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When you’re struggling with drug addiction, sobriety can seem like an impossible goal. But recovery is never out of reach, no matter how hopeless your situation seems. Change is possible with the right treatment and support, and by addressing the root cause of your addiction. Don’t give up—even if you’ve tried and failed before. The road to recovery often involves bumps, pitfalls, and setbacks. But by examining the problem and thinking about change, you’re already on your way.

Drug addiction treatment and recovery 1: Decide to make a change For many people struggling with addiction, the biggest and toughest step toward recovery is the very first one: deciding to make a change. It’s normal to feel conflicted about giving up your drug of choice, even when you realize it’s causing problems in your life. Change is never easy—and committing to sobriety involves changing many things, including:

the way you deal with stress. + who you allow in your life. + what you do in your free time

how you think about yourself + You may wonder if you’re really ready for all that change or if you have what it takes to quit. It’s okay if you’re torn. Recovering from addiction is a long process, one that requires time, commitment, motivation, and support. As you contemplate your situation, the following tips can help you make the decision.

Thinking about change: Keep track of your drug use, including when and how much you use. This will give you a better sense of the role the addiction is playing in your life.

List the pros and cons of quitting, as well as the costs and benefits of continuing your drug abuse.

Consider the things that are important to you, such as your partner, your kids, your career, or your health. How does your drug use affect those things?

Talk it over with someone you trust. Ask the person how he or she feels about your drug use.

Ask yourself if there’s anything preventing you from changing. What are some things that could help you make the change?

Preparing for change: 5 key steps to addiction recovery

Remind yourself of the reasons you want to change.

Think about your past attempts at quitting, if any. What worked? What didn’t?

Set specific, measurable goals, such as a quit date or limits on your drug use.

Remove reminders of your addiction from your home and workplace.

Tell friends and family that you’re quitting and ask for their support.

Drug addiction treatment and recovery 2: Explore your treatment options:

Once you’ve made the decision to challenge your drug addiction, it’s time to explore your treatment choices. As you consider the options, keep the following in mind:

There’s no magic bullet or single treatment that works for everyone. When considering a program, remember that everyone’s needs are different. Drug addiction treatment should be customized to your unique problems and situation. It’s important that you find a program that feels right.

Treatment should address more than just your drug abuse. Addiction affects your whole life, including relationships, career, health, and psychological well-being. Treatment success depends on developing a new way of living and addressing the reasons why you turned to drugs in the first place. It may have been because of an inability to manage stress, in which case you’ll need to find healthy ways to handle stressful situations.

Commitment and follow-through are key. Drug addiction treatment is not a quick and easy process. In general, the longer and more intense the drug use, the longer and more intense the treatment you’ll need. But regardless of the treatment program’s length in weeks or months, long-term follow-up care is crucial to recovery.

There are many places to turn for help. Not everybody requires medically supervised detox or an extended stint in rehab. The level of care you need depends on your age, drug use history, and other medical or psychiatric conditions. In addition to doctors and psychologists, many clergy members, social workers, and counselors offer addiction treatment services.

As you seek help for drug addiction, it’s also important to get treatment for any other medical or psychological issues you’re experiencing. Your best chance of recovery is through integrated treatment for both the substance abuse problem and the mental health problem. This means getting combined mental health and addiction treatment from the same treatment provider or team.

Drug addiction treatment and recovery 3: Reach out for support

Don’t try to go it alone. Whatever treatment approach you choose, having a solid support system is essential. The more positive influences you have in your life, the better your chances for recovery. Recovering from drug addiction isn’t easy, but with people you can turn to for encouragement, guidance, and a listening ear, it’s a little less tough.

Lean on close friends and family – Having the support of friends and family members is an invaluable asset in recovery. If you’re reluctant to turn to your loved ones because you’ve let them down before, consider going to couples counseling or family therapy.

Build a sober social network – If your previous social life revolved around drugs, you may need to make some new connections. It’s important to have sober friends who will support your recovery. Try taking a class, joining a church or a civic group, volunteering, or attending events in your community.

Consider moving in to a sober living home – Sober living homes provide a safe, supportive place to live while you’re recovering from drug addiction. They are a good option if you don’t have a stable home or a drug-free living environment to go to.

