Addictions - Rehabs.org

Medical Reviewer

Ariella Belote

About the Reviewer

Chronic drug and alcohol misuse can lead to several harmful consequences, including tolerance, physiological and psychological dependence, and addiction. Substance addiction is progressive, which means it can worsen with time. But professional addiction treatment can help you quit using drugs or alcohol, address the underlying issues influencing your substance use, and equip you with the coping skills you need to avoid relapse.

In this article:

What is Addiction?

Substance addiction, also known as substance use disorder, is a chronic, relapsing condition characterized by compulsive drug or alcohol use regardless of the negative effects it has on your life. It is a complex and multi-faceted condition caused by many interacting biological, psychological, and social risk factors. Addiction can cause significant impairment and dysfunction in a person’s life, disrupting work, school, relationships, and more.¹

Chronic drug and alcohol use can change the brain’s structure and function, affecting the circuits influencing stress, reward, and self-control. These changes can last long after someone has stopped using substances.¹

Common Substance Addictions

It’s possible to develop an addiction to many different mind-altering substances, such as:

Alcohol
Prescription opioids, such as oxycodone, hydrocodone, and fentanyl
Illegal opioids like heroin and illicitly-made fentanyl
Cocaine and crack cocaine
Marijuana
Methamphetamine (crystal meth)
Prescription stimulants, such as Adderall
PCP
Hallucinogens like LSD and psilocybin
Ketamine
Inhalants
Sedatives, hypnotics, and anxiolytics, such as Xanax and Ativan
Tobacco/nicotine

Symptoms of Alcohol and Drug Addiction

The most reliable way to determine if you have a substance use disorder is to receive a professional assessment from a treatment provider. But it’s also important to be aware of these symptoms of drug and alcohol addiction:²

Using substances in larger amounts or over longer periods than intended
Experiencing a desire to quit or control use
Spending a lot of time obtaining, using, and recovering from the effects of substances
Experiencing cravings to use drugs or alcohol
Failing to fulfill responsibilities at home, work, or school due to substance use
Continuing to use substances despite experiencing interpersonal problems caused by use
Giving up important recreational or social activities in favor of substance use
Using substances in dangerous situations, such as while driving
Continuing to use substances despite knowing that substance use is causing or worsening physical or psychological problems
Needing higher amounts of substances to feel the desired effects (tolerance)
Experiencing withdrawal symptoms when suddenly stopping or reducing use (known as dependence)

A substance addiction can range from mild to severe, based on the number of present symptoms. Here is the breakdown:²

Mild: Presence of two or three symptoms
Moderate: Presence of four or five symptoms
Severe: Presence of six or more symptoms

Signs of Addiction You May Notice in a Loved One

If you are concerned that someone you love is using drugs or alcohol, there are some signs of substance use you can look out for, including:

Mood swings
Aggressive or erratic behavior
Secretive behavior
Withdrawing from friends and family
Lying about their whereabouts
Changes in physical appearance, such as a lack of grooming
Noticeable weight gain or weight loss
Problems with financial management
Changes in energy levels, such as appearing sluggish or having an extreme amount of energy
Poor work or school performance

You may also notice physical signs that someone has been injecting or snorting drugs.

Signs of intravenous drug use include:²

Track lines
Puncture marks
Abscesses
Damaged blood vessels
Scars from healed skin lesions
Cellulitis

Meanwhile, you may notice the following physical signs in someone who snorts drugs:²

Frequent nose bleeds
Irritated nasal mucosa
Perforated nasal septum
Chronic sinusitis

If you suspect your loved one is struggling with an addiction, you will want to make sure to approach them with compassion, empathy, and a nonjudgmental attitude. Trying to force them into treatment or blaming them will only contribute to their shame and may cause them to become defensive. Approach them from a place of love and care, and if they aren’t ready to talk, don’t push the issue. Likewise, if they aren’t ready for treatment, you should set reasonable boundaries that protect your mental health and keep you from enabling their substance use.

Who is at Risk of a Drug or Alcohol Addiction?

