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In order to help those battling Substance Use Disorder, it’s important to understand addiction. Not only addiction, but how the addicted brain works, as well. Once this is understood, the right behavioral health therapies can be implemented to help aid in recovery. 

What is Substance Use Disorder?

There’s a fine line between regular drug use and drug abuse and addiction. Very few drug abusers or addicts are able to recognize when they’ve crossed that line. Substance use disorders occur when repeated use of alcohol or drugs causes significant impairment. This may include health problems, disability, and failure to meet major responsibilities at work, school or home.

According to the National Institute on Drug Abuse, addiction is a chronic disease characterized by drug seeking and use that is difficult to control, despite harmful consequences. Drug abuse often starts voluntarily and recreationally, as a way to socially connect. A strong desire to fit in can make it feel like doing the drugs with friends is the only option.

However, repeated drug use changes the brain. When addiction sets in, it impacts the user’s ability to resist the urge to take drugs. Addiction is considered a brain disorder because it causes changes to the brain’s circuits for reward, stress and self-control. What many people don’t realize, however, is that these changes to the brain last long after drug use has stopped.

How an Addict’s Brain Works

A Sense of Euphoria

Most drugs create a sense of euphoria by flooding the brain with dopamine. Our brains work on a reward system. If we enjoy something, we tend to repeat those behaviors. It’s why we drink soda and eat chocolate. It doesn’t matter if the behavior is unhealthy or not. The surges of dopamine program the brain to drive users to repeat the behavior that gave them pleasure. Over and over again.

Over time, the addict develops a tolerance because the brain reduces its response to the drug. This reduces the high, which causes many people to increase the amount of drugs taken to attain the same sense of euphoria they used to get. What is even worse is that the brain’s pleasure center is impacted for all things that might have brought the user joy, including food and social activities.

Changes in Brain Function

Changes in the brain interfere with the user’s ability to think clearly, exercise good judgment, control behavior, and feel normal without drugs. When a user becomes addicted, the substance takes on the same significance as other survival behaviors, such as eating and drinking. No matter which drug the user is addicted to, the uncontrollable craving to use grows more important than anything else, including family, friends, career, and even his or her own health and happiness.

As drug abuse takes hold, the user’s ability to stop is eventually compromised. What began as a voluntary choice has turned into a physical and psychological need. Eventually, drugs consume the user’s life. Life becomes less pleasurable. And, ultimately, the high is no longer as achievable.

Warning Signs of Commonly Abused Drugs

Depending on the type of drug, there are a variety of signs that help identify what the user may be addicted to. The list below gives a general overview of drugs commonly associated with Substance Use Disorder.

Marijuana

Glassy, red eyes; loud talking, inappropriate laughter followed by sleepiness; loss of interest, motivation; weight gain or loss.

Stimulants (including amphetamines, cocaine, crystal meth)

Dilated pupils; hyperactivity; euphoria; irritability; anxiety; excessive talking followed by depression or excessive sleeping at odd times; may go long periods of time without eating or sleeping; weight loss; dry mouth and nose.

Inhalants (glues, aerosols, vapors)

Watery eyes; impaired vision, memory and thought; secretions from the nose or rashes around the nose and mouth; headaches and nausea; appearance of intoxication; drowsiness; poor muscle control; changes in appetite; anxiety; irritability; lots of cans/aerosols in the trash.

Hallucinogens (LSD, PCP)

Dilated pupils; bizarre and irrational behavior including paranoia, aggression, hallucinations; mood swings; detachment from people; absorption with self or other objects, slurred speech; confusion.

Heroin

Contracted pupils; no response of pupils to light; needle marks; sleeping at unusual times; sweating; vomiting; coughing, sniffling; twitching; loss of appetite.

Opioid painkillers (including OxyContin, Vicodin, Norco)

Drooping eyes, constricted pupils even in dim light, sudden itching or flushing, slurred speech; drowsiness, lack of energy; inability to concentrate, lack of motivation, decline in performance at work or school; neglecting friendships and social activities.

Anti-anxiety medications, sedatives, and hypnotics (including Xanax, Valium, Ambien)

Contracted pupils; drunk-like, slurred speech, difficulty concentrating, clumsiness; poor judgment, drowsiness, slowed breathing.

Stimulants (including Ritalin, Concerta, Adderall, Dexedrine)

Dilated pupils, reduced appetite; agitation, anxiety, irregular heartbeat, high body temperature; insomnia, paranoia.

Substance Use Disorder Treatment Plans

A diagnosis of substance use disorder is based on evidence of impaired control, social impairment, risky use, and pharmacological criteria. Stopping drug use is just one part of a long and complex recovery process. When people enter treatment, addiction has often caused serious consequences in their lives. Sometimes this goes beyond their own health, impacting how they function in their family lives, at work, and in the community.

Because addiction can affect so many aspects of a person’s life, treatment should address the needs of the whole person to be successful. Counselors may select from a variety of services to meet the specific medical, mental, social, occupational, family, and legal needs of their patients to help in their recovery.

Behavioral Health Therapies to Treat Substance Use Disorder

Behavioral Health Therapies are used to help people with substance use disorder learn how to change their behaviors related to drug use. In addition, people learn how to handle stressful situations and identify triggers that compel them to use. Some behavioral health practices that may be implemented include:

• Cognitive-behavioral therapy, which seeks to help clients recognize, avoid, and cope with the situations in which they’re most likely to use.
• Contingency management uses positive reinforcement when clients remain drug free, attend and participate in counseling sessions and take medications properly.
• Motivational enhancement therapy uses strategies to make the most of people’s readiness to change their behavior and enter treatment.
• Family therapy helps people (especially young people) with drug use problems, as well as their families, address influences on drug use patterns and improve overall family functioning.

Behavioral health therapies such as these can enhance the effectiveness of medications and help people remain in treatment longer.

Substance Use Disorder Recovery

As indicated by SAMHSA, recovery from these disorders is a process of change whereby people improve their health and wellness, live a self-directed life, and strive to reach their full potential. For those looking for recovery support and information, SAMHSA offers a number of programs and resources to help people recognize substance use disorders and get support related to prevention, treatment, and recovery.

 

https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction

https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction

https://www.helpguide.org/articles/addictions/drug-abuse-and-addiction.htm

https://www.samhsa.gov/disorders/substance-use