Make meetings a priorityJoin a recovery support group and attend meetings regularly. Spending time with people who understand exactly what you’re going through can be very healing. You can also benefit from the shared experiences of the group members and learn what others have done to stay sober.

Drug addiction treatment and recovery 4: Learn healthy ways to cope with stress

Even once you’ve recovered from drug addiction, you’ll still have to face the problems that led to your drug problems in the first place. Did you start using drugs to numb painful emotions, calm yourself down after an argument, unwind after a bad day, or forget about your problems? After you become sober, the negative feelings that you used to dampen with drugs will resurface. For treatment to be successful, and to remain sober in the long term, you’ll need to resolve these underlying issues as well.

Conditions such as stress, loneliness, frustration, anger, shame, anxiety, and hopelessness will remain in your life even when you’re no longer using drugs to cover them up. But you will be in a healthier position to finally address them and seek the help you need.

Relieving stress without drugs Drug abuse often stems from misguided attempts to manage stress. Many people turn to alcohol or recreational drugs to unwind and relax after a stressful day, or to cover up painful memories and emotions that cause us to feel stressed and out of balance. But there are healthier ways to keep your stress level in check, including exercising, meditating, using sensory strategies to relax, practicing simple breathing exercises, and challenging self-defeating thoughts.

Strategies for quickly relieving stress without drugs You may feel like doing drugs is the only way to handle unpleasant feelings, but it’s not. You can learn to get through difficulties without falling back on your addiction. Different quick stress relief strategies work better for some people than others. The key is to find the one that works best for you, and helps you calm down when you’re feeling stressed and overwhelmed. When you’re confident in your ability to quickly de-stress, facing strong feelings isn’t as intimidating or overwhelming.

Exercise releases endorphins, relieves stress, and promotes emotional well-being. Try running in place, jumping rope, or walking around the block. Step outside and savor the warm sun and fresh air. Enjoy a beautiful view or landscape. Yoga and meditation are excellent ways to bust stress and find balance. Play with your dog or cat, enjoying the relaxing touch of your pet’s fur. Put on some calming music. Light a scented candle.

Breathe in the scent of fresh flowers or coffee beans, or savor a scent that reminds you of a favorite vacation, such as sunscreen or a seashell. Close your eyes and picture a peaceful place, such as a sandy beach. Or think of a fond memory, such as your child’s first steps or time spent with friends.  Make yourself a steaming cup of tea. Look at favorite family photos. Give yourself a neck or shoulder massage. Soak in a hot bath or shower.

Drug addiction treatment and recovery 5: Keep triggers and cravings in check While getting sober from drugs is an important first step, it’s only the beginning of the recovery process. Once sober, the brain needs time to recover and rebuild connections that have changed while addicted. During this time, drug cravings can be intense. You can support your continued sobriety by making a conscious effort to avoid people, places, and situations that trigger the urge to use:

Make a break from old drug buddies. Don’t make the mistake of hanging out with old friends who are still doing drugs. Surround yourself with people who support your sobriety, not those who tempt you to slip back into old, destructive habits.

Avoid bars and clubs, even if you don’t have a problem with alcohol. Drinking lowers inhibitions and impairs judgment, which can easily lead to relapse. Drugs are often readily available and the temptation to use can be overpowering. Also avoid any other environments and situations that you associate with drug use.

Be up front about your history of drug use when seeking medical treatment. If you need a medical or dental procedure done, be up front about your history and find a provider who will work with you in either prescribing alternatives or the absolute minimum medication necessary. You should never feel ashamed or humiliated about previous drug use or be denied medication for pain; if that happens, find another provider.

Use caution with prescription drugs. Stay away from prescription drugs with the potential for abuse or use only when necessary and with extreme caution. Drugs with a high abuse potential include painkillers, sleeping pills, and anti-anxiety medication.

Coping with drug cravings Sometimes craving cannot be avoided, and it is necessary to find a way to cope:

Get involved in some distracting activity. Reading, a hobby, going to a movie, exercising (jogging, biking) are good examples of distracting activities. Once you get interested in something else, you’ll find the urges go away. Another effective response to a drug craving is eating (but be careful what you eat, as eating junk will only add stress and inches to your waistline).