Anyone who misuses drugs or alcohol is at risk of developing an addiction; however, some people have an increased risk due to various biopsychosocial influences, such as:¹

Community poverty
Availability of drugs
Experimenting with drugs at a young age
How the drug is used (injecting and smoking a drug increases its addiction potential)
Low peer refusal skills
Lack of parental supervision
Aggressive behavior in childhood
Having a mental health disorder
Family members who misuse substances
Family members who break the law
Childhood abuse or neglect

Research also indicates that genes are responsible for between 40% to 60% of a person’s risk of drug or alcohol addiction.¹ However, it’s important to remember that just because addiction may run in your family, it doesn’t mean you’re destined to become addicted to drugs or alcohol—it simply means you need to be aware of your risk and to engage in preventative measures, such as seeking treatment for mental health disorders, educating yourself about substance use, and building a strong support system.

How is Addiction Diagnosed?

The only definitive way to receive a substance use disorder diagnosis is to seek a professional assessment from a doctor or mental health specialist. They will conduct a series of substance use evaluations to determine the nature of your drug or alcohol use, severity of addiction, risk of complicated withdrawal, need for addiction treatment, as well as intensiveness of care, such as inpatient or outpatient services.

In many cases, your provider can refer you to an appropriate treatment setting that can properly address all of your needs. For example, if you have alcohol use disorder and co-occurring depression, your doctor may refer you to a dual diagnosis rehab, where they can treat both your addiction and mental health disorder.

How to Treat Alcohol and Drug Addiction

Detox Services

The first step on the continuum of addiction care is typically detox, which can occur in several settings, with varying services and medical oversight. Detox settings may include:

A doctor’s office: This is typically reserved for people who are taking medication as prescribed but developed a dependence and need to manage withdrawal while they taper off of the medication.
Outpatient detox: Here, you would attend detox services, which may include medical care, at a facility during the day and return home during non-treatment hours. This is usually advised for people with mild withdrawal symptoms and no risk of severe withdrawal, such as seizures or delirium.
Social detox: In this setting, you’d live in a residential or home-like setting while detoxing from substances. Social detox tends to use a peer support model and doesn’t offer medical care.
Medical detox: You live at a free-standing detox facility or reside in a hospital setting while receiving 24/7 medical care and supervision. This setting is often recommended for people withdrawing from alcohol, opioids, and benzodiazepines since withdrawal can be very distressing and even life-threatening.

The goal of detox is to achieve medical stabilization and a substance-free state. This can take anywhere from a few days to a couple of weeks, depending on the substance, the severity of your symptoms, and what type of care you need. Once you complete detox, the next step on the continuum of care is beginning your addiction treatment program.

Treatment Settings

Just like detox, drug and alcohol addiction treatment can occur in several settings, including:

Inpatient rehab: You live at the facility for the duration of your program, receiving 24/7 care and a myriad of services like individual therapy, group counseling, family therapy, peer support, drug education classes, and beyond.
Partial hospitalization programs: The most intensive outpatient option, you attend therapy and treatment for several hours per day, five to seven days per week. This is a great option for people who require the intensive care of inpatient but need the flexibility of outpatient. It also serves as a solid step-down option for those who have recently completed inpatient rehab and need continued support.
Intensive outpatient programs: A step down from partial hospitalization, intensive outpatient programs offer at least nine hours of treatment per week. This is also a good option for those who have completed inpatient and require ongoing care.
Standard outpatient programs: The least intensive option, you attend counseling one or two days per week, for one or two hours at a time. This option may be best for someone with a mild addiction who has a strong internal motivation to change.

Addiction treatment is often necessary to help you quit using substances and to create lasting changes in behavior. At rehab, you will learn countless skills that can help you avoid relapse in the long run, such as:

Coping skills
Emotional regulation strategies
Impulse control skills
Drug refusal skills
Sober social strategies
Trigger recognition and avoidance skills

Make sure you find a treatment program that utilizes individualized treatment plans, meaning they tailor your plan to meet your needs. Treatment and recovery are not one-size-fits-all models and necessitate individualized attention and care.

Aftercare and Ongoing Support

Once you’ve completed your addiction treatment program, the work isn’t yet done. Recovery is a lifelong process and may have its ups and downs. You want to make sure you’re setting yourself up for success by receiving ongoing support via aftercare options, such as:

Sober living homes
Step-down care, such as an outpatient program
12-Step groups, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA)
Non-12-Step groups, such as SMART Recovery
Individual therapy
Group counseling

As you near the end of your rehab program, your treatment team should collaborate with you to create an aftercare plan that works for you and best supports your sobriety.

Resources

National Institute on Drug Abuse. (2020). Drugs, Brains, and Behavior: The Science of Addiction: Drug Misuse and Addiction.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.).

Medical Reviewer

Ariella Belote

About the Reviewer