What is Drug Addiction?

Drug addiction is a chronic disease characterized by compulsive or uncontrollable drug seeking and use despite harmful consequences and changes in the brain, which can be long-lasting. These changes in the brain can lead to unhealthy behaviors seen in people who use drugs. Drug addiction is also a relapsing disease. Relapse is the return to drug use after an attempt to stop. The path to drug addiction begins with the voluntary act of taking drugs.

But over time, a person’s ability to choose not to do so becomes compromised. Seeking and taking the drug becomes compulsive. This is primarily due to the effects of long-term drug exposure on brain function. Addiction affects parts of the brain involved in reward and motivation, learning and memory, and control over behavior. Thus, addiction is a disease that affects both the brain and behavior.

What is SUD?

A substance use disorder (SUD) is a mental disorder that affects a person’s brain and behavior, leading to an inability to control their use of substances such as legal or illegal drugs, alcohol, or medications. Symptoms can range from moderate to severe, with addiction being the most severe form of SUDs. Researchers have found that about half of individuals who experience a SUD during their lives will also experience a co-occurring mental disorder and vice versa. Co-occurring disorders can include anxiety disorders, depression, attention-deficit hyperactivity disorder (ADHD), bipolar disorder, personality disorders, and schizophrenia [1]. 

The Connection Between Substance Use Disorders and Mental Illness

Many individuals who develop substance use disorders (SUD) are also diagnosed with mental disorders and vice versa. Multiple national population surveys have found that about half of those who experience a mental illness during their lives will also experience a substance use disorder and vice versa. Although fewer studies on comorbidity among youth, research suggests that adolescents with substance use disorders also have high rates of co-occurring mental illness; over 60 percent of adolescents in community-based substance use disorder treatment programs also meet diagnostic criteria for another mental illness.

While SUDs and other mental disorders commonly co-occur, that does not mean that one caused the other. Three possibilities that could explain why SUDs and other mental disorders may occur together:

  • Common risk factors can contribute to both SUDs and other mental disorders. Both SUDs and other mental disorders can run in families, suggesting that specific genes may be a risk factor. Environmental factors, such as stress or trauma, can cause genetic changes passed down through generations and may contribute to developing a mental disorder or a substance use disorder.
  • Mental disorders can contribute to substance use and SUDs. Studies found that people with a mental disorder, such as anxiety, depression, or post-traumatic stress disorder (PTSD), may use drugs or alcohol as a form of self-medication. However, although some drugs may temporarily help with some symptoms of mental disorders, they may make the symptoms worse over time. Additionally, brain changes in people with mental disorders may enhance the rewarding effects of substances, making it more likely they will continue to use the substance.
  • Substance use and SUDs can contribute to the development of other mental disorders. Substance use may trigger brain structure and function changes that make a person more likely to develop a mental disorder.

Substance Use Disorder Treatment For People With Co-occurring Disorders

The term “co-occurring disorder” (COD) refers to the condition of having at least one mental disorder and at least one substance use disorder (SUD). Of the 51.1 million adults with any past-year mental illness in 2019, 9.5 million had both any past-year mental illness and a SUD (Substance Abuse and Mental Health Services Administration.

Completing a Full Assessment

Assessment involves a combination of:

  • Screening to detect the presence of CODs
  • Evaluating background factors, mental disorders, SUDs, and related medical and social problems critical for treatment planning
  • Diagnosing the type and severity of SUDs and mental disorders
  • Matching the client to initial services
  • Appraising the client’s needs for social and community support services
  • Conducting continuous evaluation
Substance abuse among individuals with co-occurring mental disorders has been a topic of concern with regards to prevalence, diagnostic considerations, treatment, and relapse. 
Substance abuse among individuals with co-occurring mental disorders has been a topic of concern with regards to prevalence, diagnostic considerations, treatment, and relapse. 

Providing an appropriate level of care

Whenever possible, clients should be placed in a level of care appropriate to the functional challenges, severity of symptoms, and recovery environment aligned with both their SUD and their mental disorders. Several models are available for clinicians to determine which level of care is best.

Practice Principles of Integrated Treatment for CODs

SUDs and mental disorders are treated concurrently to meet the full range of clients’ symptoms.

