common drugs teenagers are using that can quickly lead to addiction are opioids, methamphetamines, cocaine, and various forms of ecstasy.
From Recreational Use to Addiction
Most commonly, people who consume drugs recreationally do so when they want to let loose and party, whether it be at special events, concerts, or other social situations. Under these circumstances, it’s important to closely consider when use has become a problem, like when they can no longer enjoy themselves if they are not under the influence. Red flags are raised when they begin to consume much more than their friends or even begin to use when alone, outside of social situations. When personal responsibilities fall by the wayside, and drug use becomes the focus, it’s time to seek treatment. Once the line has been crossed, and the addiction has taken over, it’s very difficult to successfully recover without the help of a drug treatment program that can help assist with many different levels of care.
Phases of Misuse
Typically, the steps from recreational use to addiction are gradual. The typical process stems from early curiosity and can potentially lead to something much more serious.
Experimental: Usually this step occurs while still young. Peer pressure builds, and they want to fit in with friends who are doing it too. It can affect adults too. Some people experiment with drugs for a change of pace. It can also appear to help ease social anxiety or negative emotions surrounding an event or incident.
Recreational: Consumption of drugs becomes more frequent during this phase. Every month there’s an occasion where drugs are consumed socially. Usually, there is thrill-seeking involved. There usually aren’t many negative consequences at this phase other than feeling worn out and depleted after using.
Regular Misuse: Drugs have become commonplace every weekend and sometimes on weekdays. Things are dull when not experienced while high and using and obtaining more of the drug becomes a focus. Their social circle begins to mostly include people who use as well, and former friends have slowly pushed
Risky Use: Higher doses become the norm. There are consequences at stake, yet drug use trumps them all. Financial problems start to set in as most funds are used towards obtaining drugs. Usually, run-ins with the law like DWIs or worse are involved at this level.
Dependence: Drugs have taken control over their life, and most relationships have deteriorated with loved ones and close friends. Their body has become physically dependent and needs a constant stream of drugs to function normally.
Addiction: A high is no longer achievable, but the main purpose of ingesting drugs is to simply ward off withdrawal symptoms. Most significant areas of life have been heavily impacted by drug use, and they are holding onto life by a single thread, whether it is blatantly obvious or not from the outside.
Taking drugs recreationally may seem harmless, but it’s one step towards addiction. While some people can experiment with substances without losing control, there are many other factors involved in what makes someone more prone to addiction. Once the wheels towards addiction are set in motion, it’s hard to stop them.
If you find yourself questioning whether or not your drug use is truly recreational, or whether or not you have reached the level of addiction with your drug use, consider taking an assessment at a treatment center to help stop addiction in its tracks with the help of trained professionals.
Brain fog is a term that’s commonly used to describe cloudy mental thinking, difficulty with focus or concentration or sometimes difficulty with memory, or the ability to memorize new information.
Some of the key drivers of brain fog include:
How often do you see a patient who is complaining of cloudy mental thinking, difficulty with focus or concentration or sometimes difficulty with memory, or the ability to memorize new information?
In just 28 days, both healthy adult women and adolescent males showed significant improvements in attentional focus and motor speed when taking citicoline or one (1) Cerenx per day.
Cerenx works on attentional focus by increasing dopamine, increasing dopamine receptors, and protecting dopamine related neurons. Further evidence has shown that citicoline improves attention in a variety of patient populations including individuals with neurocognitive degeneration after a stroke, and elderly participants.
Cerenx works on attentional focus by increasing dopamine, increasing dopamine receptors, and protecting dopamine related neurons. Further evidence has shown that citicoline improves attention in a variety of patient populations including individuals with neurocognitive degeneration after a stroke, and elderly participants.
The Effect of Citicoline Supplementation on Motor Speed and Attention in Adolescent Males
Objective: This study assessed the effects of citicoline, a nutraceutical, on attention, psychomotor function, and impulsivity in healthy adolescent males. Method: Seventy-five healthy adolescent males were randomly assigned to either the citicoline group (n = 51 with 250 or 500 mg citicoline) or placebo (n = 24). Participants completed the Ruff 2&7 Selective Attention Test, Finger Tap Test, and the Computerized Performance Test, Second Edition (CPT-II) at baseline and after 28 days of supplementation. Results: Individuals receiving citicoline exhibited improved attention (p = 0.02) and increased psychomotor speed (p = 0.03) compared with those receiving placebo. Higher weight-adjusted dose significantly predicted increased accuracy on an attention task (p = 0.01), improved signal detectability on a computerized attention task (p = 0.03), and decreased impulsivity (p = 0.01). Discussion: Adolescent males receiving 28 days of Cognizin® citicoline showed improved attention and psychomotor speed and reduced impulsivity compared to adolescent males who received placebo.
