Addiction is a real disease. It is not a weakness. Or an easy thing to overcome just by willpower. Virtually, all addictions start during adolescence. Almost 4 million 12-25 year olds have a drug abuse problem in the United States — but only 9 percent get any sort of treatment.
What is addiction?
Addiction is a chronic, relapsing brain disorder. Addiction involves a three-stage cycle that becomes more severe with continued substance use:
Binge/intoxication stage: Where someone keeps using more and more of the drug of choice to get the same high he/she once previously felt.
Withdrawal/negative affect stage: The person keeps using to avoid the effects of withdrawal. He/she may lose interest in things they normally loved to do and their behavior and personality may change.
Preoccupation/anticipation stage: Thoughts of using the drug of choice overtake everything else in the person’s life. This causes the person to be depressed, irritable, agitated, etc.
This cycle causes dramatic and persistent changes in multiple areas of the brain. It takes at least a year of not using drugs for these brain abnormalities to be repaired and for healing to happen.
What increases a person’s risk of addiction?
Three important areas increase the risk of addiction in an individual:
Genetics: People with a strong family history of addiction often have a genetic tendency for addiction. A child who has 1 or 2 parents who are alcoholics has a higher chance of having an addiction based on genetics alone.
Behavior: Individual characteristics also can lead to addiction later in life. Youth who have ADD, early aggressive behavior and poor social skills are more likely to have problems.
Environment: If there is a perception at home or in the community that substance abuse is not harmful, that increases risk, as well as having friends that use drugs or alcohol.
What treatments are available?
Any person with a suspected substance abuse problem needs a comprehensive evaluation by a drug abuse professional. This assessment will determine the level of treatment required. Some people might need education sessions to learn about the negative outcomes of drug use. Those with more severe problems may need regular individual therapy, more intensive outpatient therapy (6-10 hours a week) or even months of inpatient residential care.
Medications are also available to help people with addictions to nicotine, alcohol or opioids. Many times, treatment for anxiety, depression or post-traumatic stress disorder (PTSD) is needed. Twelve step programs like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are also important for long-term sobriety.
What are the long-term effects?
Early and frequent substance abuse that continues into adulthood can lead to permanent changes in the developing adolescent brain. In turn, that makes long-term sobriety difficult. If not identified and treated early, addiction can cause:
Failure at school and at work
Accidents under the influence
A decrease in IQ
In addition, IV drug abuse can lead to serious infections including HIV and Hepatitis C.
Health care providers and families need to identify and treat people with a substance abuse problem early to improve the chance of a lifetime lived to its full potential.
For a step-by-step guide to help families get answers to question about addiction, click here for a resource from the Alcohol, Drug, and Mental Health (ADAMH) Board of Franklin County. For more information about Nationwide Children's Hospital's Medication Assisted Treatment for Addiction (MATA) Program, click here.
Steven C. Matson, MD, is interim chief of the Section of Adolescent Health at Nationwide Children’s Hospital and an Associate Professor of Clinical Pediatrics at The Ohio State University College of Medicine.
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