Addiction Defined
The American Society of Addiction Medicine defines addiction as "a disease process characterized by the compulsive use of a specific psychoactive substance despite physical, psychological, or social harm".
Some of the physical and behavioral changes that may occur include:
- Tolerance (needing more substance for the same effect)
- Withdrawal (symptoms develop when the substance is stopped or reduced, e.g., shakes, anxiety, etc.)
- Substance is taken in larger amounts and for longer periods than intended
- Persistent desire or unsuccessful efforts to cut down or control use
- A great deal of time spent to obtain the substance and to recover from its effects
- Important social, occupational or recreational activities given up or reduced
- Use continues despite knowledge of having physical or psychological problems caused or exacerbated by the substance use.
We use the term "addiction" because it best describes the brain disease we are discussing. Therefore, when we discuss addiction we are including "alcoholism" because alcohol is also a drug.
Research has shown that a network of four brain circuits is involved in addiction:
- Reward/pleasure
- Motivation/drive
- Learning/memory
- Judgement/control
The brain of someone who is addicted to drugs is a changed brain. It is different from that of a normal person.
ADDICTION / DEFINED
As the addiction progresses:
- Drugs and alcohol overrides motivators such as intimacy or achievement in the pleasure/reward center in the brain. The substance becomes a primary motivator. It can even become as strong or stronger as the instinct to eat or to procreate.
- Memories become distorted, messages from the brain tell the addict that use of drugs or alcohol will bring only pleasure and not the pain associated with continued use (this is called euphoric recall).
- Judgment and control are short-circuited. The individual continues to use in spite of negative consequences or a desire to stop. The addict loses the ability to make rational decisions regarding risks and benefits of substance use. The loss of control experienced by the addict is difficult for others to understand and often difficult for the addict to accept.
Specific structures in the brain are involved in the four circuits discussed above. Specific neuroreceptors in these regions receive chemical messages carried by neurotransmitters Repeated use of substances alters receptors and neurotransmitters. Some people may be particularly susceptible to developing addiction, perhaps due to a deficiency in specific neuro-receptors. Whether or not the individual begins with an increased susceptibility or not, the repeated use of substances alters brain function and can lead to the viscous cycle of addiction described above.
The disease of addiction is chronic and progressive.
Detoxification is the process of eliminating the substance from your system. Through this process, withdrawal symptoms emerge. In addition to the "acute" stage of withdrawal lasting days, some people experience "post acute withdrawal" symptoms. These may include irritability, insomnia, difficulty thinking clearly and other, sometimes subtle, symptoms.
Adaptation occurs as your body and brain are exposed to the substance. The "acute" stage of withdrawal is the body's attempt to return to "normal" to a state of balance ("homeostasis").
The effects of the particular substance dictate the withdrawal symptoms - withdrawal expresses itself as the opposite of the substance.
CO-OCCURRING DISORDERS
NIDA has punctuated that many individuals simultaneously suffer from mental illness, problem alcohol and drug use, and other medical or physical disorders, resulting in enormous individual suffering. Common co-occurring disorders include mood disorders compounded with substance abuse, chronic pain with depression and/or drug abuse, anxiety disorders with cancer, panic disorder with asthma, hepatitis C with alcohol dependence, and schizophrenia with post-traumatic stress disorder. Such co-occurring conditions may fluctuate across the lifespan in a cyclical pattern of heightened risk, onset, intervention, recovery, and relapse, challenging the utility of the traditional "acute care" model of service delivery for these conditions. These research findings underscore the importance of assessing and being clinically effective with adolescents.
Depending on the setting, prevalence rates for co-occurring disorders (dual diagnosis) ranges from 20 to 80%. In our experience with the adolescent population, we have found that prevalence rates of co-occurring disorders are in the higher end of these findings.
Due to the presence and effect of co-occurring disorders in adolescents, it requires that we are both clinically sensitive and effective in the diagnostic area and that therapeutic exposure be efficient in addressing the complexity required in treatment. Newport Academy has developed a multidisciplinary approach, which means that each adolescent girl is exposed to multiple therapeutic environments and opportunities that both assess and treat co-occurring issues. Research supports that treatment response to therapeutic approaches vary, there is no "silver bullet". By exposing the girls to multiple therapeutic mediums we are seeking to identify those therapeutic touch points that are most effective for each adolescent girl.
