Substance Abuse and Addiction

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    Whether withdrawal symptoms exist or not, both substance and behavioral addictions tap into a major pathway called the mesolimbic pathway in the brain. It regulates behavior by a release of dopamine, which is the pleasure and reward chemical of the brain. In addiction, the behavior persists to attain this feeling of pleasure and reward, despite the knowledge of negative consequences. That’s where the abnormality lies in the disorder.
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    Addiction is an evolving concept, as is addressed by the Diagnostic and Statistical Manual of Mental Disorders (DSM), which serves as a book of criteria for certain diagnoses (and also serves as a guide for insurance companies to decide whether or not they are going to pay for certain services).

    Previously, the DSM-IV required physical withdrawal symptoms to be present to define something as dependence. The latest edition, DSM-V, changed this definition a little bit so that it is more inclusive. There has been a shift away from the term dependence to addiction, which is a more all-encompassing term.

    Traditionally, there has been a distinction between substances that cause severe withdrawal (such as alcohol or opioids) versus those that don’t, like marijuana and nicotine -- and even gambling. The lines between chemical, physical and psychological addictions are blurring, as it has been found that they share more in common than originally thought. They definitely share a main mechanism of action.
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    About 19 women die every day of a prescription painkiller overdose in the U.S. You can prevent overdose in the following ways:
    • Avoid taking prescription painkillers more often than prescribed.
    • Dispose of medications properly, as soon as the course of treatment is done, and avoid keeping prescription painkillers or sedatives around "just in case."
    • Help prevent misuse and abuse by not selling or sharing prescription drugs. Never use another person's prescription drugs.
    • Get help for substance abuse problems by calling 1-800-662-HELP. Call Poison Help 1-800-222-1222 if you have questions about medicines. 
    The presence of the CDC logo and CDC content on this page should not be construed to imply endorsement by the US Government of any commercial products or services, or to replace the advice of a medical professional. The mark “CDC” is licensed under authority of the PHS.
     
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    A , Marriage & Family Therapy, answered
    Made famous by Justin Beiber, Three 6 Mafia and Lil' Wayne, "Sizzurp" (or "Lean" or "Purple Drink") is a combination of prescription cough syrup which consists of codeine (highly addictive opiate) and a prescription grade antihistamine. The combination of these two, when taken in extreme dosage, has the impact of suppressing one's cardiovascular system, which means the heart can stop, and the pulmonary system, which means the lungs could stop breathing.

    Typically, kids are getting the ingredients from their friends or their parents' medicine cabinet. I would encourage everyone to take a hard look at the phenomenon of “sizzurp," which is a lethal, addictive and intoxicating substance that has been glamorized by pop stars.
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    A , Endocrinology Diabetes & Metabolism, answered

    Most drugs stop intimacy in its tracks. The addicted individual is more interested in the drug, including alcohol, than you. They tend to lack motivation and are detached from reality. Motivation and emotional connectedness is a very important part of intimacy. Most drugs reduce both of these, causing a lack of intimacy in a relationship.

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    A Addiction Medicine, answered on behalf of
    Gender differences exist in patterns of drinking, treatment and recovery. The Addiction Treatment & Recovery Center at South Miami Hospital provides each patient with personalized addiction treatment plan. Using a multi-discipline strategy, the Center addresses the different factors that trigger addiction for each patient, including mental health problems. And because of societal, cultural and physical differences between men and women, personalized treatment plans reflect gender-based factors. For women, problems with sexism, self-esteem, relationships and age-related conflicts may be key elements of therapy sessions. With every patient, it’s important to identify and treat the physical, mental and emotional factors that trigger drinking or other forms of substance abuse.  
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    A Addiction Medicine, answered on behalf of

    Substance abuse is a significant health concern for women and men, according to various research reports. About 40 million people in the U.S., approximately 16 percent of the age 12-and-older population, are addicted to drugs, alcohol or nicotine, according to the National Center on Addiction and Substance Abuse (CASA) at Columbia University. Based on those research findings, CASA has labeled addiction as the largest preventable health problem in the country. 

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    A , Psychology, answered
    When do certain behaviors or habits become an addiction?

    Certain behaviors or habits can become an addiction when we use it to feel better; to compensate for something we are missing. Watch as psychologist Brenda Wade, PhD, discusses how a behavior that takes over your life can become an addiction.


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    A , Marriage & Family Therapy, answered

    There is a lot of focus on the physical and financial repercussions of performance-enhancing drugs (PEDs), often ignoring the incredible emotional toll on those who take the supplements and their families. 

    Those who regularly take PEDs are often male patients who are high-octane and have achieved great success by exceeding their competition though discipline, hard work, intelligence and street smarts. They demand exceptional performance from themselves and the people in their lives. These men see PEDs as part of the formula that keeps them at the top of their game. What they fail to see is how these drugs can impede their developmental process. 

    Often those taking the supplements are in the period of life known as middle adulthood, between 40 and 65. It’s a period that Erik Erickson referred to as Generativity v. Stagnation. In order to negotiate this phase successfully, people must focus on things outside of themselves by creating positive change that benefits other people. 

    By relying on PEDs to bolster their performance and keep them relevant, these men fail to embrace the natural progression that comes from life, and its attendant benefits. They also trap themselves in self-absorbed and narcissistic prisons. They fail to successfully negotiate this developmental stage and to find the peace of mind, gratitude, satiety, and renewed sense of purpose and direction in life that should be the fruit of their labors.

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    Having addictions in your family is considered a risk factor for developing addictions. Patients who receive a prescription for opioids to treat pain can also be at risk of developing an addiction to this medication if they have the following risk factors: 
    • Depression, anxiety or other psychiatric issues present at the time of opioid treatment or in their past history. 
    • Ongoing substance abuse with alcohol or other drugs.
    • Poor coping skills and a tendency to imagine “worst possible outcomes” in difficult situations. An individual with these traits may be primed to become addicted to these powerful drugs. 
    It’s always a good idea to have a conversation with your doctor about the pros and cons of taking any medication, especially an opioid that falls within the Schedule III classification of controlled substances.