Substance use disorder (SUD) or addiction, is detected when an individual displays specific symptoms such as preoccupation, using more than intended, continuing to use even when it causes problems in everyday life. Many experience withdrawal symptoms when stopping their drug of choice such as nausea, shakes or insomnia. Symptoms of tolerance, withdrawal and preoccupation are also observed in behaviour disorders such as shopping, gambling, or gaming (Hartney, 2020).
The word addict usually generates ideas of either someone attending A.A. or the homeless addicts or possibly a personal connection. Many assume that living this way is a choice. Furthermore, that addicts continue to choose drugs over family, friends, or societal responsibilities. Many studies with animal models show that they will also take drugs versus another option like food or water. The exception of course is when animals are in a healthy, happy environment versus a lonely, boring environment (Kuhn, Kalivas, & Bobadilla, 2019).
The psychopathological view agrees that there are several biopsychosocial factors involved in SUD. The medical model of addiction explains SUD as a disease, that the brain and body is changed physically in a way that the individual cannot be cured, instead they must live to maintain their disease similar to someone living with diabetes. Following repeated exposure to a drug or an experience, there are “…neurobiological changes that occur when a person transitions from recreational substance use to a substance use disorder” (Uhl, Koob & Cable, 2019). Some areas that are involved in craving, motivation, and the drug-taking experience are the amygdala, orbitofrontal cortex, anterior cingulate gyrus, and hippocampus. It is when one system becomes damaged, the other system will then compensate, so the body will adapt. Even the most entrenched sufferer can recover and live a healthy life free from their SUD.
A major problem is mislabeling, calling a behaviour an addiction that is not actually addiction, or the belief that addiction is permanent, which it does not have to be. Consider how nicotine is a highly addictive substance, as there are nicotinic receptors in almost every neuron. However, over forty-million Americans have quit smoking (Peele & Brodsky, 2015). There are also countless stories of heroin, cocaine, and alcoholics that have recovered, similarly with behaviour disorders. The work of Stanton Peele and Gaber Mate tell us a great deal about how people are instead “…active agents in-not passive victims of-their addictions” (Peele & Brodsky, 2015). Peele condemns the societal issues associated with addiction. Anyone familiar with Mate knows how he strives to connect childhood trauma to addiction as well as other mental and physical problems. Moreover, he argues that the focus should be on healing the underlying issues being masked, and for a societal shift to happen regarding how addiction is perceived and dealt with. Moreover, parents should comprehend that the first three years are vital in development, although there are other sensitive periods throughout development that you can essentially “fix” or mold the brain in a certain way, some damage is extremely difficult to repair (Mate, 2018).
There are 400 types of therapy, some are helpful with SUD. Considering some cognitive-behaviour models can change habits and prevent relapse. Specifically, acceptance and commitment therapy tends to work better than other therapies such as aversion or contingency (Comer & Comer, 2019). Conversely, contingency management does seem to mitigate dropouts and relapse. Prior to applying these, the individual may require detox to engage in therapy with a “clearer” mind. Antagonist drugs or drug maintenance approaches have been shown to be helpful in many cases. Complimentary activities should be added to any treatment ensuring overall wellbeing and healthy living such as yoga, meditation, exercise, or equine-assisted therapy. Even massage has been useful to relieve the tension that is seen in many SUDs, as well as decrease withdrawal symptoms (Miller, 2021). Family and group therapy are effective as witnessed in the 2 million members of Alcoholics Anonymous. This particular type of group therapy adds abstinence and a spiritual aspect. Those suffering with SUD are individualized, the clinician must work to find the specific type of treatment combination that works for their unique client. Unfortunately, of the close to 21 million Americans who suffer with a SUD, only about 2.5 million will receive the treatment they need (Miller, 2021). Key factors that can make or break someone’s choice to use is the resiliency they built through life and knowing they are worthy of more.
Comer R., & Comer J. (2019). Fundamentals of Abnormal Psychology. 9th edition. Worth Publishing. New York. NY. Hartney, E., (2020, March 21).
DSM-5 criteria for substance use disorders. Very Well Mind. Retrieved from https://www.verywellmind.co
Caylee Gorzitza is completing her BSc. of Psychology as well as completing her Integrative Health Coach training through the Nickerson Institute. Her company, Mind Mechanic, combines her skill sets to improve mental health care access for men.