My first post in this series on drug abuse touched on how pervasive the problem is in our society. In this post, I will briefly discuss how it is defined on an individual level and the theoretical framework upon which professionals use to diagnose. Obviously, this is an expansive and much-debated topic that cannot be satisfactorily covered here. I also want to stress that anyone reading this who might be dealing with these challenges should seek out a medical health professional who can help within the context of their individual experience – which is extremely vital to successful treatment.
My goal here is simply to cue some useful background information that will help further our overall discussion.
Drug Abuse Analysis
The American Psychological Association (APA) categorizes addiction as a “a chronic disorder with biological, psychological, social and environmental factors influencing its development and maintenance.” It has ceased to use the word “addiction” as a diagnosis involving drug abuse to avoid the confusion that is attendant with the term in its popular usage. Instead it uses the more descriptive, “substance abuse disorder.”
The core of popular confusion surrounding the meaning of addiction is whether it should be categorized as a disease, a choice, or some gradient along the scale. It should be noted that every major government, health, and substance abuse organization falls squarely into the “addiction as a disease” camp. The National Institutes of Health refers to addiction as a “chronic relapsing disorder” that is characterized by compulsive behavior despite its adverse consequences. It is considered a brain disorder because “it involves functional changes to brain circuits involved in reward, stress, and self-control.” The APA further stresses that heritable traits can increase the risk factor for addiction significantly.
Those who believe addiction is a choice stress social and environmental factors as the primary influencers. Unlike other diseases, addiction is not transmissible or contagious, hereditary or degenerative, and it is self-acquired. However, if drug abuse was simply a matter of choice, treatment would be far simpler, and relapses would be far less common.
Treatment Strategies for Drug Abuse
There is a great variety of treatment strategies even within the disease premise. They can include pharmacological therapy, behavioral therapy, contingency management, or supplement each other in combination. As reported in the APA Monitor on Psychology, as part of an article discussing the changing drug abuse treatment landscape in the wake of the opioid crisis, psychologists are “investigating whether adding counseling enhances outcomes for patients on medication-based treatment. They're also exploring new ways of getting treatment to patients, whether in primary-care settings or via computer.”
As with many diseases, prevention is the best strategy from the standpoint of public health. In my next post, I will discuss some signs of drug abuse that can serve to help families or organizations intervene and alleviate an individual’s substance abuse disorder.