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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. They keep using alcohol or a drug even when they know it will cause problems. Yet a number of effective treatments are available and people can recover from addiction and lead normal, productive lives.

People can develop an addiction to:

  • Alcohol
  • Marijuana
  • PCP, LSD and other hallucinogens
  • Inhalants, such as, paint thinners and glue
  • Opioid pain killers, such as codeine and oxycodone, heroin
  • Sedatives, hypnotics and anxiolytics (medicines for anxiety such as tranquilizers)
  • Cocaine, methamphetamine and other stimulants
  • Tobacco

People with a substance use disorder have distorted thinking, behavior and body functions. Changes in the brain’s wiring are what cause people to have intense cravings for the drug and make it hard to stop using the drug. Brain imaging studies show changes in the areas of the brain that relate to judgment, decision making, learning, memory and behavior control.

These substances can cause harmful changes in how the brain functions. These changes can last long after the immediate effects of the drug — the intoxication. Intoxication is the intense pleasure, calm, increased senses or a high caused by the drug. Intoxication symptoms are different for each substance.

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  • Mar 24, 2020
Online Support for People with Mental Health Conditions

While these unprecedented times are stressful for everyone, people with mental health conditions may face particular challenges. As much as possible, try to keep up your overall health, try to follow your treatment plan, and try to manage your stress. Engage in activities that help manage your stress, such as exercise, relaxation techniques and creative activities. It is even more important to stay connected with friends, family and your support network. Many organizations offer ways to connect and find support online or by phone for general mental health and for specific conditions.

  • Mar 23, 2020
New Research Affirms Effectiveness of AA and Other 12-Step Programs in Treating Alcohol Use Disorder

Alcoholics Anonymous (AA) has been helping people recover from alcohol use disorder for more than 80 years. There has been very little rigorous research to date, but a new review study finds AA is effective in helping treat alcohol use disorder and reduces health care costs.

  • Sep 27, 2019
A Presidential Initiative for Mental Health

The 2020 presidential election will be one of the most consequential in recent memory. Whoever is inaugurated the following January will have to contend with a growing health care crisis, particularly where mental health and substance use disorders are concerned.

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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

What resources are available for family members of an individual with addiction?

Al-Anon and Alateen are widely available and free resources for family members. These organizations offer mutual help groups. Members do not give direction or advice to other members. Instead, they share their personal experiences and stories, and invite other members to “take what they like and leave the rest” — that is, to determine for themselves what lesson they could apply to their own lives. The best place to learn how Al-Anon and Alateen work is at a meeting in your local community. Most professional treatment programs also offer family groups to help families support their loved ones struggling with addiction. 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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