There’s a lot of confusion about what drug addiction (also called substance use disorder, or SUD) actually means, even though it’s a problem that affects millions of Americans from all walks of life. The National Institute on Drug Abuse (NIDA) defines drug addiction as a chronic brain disease and one in which relapses are very common. It isn’t, though, a sign of weak moral character or lack of willpower. What might start as a choice to try a drug (as a legitimate prescription or recreationally) can result, over time, in someone losing the ability to choose and becoming addicted.
People with addiction cannot abstain, stop their drug-seeking behavior or control cravings without getting help. They compulsively need to use, regardless of the damage the addiction is causing in their lives – physically, mentally, emotionally, educationally, socially, spiritually, financially. Treatment is often necessary because the disease typically gets progressively worse and can even lead to disability or premature death. In fact, according to NIDA, using tobacco products is the number one preventable cause of disease, disability and death in the U.S.
Drugs of Addiction
To make matters more complicated, there are many types of drugs that people can become addicted to, and each has its own way of affecting the body, including its own unique withdrawal symptoms. Commonly abused substances include not just illicit drugs but also some prescription medications such as opioids (like oxycodone and hydrocodone), stimulants (such as cocaine and dextroamphetamine) and depressants (including benzodiazepines and barbiturates). These drugs may at first be prescribed for medical reasons and a person later takes the medication in a way that wasn’t prescribed by their healthcare provider, or illegally takes a medication without a prescription. Still others become addicted to over-the-counter medications like cough or cold syrups and sleeping pills that are readily available, legal drugs. Other commonly abused drugs include hallucinogens, inhalants, sedatives, hypnotics, cannabis (marijuana, for non-medical purposes), alcohol and, as mentioned above, tobacco.
Drugs Change the Brain
Part of the reason substance use disorders are so complex to understand and to treat is that over time drugs of abuse can actually change circuits in the brain – and those changes can persist even after stopping the drug and going through detoxification, or “detox.” Some drugs activate the brain’s reward system in such an intense way that a person can start to ignore activities they once enjoyed as they seek the intense pleasure or “high” the drug gives, driving them to keep using; cocaine and methamphetamine are good examples of this. When a drug user experiences this feeling of intoxication, it can affect their thinking, judgment, emotions and behavior and can lead to breathing problems, seizures, coma or even death. The brain can adapt to produce less dopamine (the neurotransmitter that controls the body’s reward and pleasure centers); the result is that the addict needs an ever-larger dose to experience the same high. Still other drugs, such as marijuana and heroin, work to dupe the brain into believing they’re brain chemical messengers known as neurotransmitters.
It’s important to understand that not everyone who tries a drug of abuse becomes addicted. Several factors are involved, including one’s biology (which includes family history and physiology), environment (whether friends and family use illicit drugs, for example) and developmental stage (adolescents are particularly vulnerable because their brains are still developing). All drugs have the potential to be addictive. But, in general, addiction to cocaine, methamphetamine and heroin can happen more quickly with fewer doses. (Alcohol is a very commonly abused drug, too; for more information on alcoholism, please visit the Alcoholism section.)
How Big is the Problem?
If you’re reading this because you’re concerned that you or a loved one may have a substance use problem, you’re not alone. Drug use is very common:
Nearly 25 million Americans were illicit drug users in 2013, according to the National Survey on Drug Use and Health (NSDUH), which came out in 2014.
That same report shows that an estimated 21.6 million Americans ages 12 and older had a substance use disorder in the previous year, meaning an addiction to drugs or alcohol.
Depression and other mental health issues play an important role in the prevalence of drug addiction; many people have both an SUD and a mental health issue (what’s known as co-occurring disorders). In other cases, people who become addicted to a drug of abuse may go on to experience one or more symptoms of a mental health problem such as an anxiety disorder, depression or psychosis – what’s known as a substance-induced mental disorder.
