A loved one’s substance abuse problem
(22 March 2009: VIDYYA MEDICAL NEWS SERVICE) -- Your brother has been irritable, angry and anxious. Sometimes he acts depressed. You’ve noticed he can’t seem to concentrate when you’re talking to him. You start to suspect he may be on drugs. You feel helpless, but you can’t just watch while your brother continues to hurt himself and those around him. What can you do?
The best way to start is to learn the facts. There are a lot of misconceptions about drug abuse and addiction. Many people can’t understand how anyone could become addicted to drugs. They mistakenly view it as strictly a social problem and think those who take drugs are morally weak.
Research has revealed that drug addiction is a disease of the brain. “We now have incontrovertible evidence that repeated exposure to drugs changes the brain—in structure and in function,” says Dr. Susan Weiss, an expert on addiction research at NIH’s National Institute on Drug Abuse (NIDA). “It’s true that for most people, the initial decision to take drugs is voluntary. Over time, however, the brain changes that occur with drug abuse erode a person’s self-control and ability to make sound decisions, while prompting intense urges to take drugs.”
The brain controls how our bodies function through a far-reaching communications network of chemical message transmissions between nerve cells. Research has shown that when the brain is exposed to drugs, these brain control systems become altered, compromising the ability to make healthy decisions.
Why do people start taking drugs in the first place? “Drugs make people feel good, or make them feel better. Some use drugs to get high or to feel different and others attempt to self-medicate problems,” Weiss says. “Drugs affect the brain in some of the same ways as natural rewards like eating a good meal or spending time with loved ones—but drugs can be even more potent, and in those who are vulnerable, drug abuse can lead to addiction.”
It’s hard to predict whether or not a person will become addicted after starting to use a drug. Scientists estimate that genetic factors account for about half of a person’s vulnerability to addiction. Other factors include the influence of the home environment, friends and acquaintances, and the age when drug use begins.
Many cultural factors affect drug abuse trends. Research has shown that addiction often begins in childhood or adolescence. NIH-funded studies have found that prevention programs targeting this time of life are effective in reducing drug abuse. Successful prevention involves families, schools, communities and the media.
Despite these efforts, people still try drugs, and some become addicted. How do you know when someone you love has become addicted to a drug? If that person is compulsively seeking and using a drug despite negative consequences—such as job loss, debt or physical, mental or family problems brought on by drug abuse—then he or she is probably addicted.
“The actual signs of abuse or addiction can vary depending on the person and the drug being abused,” Weiss says. Drug abuse can show itself physically—for example, loss of appetite, slurred speech or problems sleeping. It can also cause changes in behavior, such as a general attitude change, difficulty paying attention or a drop in school grades or work performance. See the sidebar for a list of things to watch out for.
If you suspect your brother is addicted, find a way to gently ask him about it and suggest that he seek professional help. “It is a myth that an addict must hit ‘rock bottom’ to be ready for treatment,” Weiss says. “The reality is, treatment works regardless of whether a person has hit rock bottom, and catching a person earlier in the addiction cycle may mean fewer accompanying problems and a better overall prognosis for long-term recovery.”
It’s important to realize that drug addiction can be treated. Research has revealed several basic principles that underlie effective drug addiction therapies. No single treatment is appropriate for everyone. The treatment course depends on both the drug and the needs of the individual. The process often begins with detoxification, in which the person is systematically withdrawn from the drug under the care of a physician.
Studies have found that the best way to ensure success is to combine appropriate treatment medications, when available, with behavioral therapy. Behavioral therapy helps people modify their attitudes and behaviors. It teaches them skills for handling stress and the environmental cues that may lead to relapse.
Treatment may last for an extended period of time, and multiple courses of treatment may be needed to ensure success.
NIH scientists continue to study what makes people more or less vulnerable to addiction. They are also exploring how to use that information to design effective prevention programs to reach people before they start abusing drugs. These programs involve schools, families, sports teams, faith-based organizations and the broader community. NIH is also working hard to engage the medical community to help catch drug problems early, before they develop into addictions.
“If you think a loved one is in need of treatment,” Weiss says, “do everything in your power to help them find the courage, determination and means to seek treatment as early as possible. Express your concern and then provide the person with resources, or make the call yourself.”
An addicted person needs medical help from trained professionals. Of course, if someone is in immediate danger, call 9-1-1. To find a treatment center in your state, call 1-800-662-HELP or visit www.findtreatment.samhsa.gov.
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