Addiction Psychiatry

What is addiction and is it a choice?

Addiction is a chronic, often relapsing brain disease that causes compulsive or uncontrollable drug seeking and use despite harmful consequences to the addicted individual and to those around them. The key is that the addicted person will continue using even when they see the harm their addiction is causing. They know it’s bad for them, and they don’t want to be addicted. But addiction is characterized by the inability to stop. Drug addiction follows a similar pattern to other chronic diseases such as asthma and diabetes. The patient will go into remission, but may have several relapses before beating the disease. And like these diseases, addiction too can be treated and managed.

Can drug addiction be treated?

Yes, addiction is a treatable disease. Research in the science of addiction and the treatment of substance abuse disorders has led to the development of evidence-based interventions that help people stop abusing drugs and resume productive lives. But it’s not simple. Because addiction is a chronic disease, people can’t simply stop using drugs for a few days and be cured. Most patients need long-term or repeated care to stop using completely and recover their lives. Detox is the starting point for recovery and not the cure. Addiction treatment will help the person stop using drugs, stay drug-free and be productive in the family, at work and in society.

Does relapse to drug abuse mean treatment has failed?

No. The chronic nature of the disease means that relapsing to drug abuse at some point is not only possible, but also likely. Relapse rates (i.e., how often symptoms recur) for people with addiction are similar to relapse rates for other well-understood chronic medical illnesses such as diabetes, hypertension and asthma, which also have both physiological and behavioral components. Treatment of chronic diseases involves changing deeply imbedded behaviors, and relapse does not mean treatment has failed. For a person recovering from addiction, lapsing back to drug use indicates that treatment needs to be reinstated or adjusted or that another treatment should be tried.

How is drug addiction treated?
Successful treatment has several steps:

  • Detoxification (the process by which the body rids itself of a drug)
  • Behavioral counseling
  • Medication for cravings
  • Evaluation and treatment for co-occurring mental health issues, such as depression and anxiety
  • Long-term follow-up to prevent relapse
  • A range of care with a tailored treatment program and follow-up options can be crucial to success.
  • Treatment should include both medical and mental health services as needed. Follow-up care may include community or family-based recovery support systems.
  • Are people with addiction responsible for their actions?
  • People with addiction should not be blamed for suffering from the disease. All people make choices about whether to use substances. However, people do not choose how their brain and body respond to drugs and alcohol, which is why people with addiction cannot control their use while others can. People with addiction can still stop using — it’s just much harder than it is for someone who has not become addicted.
  • People with addiction are responsible for seeking treatment and maintaining recovery. Often, they need the help and support of family, friends and peers to stay in treatment and increase their chances of survival and recovery.