An SUD can be mild, moderate or severe, depending on how many symptoms a person has. The more symptoms, the greater the severity of the drug addiction. Many illicit drugs, but not all, produce withdrawal symptoms; those that do include opioids, sedatives, hypnotics (such as LSD) and anxiolytics (drugs to treat anxiety). Tobacco products, stimulants and marijuana have less apparent withdrawal symptoms, according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, but they still cause withdrawal.
When people are addicted to a substance, it means in part that they’ve built up a tolerance to the drug; cravings make quitting extremely difficult – one of the reasons stopping a drug should be done under medical supervision. The first step, detoxification, is often done with the help of prescription medication to make the process more comfortable, but counseling is also needed to prevent the relapses that are common with this disease. Unfortunately, millions of addicts who could benefit from care at a specialty facility like a rehabilitation center don’t receive it, according to the NSDUH. For those who are addicted to two or more substances (what’s called a poly-drug addiction), treatment providers need to consider every substance a person is using when creating a treatment plan.
If you suspect that you or a loved one has a substance use problem, talk to a doctor, health care professional, addiction specialist or psychotherapist. These professionals can evaluate symptoms and make an accurate diagnosis that will help the recovery process begin.
People who abuse substances often say they take them to have fun or get high. It’s not that simple for addicts, though. An addicted person can no longer control whether or not he/she uses. Mentally and physically, the addict feels compelled to have the drug. Addiction is considered a chronic disease with the possibility of relapse an ever-present reality.
What you should know:
Addiction is a disease that is complex but treatable.
Prolonged drug use affects brain function.
Illegal drugs are defined as controlled substances under federal and state law. They are monitored and enforced by the Drug Enforcement Agency (DEA).
Marijuana is the most-used illicit drug, with 19.8 million U.S. users age 12 and over, according to the 2013 National Survey on Drug Use and Health (NSDUH), which is published by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Six-and-a-half million Americans use prescription pain relievers non-medically, and 1.5 million are dependent on or abusing cocaine, according to SAMHSA’s 2013 NSDUH survey.
In 2013, 22.7 million people 12 and over who could have benefited from substance use treatment in a specialty facility did not receive that help. It’s a myth that someone must want to go into treatment for substance abuse for it to be effective, says the National Institute on Drug Abuse (NIDA).
For decades, researchers have been trying to figure out what leads people to become addicted to drugs. While there’s no single root cause of drug addiction, experts think a combination of the following are most likely to play a role:
Your role models. Your early years, including your mother’s and father’s parenting styles and whether one or both parents or even an older sibling abused substances can affect whether you experiment with drugs and go on to develop an addiction. Our early role models, for good or ill, influence our behavior. They can also teach us appropriate ways to handle problems, bounce back and persevere; these coping skills make it less likely someone will develop an addiction. A family history of substance abuse is also linked to an increased risk. For more on the role of genetics, go the Risk Factors section.
Your personal history. Stressful or traumatic events, living in poverty, the availability of illegal drugs, peer pressure and whether or not your friends and family use drugs – all are associated with a greater likelihood of developing a substance abuse problem.
Your psychological makeup. How you feel about yourself, especially your self-esteem during adolescence, your temperament, a tendency toward impulsive behavior and exhibiting aggressive or antisocial behavior early in life are thought to forecast later drug or alcohol problems as well as a tendency toward violence.
On the flip side, there are factors that can lower someone’s chances of having an addiction; these include developing good self-control, practicing religious beliefs, having healthy relationships with family and friends and being involved in social activities in the community, reports SAMSHA.
Symptoms of Drug Addiction
There are a number of signs that may indicate a substance abuse problem, including:
A change in friends and hangouts
An unexplained need for cash
Bloodshot eyes or enlarged pupils
Sudden weight changes (gain or loss)
Tremors in the hands
A drop in attendance at work or school
Changes in sleep, mood, motivation or attitude
Keep in mind that physical dependence on a drug or medication is not the same thing as having an addiction; a person may be dependent on a drug if he or she experiences withdrawal symptoms if the drug is stopped. Someone may also develop a tolerance to the substance so that he or she requires increasingly larger doses of a drug in order to achieve the same effect or high. And when a drug user comes off a substance, he or she may experience withdrawal symptoms that vary depending on the substance(s). According to the American Psychiatric Association’s (APA) diagnostic manual, DSM-5, “Neither tolerance nor withdrawal is necessary for a diagnosis of a substance use disorder.”
