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No more shying away from “Addiction” by Farida El Ghandour, MSc.

Addiction is a lot more than someone scoring heroin in a dark alley.

Addiction is a prevalent mental health problem that isn’t receiving half of the attention it needs and when it does, more often than not it is the wrong kind of attention. So, I always feel like it is my duty as a mental health professional with a large experience and knowledge in the area of substance abuse to shed light on the topic and fight as many related stigmas as possible. When I first decided to write this article, I went around speaking to people about addiction and asked them to throw at me their most unanswered questions. Below are the most common things I heard.

So, let’s delve into them

Can someone do drugs and not be an addict?

To answer this question, we need to establish a distinction between drug misuse, and drug addiction.

Misuse and addiction are often confused given their overlapping patterns. However, misuse is a term used to distinguish inappropriate, excessive or unhealthy substance use from the use of alcohol or drugs in moderation or through a prescription. Misuse usually includes repeated use of drugs for pleasure, stress relief, and/or to avoid reality and obligations. It also includes using prescription drugs in ways other than prescribed.

Drug addiction on the other hand is on the severe end of the substance use spectrum as individuals with an addiction problem, are people who have reached a point of entirely relying on the substance to function and cope with distress in any area of life. Addicts usually struggle to stop or manage their use despite the harmful and destructive impact it continues to cause them. An addict is someone whose whole life and thinking is centered around drugs in one form or another—the getting, the using and then finding ways and means to get more.

Is Addiction a moral issue?

Actually, conversely to what many people still think, addiction does not happen due to a moral failure or lack of willpower. Yes, the original decision to take drugs is largely voluntary. However, with continued use, a person’s ability to exert self-control can become extremely impaired.Addiction is a mental health condition driven by the compulsive need to engage in a certain behavior/action. A person with an addiction problem, is someone who developed a dependency on one or multiple substances/activities and is unable to quit despite their harmful effects. A person doesn’t choose to become addicted just as much as they don’t choose to get depression or any other mental illness. There are biological predispositions that play part in making someone more prone to becoming addicted than another. But for such a condition to be activated, these predispositions need to be triggered by one or more environmental factors such as peer pressure, family dysfunctions, psychological struggles or traumas.

Are all drugs addictive?

I know what you think

“but everybody smokes up!”

“but hash isn’t really addictive”.

Well, I am sorry to burst your bubble but all mood-altering substances are addictive. All addictive drugs directly or indirectly target the brain’s reward system by overflowing the circuit with dopamine. Overstimulating the system with drugs, produces effects which strongly reinforce the behavior of drug use, encouraging the person to repeat it.

Another worth mentioning point is that, some drugs are sometimes considered to be less addictive such as cannabinoids (Hash-marijuana-weed...etc) only because they happen to be more socially acceptable and accessible. While in fact, Cannabinoids have a lot of damaging effects on the mind, body and psyche. People who use Cannabinoids often report low mood, irritability, sleep disturbances, restlessness and many other physical symptoms within the first week after quitting. Many of them also usually report that the drug affects their daily performance, mood, memory and concentration.

There is also an established correlation between the frequent long term of use cannabinoids and mood disorders such as depression.

Is Addiction Curable?

Addiction is a chronic relapsing mental health condition. And so, it is more about recovery than curability. A recovering addict is someone who has been able to stay off of any substances or activities that they were dependent on and has chosen a healthier path for themselves. Getting off of drugs entails two main steps; firstly, one needs to manage and go through the physical withdrawal symptoms of the toxins leaving the body. Then, inpatient or outpatient psychological and social rehabilitation is needed. During this stage, the recoverig addict is learning new skills to cope with their emotions and thoughts, getting the proper treatment for any other psychological conditions that they might have and are tackling all of their unhealthy beliefs around drugs. Getting the necessary psychological, physical and social support is crucial for any recovering addict. And hence, recovery is a lot more than just one getting sober. The Substance Abuse and Mental Health Services Commission (SAMHSA) looks at recovery as “a process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential.”

How to judge if I am an addict?

According to the DSM-5 (Diagnostic and Statistical Manual of Mental Health Disorders), The diagnostic criteria are as follows:

1- persistent desire or unsuccessful effort to cut down or control use of the substance.

2- The substance is often taken in larger amounts or over a longer period than was initially intended

3- A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects

4- Craving, or a strong desire or urge to use the substance, occurs.

5- Use of the substance continues despite having persistent or recurrent social or interpersonal problems

6- Recurrent use of the substance results in a failure to fulfill major role obligations

7- Use of the substance is recurrent in situations in which it is physically hazardous

8- Developed Tolerance

9- Withdrawal symptoms within the first few days of stopping

If you think you meet more than 3 of these criteria, it will be very useful for you to seek professional help. Please do not quickly judge or label yourself and remember that Substance-Use is a spectrum.


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