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Help With Addiction and Substance Use Disorders

Curated and updated for the community by APA

Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life.

See definition, symptoms, & treatment

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What can you do to prevent relapse?

Preventing relapse to substance use is mainly a matter of becoming aware of the triggers to relapse and either finding ways to avoid or cope with them. Triggers can be external, for example being in places where substances are being used. Stress of any kind (job stress, financial stress, arguments with important people) can also be an external trigger. Triggers can also be internal such as craving, depressed mood, anxiety, hunger or fatigue. The key is to anticipate triggers ahead of time so they don’t come as a surprise and use a plan or coping strategy to deal with the triggers. Usually professional help is needed to gain awareness of and plans to deal with triggers to relapse. There are also very good medications for alcohol, opioid and tobacco use disorders that effectively reduce craving and can help prevent relapse. More

I live with pain and I want help, but I’m worried about becoming addicted to pain medication. What can I do?

Opioid type medications that have potential to lead to addiction are only one way, and probably not the best way, to help manage chronic pain. So the best plan is to try all the alternatives first.

Non-medication interventions such as graded exercise programs, physical therapy, mindfulness meditation, yoga, tai-chi and a form of psychotherapy called cognitive-behavioral therapy (CBT) all take some effort but often work very well. Acupuncture may benefit some people living with pain. Many medications that do not have addiction potential can also be helpful for chronic pain. These include anti-inflammatory medications like aspirin, ibuprofen or naproxen; antidepressants like nortriptyline or duoloxetine; or medications often used for seizures like gabapentin or pregabalin.

If you or someone you know does require opioid pain medications to help manage chronic pain, it is reassuring to know that the majority of people who take these medications for chronic pain do not become addicted to them, although anyone who takes these type of medications for more than a few weeks is likely to have some tolerance (less effect of the medication over time) and withdrawal symptoms if the medications are stopped abruptly. More

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About the Expert:

Andrew Saxon, M.D.
Professor and Director, Addiction Psychiatry Residency Program
University of Washington
Director, Center of Excellence in Substance Abuse Treatment and Education (CESATE)
VA Puget Sound Health Care System
Seattle, Wash.

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Keith’s Story

Keith, a 45-year-old plumber, was referred for a psychiatric evaluation after his family met with him to express their concern about his heavy drinking. Since making the appointment three days earlier, Keith denied having a drink.

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Have a Story of Your Own to Share?

Editor's Choice

MAY 20, 2017

Snapshots of Recovery from Addiction

Foster's Daily Democrat

It is estimated that 478 people died of a drug overdose in New Hampshire in 2016. The epidemic that continues to shatter lives and families across New England has swelled in recent years, as states have begun taking an all-hands-on-deck approach to ceasing its destruction. The four components of recovery are health, home, purpose and community, according to New Hampshire’s Granite Pathways. Several individuals shared their stories at a Seacoast Public Health Network addiction and recovery event in Brentwood, New Hampshire.

MAY 21, 2017

“Why Won’t They Just Stop?” Some Misconceptions of Addiction

PsychCentral

Finding out that a loved one is addicted to drugs is a confusing time for family members, often evoking feelings of anger, anxiety and helplessness. When the addict finally enters treatment either willingly or not so willingly, family members struggle with many questions and often have misconceptions about addiction.

MAY 22, 2017

How Addiction Holds Our Brains Hostage

Paste Magazine

Addictive drugs and behaviors stick in our brains. From the positive—love—to the negative—alcohol, gambling and cigarettes—we crave the dopamine and positive neurotransmitters that flood our brain when we get what we want. Over time, with both love and other drugs, our brain adapts in a way that makes the substance boring, old, and typically less pleasurable. Naturally, we seek more reward to meet the same dopamine reaction we first received.