Addiction is a complex condition, a chronic 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, such as alcohol or drugs, to the point that it takes over their life. They keep using alcohol or a drug when they know it will causes problems. Yet a number of effective treatments are available and people can recover from addiction and lead normal, productive lives.

    People with a substance use disorder have disturbed 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.

  • People can develop an addiction to:
  • According to the National Institute on Drug Abuse, people begin taking drugs for a variety of reasons, including:

      Several types of anxiety disorders are identified in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).

    • to feel good – feeling of pleasure, "high"
    • to feel better – e.g., relieve stress
    • to do better – improve performance
    • curiosity and peer pressure
    • People with addictive disorders may be aware of their problem, but be unable to stop it even if they want to. The addiction may cause health problems as well as problems at work and with family members and friends. The misuse of drugs and alcohol is the leading cause of preventable illnesses and premature death.

  • Symptoms of substance use disorder are grouped into four categories:

      Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use

      Social problems: substance use causes failure to complete major tasks at work, school or home; social, work or leisure activities are given up or cut back because of substance use

      Risky use:: substance is used in risky settings; continued use despite known problems

      Drug effects:: tolerance (need for larger amounts to get effect); withdrawal symptoms (different for each substance)

      Many people experience both mental illness and addiction. The mental illness may be present before the addiction. Or the addiction may trigger or make a mental disorder worse.

  • How Is Addiction Treated?

      People can recover from addiction. Effective treatments are available.

      The first step on the road to recovery is recognition of the problem. The recovery process can be hindered when a person denies having a problem and lacks understanding about substance misuse and addiction. The intervention of concerned friends and family often prompts treatment.

      A health professional can conduct a formal assessment of symptoms to see if a substance use disorder exists. Even if the problem seems severe, most people with a substance use disorder can benefit from treatment. Unfortunately, many people who could benefit from treatment don't receive help.

      Because substance misuse affects many aspects of a person's life, multiple types of treatment are often required. For most, a combination of medication and individual or group therapy is most effective. Treatment approaches that address an individual's situation and any co-occurring medical, psychiatric and social problems can lead to sustained recovery.

      Medications are used to control drug cravings and relieve severe symptoms of withdrawal. Therapy can help addicted individuals understand their behavior and motivations, develop higher self-esteem and cope with stress. Other treatment methods may include:

    • Hospitalization
    • Therapeutic communities (highly controlled, drug-free environments)
    • Outpatient programs
  • Some suggestions to get started:

      Learn all you can about alcohol and drug misuse and addiction.

      Speak up and offer your support: talk to the person about your concerns, and offer your help and support, including your willingness to go with them and get help. Like other chronic diseases, the earlier addiction is treated, the better.

      Express love and concern: don't wait for your loved one to "hit bottom." You may be met with excuses, denial or anger. Be prepared to respond with specific examples of behavior that has you worried.

      Don't expect the person to stop without help: you have heard it before – promises to cut down, stop – but, it doesn't work. Treatment, support, and new coping skills are needed to overcome addiction to alcohol and drugs.

      Support recovery as an ongoing process: once your friend or family member is receiving treatment, or going to meetings, remain involved. Continue to show that you are concerned about his/her successful long-term recovery.

  • Some things you don't want to do:
    • Don't preach: Don't lecture, threaten, bribe, preach or moralize.
    • Don't be a martyr: Avoid emotional appeals that may only increase feelings of guilt and the compulsion to drink or use other drugs.
    • Don't cover up, lie or make excuses for his/her behavior.
    • Don't assume their responsibilities: taking over their responsibilities protects them from the consequences of their behavior.
    • Don't argue when using: avoid arguing with the person when they are using alcohol or drugs; at that point he/she can't have a rational conversation.
    • Don't feel guilty or responsible for their behavior; it's not your fault.
    • Don't join them: don't try to keep up with them by drinking or using.
    • Adapted from: National Council on Alcoholism and Drug Dependence

  • Gambling Disorder:

      In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gambling disorder is included in a new category on behavioral addictions. This reflects research findings that gambling disorder is similar to substance-related disorders in many ways. Recognizing these similarities will help people with gambling disorder get needed treatment and services, and may help others better understand the challenges.

  • Internet Gaming Disorder:

      Internet gaming disorder is included in DSM-5 in the section of disorders requiring further research. This reflects the scientific literature showing that persistent and recurrent use of Internet games, and a preoccupation with them, can result in clinically significant impairment or distress. The condition criteria do not include general use of the Internet or social media.

  • Caffeine Use Disorder

      Caffeine use disorder is also included in DSM-5 in the section of conditions requiring further research. While there is evidence to support this as a disorder, it is not yet clear to what extent it is a clinically significant disorder.