  • Providers of integrated care receive training in the treatment of both SUDs and mental disorders.
  • CODs are treated with a stepwise approach tailored to the client’s stage of readiness for
    treatment (e.g., engagement, persuasion, active treatment, relapse prevention).
  • Motivational techniques (e.g., motivational interviewing, motivational counseling) are integrated
    into care to help clients reach their goals, particularly at the engagement stage of treatment.
  • Addiction counseling is used to help clients develop healthier, more adaptive thoughts and
    behaviors in support of long-term recovery.
  • Clients are offered multiple treatment formats, including individual, group, family, and peer
    support, as they move through the various stages of treatment.
  • Pharmacotherapy is discussed in multidisciplinary teams, offered to clients when appropriate,
    and monitored for safety (e.g., interactions with other medications), adherence, and response.

Diagnosis and Treatment

SUDs and mental disorders are treated concurrently to meet the full range of clients’ symptoms.
SUDs and mental disorders are treated concurrently to meet the full range of clients’ symptoms.

Generally, it is better to treat the SUD and the co-occurring mental disorders together rather than separately. Thus, people seeking help for SUD and other mental disorders need to be evaluated by a health care provider for each disorder. Because it can be challenging to make an accurate diagnosis due to overlapping symptoms, the provider should use comprehensive assessment tools to reduce the chance of a missed diagnosis and provide targeted treatment.

It is also essential that treatment, including behavioral therapies and medications, be tailored to an individual’s specific combination of disorders and symptoms, the person’s age, the misused substance, and the specific mental disorder(s). The several behavioral therapies promise to treat individuals with treating substance use and mental disorders. Health care providers may recommend behavioral therapies alone or in combination with medications.

The effective behavioral therapies for adults with SUDs and different co-occurring mental disorders include the following:

  • Assertive Community Treatment (ACT): This form of community-based mental health care emphasizes outreach to the community and an individualized treatment approach.
  • Therapeutic Communities (TC)[2]: TCs are a common form of long-term residential treatment that focuses on helping people develop new and healthier values, attitudes, and behaviors.
  • Cognitive Behavioral Therapy (CBT): CBT is a type of talk therapy aimed at helping people learn how to cope with difficult situations by challenging irrational thoughts and changing behaviors.
  • Contingency Management (CM)[3]: CM principles encourage healthy behaviors by offering vouchers or rewards for desired behaviors.
  • Dialectical Behavior Therapy (DBT): DBT uses concepts of mindfulness and acceptance or being aware of and attentive to the current situation and emotional state. DBT also teaches skills that can help intense control emotions, reduce self-destructive behaviors (e.g., suicide attempts, thoughts, or urges; self-harm; and drug use), and improve relationships.

Behavioral Therapies

Some effective behavioral treatments[4] include:

  • Brief Strategic Family Therapy (BSFT): BSFT therapy targets family interactions to maintain or worsen adolescent SUDs and other co-occurring problem behaviors.
  • Multidimensional Family Therapy (MDFT): MDFT works with the whole family to simultaneously address multiple and interacting adolescent problem behaviors, such as substance use, mental disorders, school problems, delinquency, and others.
  • Multisystemic Therapy (MST): targets key factors associated with severe antisocial behavior in children and adolescents with SUDs.

Medications

Effective medications exist for treating opioid, alcohol, and nicotine addiction and lessening the symptoms of many other mental disorders. In addition, some medications may help treat multiple disorders. Many options have successfully treated drug addiction, including behavioral counseling, medication; medical devices and applications used to treat withdrawal symptoms or deliver skills training; evaluation and treatment for co-occurring mental health issues such as depression and anxiety; and long-term follow-up to prevent relapse. A range of care with a tailored treatment program and follow-up options can be crucial to success. Treatment should include both medical and mental health services as needed.

At We Level Up Treatment Center provides world-class care with round-the-clock medical professionals available to help you cope. We work as an integrated team providing information about treating drug addiction by treating co-occurring mental health issues and other aspects of treatment. Make this your opportunity to reclaim your life. Call today to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions.

We Level Up treatment center can help with inpatient therapy programs exclusively. Depending on the extent of secondary behavioral disorders such as addiction we can first help assess your condition and thereafter guide you to suitable treatment options. We do not provide outpatient and PHP services at this time. Call to learn more.

Your call is private and confidential, and there is never any obligation.

Sources

[1] NIH – https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health

[2] NIDA – https://www.drugabuse.gov/publications/research-reports/therapeutic-communities/what-are-therapeutic-communities

[3] NIDA – https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/contingency-management-interventions-motivational-incentives

[4] NIDA – https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/

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