Doctors, therapists and addiction counselors look at a variety of factors when deciding whether someone has a substance use disorder. If you or a loved one have two or three of the indicators below, it can point to a mild problem with drugs, while having four or five symptoms can underscore a moderate problem. Six or more of these symptoms may signal a severe substance use disorder. No matter how serious a drug problem is, recognizing the symptoms of drug addiction is the all-important first step to getting help – and recovering. So ask yourself these questions:
Are you or a loved one…
Using a substance over a longer time period of time than planned?
Making unsuccessful attempts to control or stop taking the drug(s)?
Spending a lot of time finding, using or recovering from using a substance(s)?
Experiencing cravings for a substance(s)?
Failing to show up or fulfill expectations at work, school or home?
Continuing to use an illegal substance(s) despite problems it’s causing in relationships?
Giving up activities once enjoyed in order to use a drug(s)?
Using a drug(s) regularly while in situations where it poses physical danger (such as driving, operating machinery or boating)?
Ignoring physical or psychological problems resulting from drug use?
Developing a tolerance for a drug’s effects?
Experiencing withdrawal symptoms or masking them with another substance(s)?
The more you know about substance abuse, the better the chances of avoiding a drug addiction before it starts. Here are several red flags that raise the risk of becoming a substance abuser:
Inheriting the genes
As mentioned above, your biological makeup has a lot to do with whether you’ll develop an addiction. In fact, the APA goes so far as to say that 50% of your susceptibility to becoming addicted is related to genetic factors. And when it comes to tobacco, genetics account for 75% of a person’s tendency to try smoking and 60% of their chances of becoming hooked. But DNA alone isn’t destiny. Besides the genes you’re born with, environmental factors, like how you were raised; whether you were sexually or physically abused; and whether you grew up in poverty or witnessed violence can also influence a person’s vulnerability to addiction.
Dealing with a mental health issue
If you or someone you love suffers from a mental disorder such as depression, anxiety, attention deficit disorder, post-traumatic stress disorder schizophrenia or an eating disorder, among other conditions, substance abuse is likelier to become a problem. In 2013, nearly eight million U.S. adults had both a substance use disorder and at least one mental issue. And 2.3 million of that group had a co-occurring SUD and a serious mental health issue, which the NSDUH defines as “a mental, behavioral or emotional disorder that substantially interferes with or limits one or more major life activities.”
Experimenting at an early age
In 2013, nearly 9% of U.S. adolescents ages 12 to 17 were illicit drug users, and 1.3 million teens had a diagnosed SUD. While it’s possible to become an addict at any age, many teens are natural risk-takers, mostly because the parts of the brain in charge of self-control and good judgment are still developing in adolescence. That can make trying illicit drugs a lot more attractive. The trouble is, say experts at NIDA, “the earlier drug use begins, the more likely it will progress to more serious abuse.” And there’s some evidence to suggest that how a drug is taken – especially if it’s smoked or injected into a vein – may increase its risk of becoming addictive.
There’s no single treatment that’s right for someone trying to overcome a substance addiction. Treatment for a substance use disorder (SUD) usually begins with detoxification or “detox” – a process during which the patient is medically supported while the substance(s) is removed from the person’s system. When someone enters treatment, one of the first things he/she may experience during the detox process is withdrawal, which can include physical symptoms such as nausea, diarrhea, shaking, fever, insomnia and sweating and/or psychological symptoms such as depression, anxiety, anger and upset. In some cases, a drug rehabilitation center will use FDA-approved medications to help counteract withdrawal symptoms with the goal of weaning the patient off the medication as soon as possible; although sometimes medication-assisted therapy is needed on a long-term basis to prevent cravings that can trigger drug-seeking behavior and relapse. While detox is the first step to any kind of treatment, counseling is also typically needed to achieve lasting results.
