Substance Abuse / Addiction

Addiction, or dependence on a particular substance or activity, is one of the most complex areas of mental health. Addiction can often be difficult to treat, and there is a good deal of controversy surrounding the causes of addiction and the best approaches to treatment. Individuals who find themselves experiencing an addiction to drugs or alcohol often find the services of a mental health professional to be helpful in overcoming the addiction.

WARNING SIGNS OF DRUG OR ALCOHOL ABUSE

Drug and alcohol abuse or misuse—excessive or inappropriate use of a substance—can be difficult to define, and people’s opinions, values, and beliefs vary significantly on the topic. For some, any use of an illegal drug or any use of alcohol with the primary purpose of intoxication constitutes abuse. For others, abuse is indicated by recurring, negative consequences, such as:

  • Failure to meet social, work, and academic obligations.

  • Alcohol- or drug-related legal problems, such as arrest for driving while intoxicated.

  • Relationship problems with intimate partners, friends, and family.

  • Impulsivity, such as spending money excessively.

  • Diminished interest in other activities.

  • Short-term memory loss or blackouts.

SIGNS THAT ABUSE HAS BECOME ADDICTION

Substance abuse can lead to substance dependence or addiction when both the amount of substance used and the rate of use increase. People who experience drug or alcohol addiction feel unable to control the impulse to use, and they often experience withdrawal symptoms in the sudden absence of the substance.

Alcoholism, for example, occurs when people become chemically dependent on alcohol, and those who are addicted may become ill if they suddenly stop drinking. People may also feel psychologically dependent on a substance and continue to use it, particularly under stressful circumstances or to alleviate other psychological problems. Some people deny or are unaware that they have a problem with addiction, and sometimes a person’s substance dependency and abuse remain hidden from loved ones.

Signs of chemical dependence include:

  • Increasing tolerance, or the need to consume more of the substance to reach the desired altered state.
    Requiring the substance throughout the day.
  • Seeking the company of other users and cutting off social ties with non-users.
  • Dismissing or resenting expressions of concern from loved ones.
    Avoiding other activities and failing to meet obligations.
  • Experiencing withdrawal symptoms in the absence of the substance.
    Hiding use from family and friends.
    Binging—using heavily—for many hours or several days.
  • Feeling unable to quit.

WHAT LEADS A PERSON TO MISUSE DRUGS OR ALCOHOL?

Psychological, biological, social, and physiological factors might all play a role in whether or not a person comes to abuse drugs or alcohol. A family history of substance abuse can make a person more vulnerable to addiction, and social factors, such as peer pressure and ease of availability can increase the likelihood of a person developing a problem with drugs or alcohol. In addition, once a person begins using heavily, physiological changes often take place, and that person may then become physically dependent, requiring him or her to continually use the substance in order to avoid withdrawal symptoms.

Alcoholism tends to run in families, although not all children of people addicted to alcohol become addicted themselves, and there is some debate among psychologists about the degree to which alcoholism is genetic. Some researchers are searching for an addiction or alcoholism gene, while others point out that simply witnessing a parent drink in response to stress increases a child’s likelihood of choosing to drink in response to stress. Studies do show that genes, such as those that have an effect on the way a person responds to alcohol, may be responsible for about half of the risk of developing alcoholism. Some of these genes increase a person’s risk, while some may instead decrease the risk of a person’s developing alcoholism.

Research indicates that the vast majority of people who are addicted to drugs or alcohol have an underlying mental health condition or significant emotional/psychological difficulty. About half of all people with mental health diagnoses will face challenges with drugs or alcohol at some point in their lives, usually as a result of using drugs or alcohol to self-medicate.

People who misuse drugs or alcohol often do so as a way of coping with experiences, memories, or events that emotionally overwhelm them. Whether they are equipped with appropriate coping strategies or not, people who misuse substances rely on the immediate gratification of drugs and alcohol as an alternative to facing the issues at hand. In the long term, however, reliance on drugs and alcohol will almost surely worsen any emotional or psychological condition. Chronic self-medication may be a sign that therapy is warranted in order to address an underlying condition or difficulty.

SUBSTANCE ABUSE AND ADDICTION IN THE FAMILY UNIT

According to Jeremy Frank, PhD, CADC, a Philadelphia addiction psychologist, “The effects and consequences on substance use on families are devastating. Over 7 million children in the United States—more than 10%—live with a parent who has problems with alcohol, according to a 2012 Substance Abuse and Mental Health Services Administration report. These children and their families are at risk for other co-morbid mental health problems, such as depression, anxiety, low self-esteem, substance use issues, and addiction.”

A parent who has become addicted to alcohol or uses drugs is statistically more likely to abuse or neglect his or her partner and/or children, and when parents of very young children are emotionally distant due to alcohol and drug use, the attachment bond between parent and child is likely to be weak. A family affected by addiction may also experience financial difficulties, and in some circumstances, a parent may be imprisoned as a result of drug or alcohol abuse, potentially leading to long-term separation from children and often putting further strain on the family unit. Some children of adults who are addicted may have difficulties in school due to anxiety and other stressors that may be experienced as a result of their parents’ addictions. They might also find themselves acting as parents to any younger siblings as well as the parent who is addicted, which can make it more difficult for the child to have healthy relationships with appropriate boundaries, later in life.

It may also be difficult for parents to address the addiction of an adult child. Parents may feel responsible for their child’s addiction or may be unsure of how to best help the child. In trying to help them overcome addictive behavior, they may at times end up enabling the child instead. In programs such as Alcoholics Anonymous, these parents can learn how to keep from enabling their child while still offering love. Often a counselor or social worker can provide assistance to parents in this area and help them find the best way to bring up the subject of substance abuse and addiction with their child.

It is likely that all members of a family until will be affected when one member of a family experiences an addiction. Early acknowledgment and treatment of the substance abuse or addiction may have significant benefit in promoting recovery and preventing long-term negative effects, both on the health of the person who is addicted and on the bonds between family members.

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