Talk it through. Talk to friends or family members about craving when it occurs. Talking about cravings and urges can be very helpful in pinpointing the source of the craving. Also, talking about craving often helps to discharge and relieve the feeling and will help restore honesty in your relationship. Craving is nothing to feel bad about.

Urge surf. Many people try to cope with their urges by gritting their teeth and toughing it out. But some are just too strong to ignore. When this happens, it can be useful to stay with the urge until it passes. This technique is called urge surfing. Imagine yourself as a surfer who will ride the wave of your drug craving, staying on top of it until it crests, breaks, and turns into less powerful, foamy surf.

Challenge and change your thoughts. When experiencing a craving, many people have a tendency to remember only the positive effects of the drug and forget the negative consequences. Therefore, you may find it helpful to remind yourself that you really won’t feel better if you use and that you stand to lose a lot. Sometimes it is helpful to have these benefits and consequences listed on a small card that you keep with you.

Drug addiction treatment and recovery 6: Build a meaningful drug-free life You can support your drug treatment and protect yourself from relapse by having activities and interests that provide meaning to your life. It’s important to be involved in things that you enjoy and make you feel needed. When your life is filled with rewarding activities and a sense of purpose, your addiction will lose its appeal.

Pick up a new hobby. Do things that challenge your creativity and spark your imagination—something you’ve always wanted to try.

Adopt a pet. Yes, pets are a responsibility, but caring for an animal makes you feel loved and needed. Pets can also get you out of the house for exercise.

Get involved in your community. Replace your addiction with drug-free groups and activities. Volunteer, become active in your church or faith community, or join a local club or neighborhood group.

Set meaningful goals. Having goals to work toward and something to look forward to can be powerful antidotes to drug addiction. It doesn’t matter what the goals are—whether they involve your career, your personal life, or your health—just that they are important to you.

Look after your health. Regular exercise, adequate sleep, and healthy eating habits help you keep your energy levels up and your stress levels down. When you feel good, drugs are much less of a temptation. The more you can do to stay healthy, the easier it will be to stay sober.

Drug addiction treatment and recovery 7: Don’t let relapse keep you down Relapse is a common part of the recovery process from drug addiction. While relapse is understandably frustrating and discouraging, it can also be an opportunity to learn from your mistakes and correct your treatment course.

What causes relapse? Various “triggers” can put people at risk of relapsing into old patterns of substance use. Causes of relapse can differ for each person. Some common ones include: negative emotional states (such as anger, sadness, trauma or stress)physical discomfort (such as withdrawal symptoms or physical pain) positive emotional states (wanting to feel even better) testing personal control (“I can have just one drink”)strong temptations or urges (cravings to use) conflict with others (such as an argument with a spouse or partner) social pressures to use (situations where it seems as though everyone else is drinking or using other drugs) good times with others (such as having fun with friends or family) etc.

The important thing to remember is that relapse doesn’t mean treatment failure. Rather than giving up, get back on the wagon as quickly as you can. Call your sponsor, talk to your therapist, go to a meeting, or schedule an appointment with your doctor. When you’re sober again and out of danger, look at what triggered the relapse, what went wrong, and what you could have done differently. You can choose to get back on the path to recovery and use the experience to strengthen your commitment.

Next steps... Is Find a drug addiction recovery support group. Support groups can be an invaluable source of guidance, assistance, and encouragement. Many use sponsors (former addicts who have time and experience remaining sober) to provide support when you’re dealing with the urge to use. Read: Self-Help Groups for Drug Addiction.

Find the right drug treatment program. Many types of substance abuse treatment programs are available. Quality programs not only address the substance abuse but also any other life problems that contribute to your addiction. Read: Choosing a Drug Treatment Program.

Drug Abuse & Addiction Signs, Symptoms, and Help for Drug Problems and Substance Abuse Etc.

Some people are able to use recreational or prescription drugs without ever experiencing negative consequences or addiction. For many others, substance use can cause problems at work, home, school, and in relationships, leaving you feeling isolated, helpless, or ashamed.

If you’re worried about your own or a friend or family member’s drug use, it’s important to know that help is available. Learning about the nature of drug abuse and addiction—how it develops, what it looks like, and why it can have such a powerful hold—will give you a better understanding of the problem and how to best deal with it.