Whether a substance use disorder is mild, moderate or severe, some kind of treatment is usually necessary, which makes it tragic that only a small number of those who need help actually get it. According to the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health (2013), only 2.5 million people out of the 22.7 million people who needed treatment for drug or alcohol use actually received help at a specialty facility While there’s no cure for drug addiction, for most (though not all), abstinence or giving up the substance entirely is necessary.
Below are some of the most common treatment options for substance use disorders. If you or a loved one seek treatment for drug addiction, it’s likely that a combination of several of these approaches will be recommended and used:
Drug rehabilitation programs use a variety of counseling approaches to help people experience lasting recovery. Types of counseling include:
SMART Recovery® (Self-Management and Recovery Training): This community-support program has a four-point plan to teach self-reliance, and clients using SMART Recovery benefit from online support groups, message boards and chat rooms as well as in-person meetings to stay motivated in their recovery efforts.
BRENDA: BRENDA combines psychosocial counseling and pharmacotherapy (prescription drugs) to help patients deal with substance addiction. The acronym refers to the steps a counselor takes in treating a client using this method:
Report to the patient on evaluation findings
Needs identified by both the patient and therapist
Direct advice to the patient
Assessing the patient’s reaction to advice; modifying the plan when needed
This treatment model uses a type of psychotherapy called cognitive-behavioral therapy (CBT) in which a therapist will help clients examine their thinking and feelings in an effort to change negative and unproductive thoughts and beliefs that may lead to drug use.
Other types of counseling:
Motivational incentives: For gains made in treatment, drug and alcohol counselors may offer a reward system to encourage patients to work hard in recovery. Rewards might be for a special privilege, outing or voucher.
Motivational Interviewing (MI): Therapists who use MI help clients feel inspired and empowered to make needed life changes and to reach recovery goals.
Multidimensional Family Therapy (MDFT): Sometimes the whole family needs to be willing to evaluate its dynamics in order to help one or more member(s) overcome an addiction and/or another mental health issue. MDFT involves the whole family in the healing process to improve relationships, end enabling behavior and create harmony.
Sometimes the right option for treating drug addiction may be going to an inpatient or residential treatment center to live for a period of time. How long depends on the severity of the addiction, the kind of addiction(s) and the patient’s progress. These specialized facilities offer medically-supervised detox, which is a process to get drugs out of the bloodstream and tissues. In rehab, patients also receive intensive counseling to cope with triggers, cravings and any co-occurring mental health disorders. It’s helpful to think of rehab as a kind of retreat where the addict lives and works on learning to overcome triggers of addiction and manage any underlying mental disorders that require treatment along with the substance use disorder.
There are also outpatient rehab programs where patients live at home but attend a drug treatment (or partial hospitalization) program during the day, which may last for seven or eight hours. Or you or your loved one may attend an evening program that meets several times a week for several hours in the evenings only. With outpatient day or evening programs, patients sleep at home, which can be successful as long as drug networks, old haunts and triggers don’t interfere with the progress of treatment. While in treatment, patients in these programs, too, work on understanding their addiction and any mental health issues through counseling.
When selecting a program, be aware that there are customized programs tailored to groups of people who are like-minded; by bringing together people from similar backgrounds who are grappling with the same or similar issue, members can effectively work together as a group. Program alumni may even meet up later for special weekends and offer one another ongoing support in recovery. Read on for several examples of custom-tailored programs now being offered by some treatment centers:
Christian programs address drug addiction with a Bible-based approach, so attendees can find strength through faith. Treatment may include counseling and 12-step or other community-support programs, yet the focus on scripture allows members of these programs to be guided to recovery in large part through their beliefs.
Women-only programs address both the substance use disorder as well as any past history of abuse or trauma or mental illness that may underpin a drug addiction.
Adolescent programs tend to be gender-specific and allow teens a safe place where they can work to overcome drug addiction while also attending classes, so they don’t fall behind in school during treatment.
Spanish-speaking programs make treatment more relatable for those who speak English as a second language. Counselors, too, speak Spanish, and all written materials are printed in Spanish.
