Substance Abuse and Addiction

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    What are tips for maintaining my sobriety when I'm faced with temptation?
    To maintain sobriety when faced with temptation, plan around your triggers, use behavioral replacement therapy, and send loving kindness to those in your life. Watch psychotherapist Mike Dow, PsyD, share these strategies for resisting temptation.
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    A , Addiction Medicine, answered
    What are some common triggers for recovering addicts over the holidays?
    Some common triggers for recovering addicts are related to feelings of hunger, anger, loneliness, and being tired (HALT). In this video, psychotherapist Mike Dow, PsyD, explains how these feelings can really throw a recovering addict off track. 
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    Why are the holidays especially difficult if I’m sober and in recovery?
    The holiday season is especially difficult if you're in recovery because there are temptations at every turn. In this video, psychotherapist Mike Dow, PsyD, explains how holiday celebrations and travel can be extra stressful for those who are sober. 
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    Substance abuse and the use of intravenous drugs in the United States has increased dramatically. A major limitation of current medical care for people with injection drug use (IDU) is that appropriate treatment for addiction is very difficult to come by due to a lack of providers or facilities or the lack of insurance or other means to pay for the scarce resources that may be available.

    The current fractured structure and silos between acute and chronic health care and social services leads to an inability to bridge the “treatment gap” between the urgent symptoms of a disease and its underlying cause. Addiction therapy should ideally be tied to related medical treatment in order to achieve optimal results. Until addiction therapy is recognized as a critical component of care for people with IDU, long-term results in the treatment of acute and chronic conditions are unlikely to improve.
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    Addiction psychiatrists are medical doctors with general psychiatry training, as well as additional training in diagnosing and treating people with addictions. The most common types of addiction include alcohol and drug addiction, including addiction to nicotine. But addiction psychiatrists may also treat people with other addictions, such as gambling or sex addiction. To treat addiction, addiction psychiatrists may prescribe medications and provide psychotherapy. In some cases, they may also admit people to the hospital or outpatient programs for treatment. They may also diagnose and treat people with other mental health issues, in addition to addiction. To become certified as addiction specialists, they usually complete a residency or fellowship in addiction medicine, following their general medical and psychiatry training. In the US, they can be board certified by the American Board of Addiction Medicine or the American Board of Psychology and Neurology.
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    Alcohol or drug withdrawal occurs when a person stops drinking or taking drugs after using them for a long time. Because their body (including their brain) has become addicted or dependent on the substance, they are likely to have a range of uncomfortable or painful symptoms when they're no longer getting enough of it. This may include anxiety, depression or irritability, fatigue, confused thinking, sleep problems, shaking, headaches, nausea, dilated pupils, a fast heartbeat and sweating. Alcohol withdrawal can also cause hallucinations and seizures. People withdrawing from opiate drugs, such as heroine or codeine, may also have a runny nose, excess tears or yawning during withdrawal. People with withdrawal symptoms should see their doctor for supportive care and to avoid serious problems. Sometimes medications or hospital treatment are needed. Alcohol or drug treatment programs may also be recommended.
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    A , Neurology, answered
    How has addiction treatment evolved and how does that impact my options?
    Addiction treatment has evolved over the years; there has been a shift from spiritual, community-based programs to more comprehensive, integrative treatments. Watch psychiatrist Reef Karim, DO, discuss how addiction treatment has progressed. 
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    A , Neurology, answered
    How common is it to replace one addiction with another one?
    There are both chemical and behavioral addictions, and it's possible for people who are more susceptible to addiction to replace one for another. In this video, psychiatrist Reef Karim, DO, explains the concept of cross-addiction and why it happens. 
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    A , Addiction Medicine, answered
    How does replacement therapy help me break an addiction?
    Replacement therapy can help break an addiction by replacing the element you are addicted to with a healthier one. In this video, psychotherapist Mike Dow, PsyD, explains replacement therapy and how it can help you kick an addiction successfully.
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    Continued drug use is not voluntary most of the time. The voluntary part of it comes in the very beginning, before addiction begins. You voluntarily take the first couple of substances, and after that, the brain changes and the drug quickly becomes a requirement for survival. It’s like a thirst for water or a hunger for food.