Understanding Drug Addiction
By CareerSmart Learning Contributor, November 20, 2015, as published by Healthcare Hot Spot
From alcohol to methamphetamine, to prescription drugs and cold medicines, drug use and addiction is a highly complex and controversial subject. One might assume that the user of a drug can change their behavior and stop using the drug if they simply have willpower and the right attitude. Due to this assumption, people who are addicted to drugs are often seen as suffering from a moral failing or lack of self-control rather than from a health condition. Many authorities of substance abuse and addiction support that drug addiction is an illness and “disease of the brain”1 and acknowledge that drugs can change the brain in ways that foster continuation of drug use, even when the individual may no longer want to use it. While drug use may initially be voluntary, it is believed that with long-term use, chemicals in drugs interrupt the neurotransmitters and neuroreceptors of the brain and alter how the brain functions in sending, receiving, and processing information, thus interfering with an individual’s ability to make voluntary decisions and further leading to compulsive craving, seeking, and abuse of the drug. Brain imaging studies of people with addiction show physical changes in the area of the brain responsible for judgment, decision making, learning, and memory and behavior control.
However, opponents and other researchers define drug addiction as a “disorder of choice”2 and argue that a gathering of clinical evidence and survey data suggest that drug addiction is a result of voluntary behavior (choice) and that changes of the brain in imaging studies do not necessarily represent malfunctioning of the brain. While no one wants to battle drug addiction, some may dispute that drug addiction is a voluntary process that an individual leads themselves to with their own decisions. Some experts fear that describing drug addiction as a disease removes the primary responsibility away from the person who is addicted.3
Additionally, there are other studies that add other predispositions to addiction, such as genetics, addictive personality disorder, or other psychological issues.
Whether you believe drug addiction is a disease of the brain or a disorder of choice, the consequences of drug addiction are far reaching and result in substantial personal, professional, and societal costs. When considering financial cost alone, it is reported that abuse of tobacco, alcohol, and illicit drugs exceeds $700 billion annually in costs related to crime, lost work productivity, and healthcare.3 While significant, these financial costs pale in comparison to the personal costs to those addicted and their loved ones.
Addiction is complex but treatable. Nurses and other healthcare professionals play a vital role in the care of people with addiction and will find these patients in all types of care settings. Evidence-based interventions in working with persons with addiction yield the best opportunities for helping them achieve the highest level of health possible. Fortunately, the scientific knowledge of effective, evidence-based therapy to treat people with addiction has increased substantially.4 Promoting and implementing prevention and early intervention programs is ideal for reducing the impact of substance abuse or addiction.
Before considering treatment practices, it is vital that healthcare professionals incorporate interventions such as:
- Replace negative attitudes towards persons struggling with addiction with nonjudgmental care. It has been found that negative attitudes of healthcare providers have a negative impact on the care these patients receive.5
- Educate the patient and provide information about the harmful effects, both physical and psychological, of drug use and how to prevent serious outcomes. For example, provide education on possible disease transmission, such as the association of sharing needles with the transmission of HIV and Hepatitis B and C.
- Know resources in advance so that you have these types of supports and community resources available when the individual is ready and amenable to treatment options.
Treatment takes place within a care continuum that includes:
- Screening, diagnosis, and assessment
- Active treatment including stabilization, early recovery treatment, and management of comorbidities (such as mental illness)
- Continuing engagement as part of a longer-term chronic care plan and relapse prevention
By engaging the patient and continuing efforts to retain them in treatment, providers can help support the changes needed to recover from addiction. For the healthcare professional, remembering that addiction is an illness, applying evidence-based treatments/interventions, and providing care in a non-judgmental manner will help the individual obtain the help they need.
- National Institute on Drug Abuse. Drug Facts: Understanding Drug Abuse and Addiction. Revised November 2012. Retrieved on 11/17/15 from http://www.drugabuse.gov/publications/drugfacts/understanding-drug-abuse-addiction
- Branch, Marc N. NCBI (National Center for Biotechnology Information). Review of Gene Heyman’s Addiction: A Disorder of Choice. March, 2011. Retrieved on 11/17/15 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047254/
- NIH, National Institute on Drug Abuse http://www.drugabuse.gov/related-topics/trends-statistics). Retrieved November 07, 2015 from http://www.drugabuse.gov/related-topics/trends-statistics
- American Psychological Association. Retrieved November 07, 2015, from http://www.apa.org/divisions/div50/doc/evidence_-_based_treatment_practices_for_substance_use_disorders.pdf
- Harm Reduction: Compassionate Care Of Persons with Addictions. (n.d.). Retrieved November 06, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4070513/