Medication-Assisted Therapy (MAT)
The Food and Drug Administration (FDA) has approved several prescription medications for the treatment of substance use disorders. Medication-assisted therapy proves most effective when used in conjunction with other approaches, such as counseling. Pharmacological approaches designed to help substance abusers detox and reduce the chances of relapse include these medications:
For opioids: The FDA has approved several prescription medications for opiate addiction to heroin, morphine or prescription painkillers like oxycodone and hydrocodone. There are a variety of prescription drugs that are used in treating opioid use disorders with active ingredients that either reduce withdrawal symptoms, like cravings, or block the effects of opiates altogether. These include:
Buprenorphine – (brand name: Subutex): An initial treatment to prevent or reduce withdrawal symptoms such as drug cravings
Methadone – (brand names: Dolophine or Methadose): Used to prevent withdrawal symptoms and to block the high from taking illicit opiates. Only authorized, specially licensed facilities can administer methadone maintenance.
Naltrexone – (brand names: Depade, Revia, and Vivitrol): All three block the effects of opioids; Vivitrol is an extended-release injection, given once a month.
Naloxone – (brand name: Suboxone): Prescribed as a maintenance medication that contains buprenorphine as well, Suboxone blocks or reverses the effects of opioids. For opioid overdoses, Evzio, an auto-injector containing naloxone, is available for emergency home use.
While there are other prescription medications in the drug pipeline and now being tested, there are no drugs currently available for the treatment of cocaine, methamphetamine, cannabis (marijuana) or hallucinogen use disorders.
The original 12-step program is one you’ve undoubtedly heard of before: Alcoholics Anonymous (AA), which has been around since 1935. AA has been helping alcoholics get and stay sober for decades with meetings available in big cities and small towns across the globe. Over time, this community of support, in which alcoholics help each other, has inspired other, similar programs for a wide variety of drug addictions that people grapple with:
These 12-step programs borrow at least in part from the AA model, which is based on 12 consecutive processes (each step building on the one(s) preceding it). The steps include minimizing self-centeredness, providing support to others in the group and making amends to those whom the substance abuser has hurt, among others. For a full list of the 12 steps, go to the Get Help section.
While some addicts rely solely on 12-step programs to treat and recover from their drug addiction, others use it in conjunction with counseling. And often 12-step programs are included as part of inpatient and outpatient drug rehabilitation.
For tobacco/nicotine: For tobacco products containing highly addictive nicotine, several nicotine replacement therapies are available over-the-counter at drugstores. These include nicotine patches, sprays, gums and lozenges that alleviate drug cravings. Prescription drugs such as bupropion (brand names: Wellbutrin, Zyban) and varenicline (brand name: Chantix) are also FDA-approved.
If you find yourself asking the question, Am I addicted to drugs? you should take the answer to that question very seriously. Unless recognized and treated, an addiction to a medication or illicit/illegal drug can greatly diminish your chances of leading a functional life, maintaining a daily routine or experiencing an enduring sense of well-being. Fortunately, you can perform a fairly accurate self-assessment of your drug-using status if you know the signs that indicate active addiction.
What Is Drug Addiction?
The potential for drug (and alcohol) addiction arises when your brain starts to treat the chemical changes triggered by your habitual substance intake as a normal operating condition. Experts in the field refer to this state as physical dependence. Physical dependence transitions into active addiction when you lose control over your ability to limit the number of times you use a given substance and/or your ability to limit the amount of that substance you take on any given occasion.
Signs to Look For
In addition to losing control over the frequency and amount of your drug intake, you may also experience a range of other problems that point to the presence of an addiction. Specific things you may notice include:
An intense desire for the drug
The need to increase your intake of the drug in order to keep feeling its effects
Establishment of drug use as your daily priority
Devotion of money to purchasing drugs even if it means failing to meet important financial obligations
A drug-based inability to meet other important personal, social, school-related or work-related responsibilities
Repeated use of drugs in situations that pose a clear danger to yourself or others
Overlap With Substance Abuse
When trying to figure out if you are addicted to drugs, it’s crucial to understand that doctors and public health officials don’t make a firm distinction between drug addiction and non-addicted drug abuse. Even if you don’t have problems with physical dependence, you can experience changes in your thoughts and behaviors that significantly interfere with your ability to function or maintain a feeling of wellness. In fact, the guidelines currently used by doctors in the U.S. include the symptoms of addiction and non-addicted substance abuse in a single illness category called substance use disorder. There are subtypes of this disorder for alcohol and every major addictive drug/medication.
An inability to stop using a drug for any substantial amount of time, and
The appearance of withdrawal symptoms if you halt your drug use even briefly
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