Understanding drug use, drug abuse, and addiction: People experiment with drugs for many different reasons. Many first try drugs out of curiosity, to have a good time, because friends are doing it, or in an effort to improve athletic performance or ease another problem, such as stress, anxiety, or depression. Use doesn’t automatically lead to abuse, and there is no specific level at which drug use moves from casual to problematic. It varies by individual. Drug abuse and addiction is less about the amount of substance consumed or the frequency, and more to do with the consequences of drug use. No matter how often or how little you’re consuming, if your drug use is causing problems in your life—at work, school, home, or in your relationships—you likely have a drug abuse or addiction problem.

Why do some drug users become addicted, while others don’t? As with many other conditions and diseases, vulnerability to addiction differs from person to person. Your genes, mental health, family and social environment all play a role in addiction. Risk factors that increase your vulnerability include: Family history of addiction Abuse, neglect, or other traumatic experiences in childhood Mental disorders such as depression and anxiety Early use of drugs Method of administration—smoking or injecting a drug may increase its addictive potential.

Drug addiction and the brain Addiction is a complex disorder characterized by compulsive drug use. While each drug produces different physical effects, all abused substances share one thing in common: repeated use can alter the way the brain looks and functions.
Taking a recreational drug causes a surge in levels of dopamine in your brain, which trigger feelings of pleasure. Your brain remembers these feelings and wants them repeated. If you become addicted, the substance takes on the same significance as other survival behaviors, such as eating and drinking. Changes in your brain interfere with your ability to think clearly, exercise good judgment, control your behavior, and feel normal without drugs. Whether you’re addicted to inhalants, heroin, Xanax, speed, or Vicodin, the uncontrollable craving to use grows more important than anything else, including family, friends, career, and even your own health and happiness. The urge to use is so strong that your mind finds many ways to deny or rationalize the addiction. You may drastically underestimate the quantity of drugs you’re taking, how much it impacts your life, and the level of control you have over your drug use.

How drug abuse and addiction can develop People who experiment with drugs continue to use them because the substance either makes them feel good, or stops them from feeling bad. In many cases, however, there is a fine line between regular use and drug abuse and addiction. Very few addicts are able to recognize when they have crossed that line. While frequency or the amount of drugs consumed don’t in themselves constitute drug abuse or addiction, they can often be indicators of drug-related problems.

Problems can sometimes sneak up on you, as your drug use gradually increases over time. Smoking a joint with friends at the weekend, or taking ecstasy at a rave, or cocaine at an occasional party, for example, can change to using drugs a couple of days a week, then every day. Gradually, getting and using the drug becomes more and more important to you.

If the drug fulfills a valuable need, you may find yourself increasingly relying on it. For example, you may take drugs to calm you if you feel anxious or stressed, energize you if you feel depressed, or make you more confident in social situations if you normally feel shy. Or you may have started using prescription drugs to cope with panic attacks or relieve chronic pain, for example. Until you find alternative, healthier methods for overcoming these problems, your drug use will likely continue.

Similarly, if you use drugs to fill a void in your life, you’re more at risk of crossing the line from casual use to drug abuse and addiction. To maintain healthy balance in your life, you need to have other positive experiences, to feel good in your life aside from any drug use.

As drug abuse takes hold, you may miss or frequently be late for work or school, your job performance may progressively deteriorate, and you start to neglect social or family obligations. Your ability to stop using is eventually compromised. What began as a voluntary choice has turned into a physical and psychological need.

The good news is that with the right treatment and support, you can counteract the disruptive effects of drug use and regain control of your life. The first obstacle is to recognize and admit you have a problem, or listen to loved ones who are often better able to see the negative effects drug use is having on your life.

5 Myths about Drug Abuse and Addiction

MYTH 1: Overcoming addiction is a simply a matter of willpower. You can stop using drugs if you really want to. Prolonged exposure to drugs alters the brain in ways that result in powerful cravings and a compulsion to use. These brain changes make it extremely difficult to quit by sheer force of will.

MYTH 2: Addiction is a disease; there’s nothing you can do about it. Most experts agree that addiction is a brain disease, but that doesn’t mean you’re a helpless victim. The brain changes associated with addiction can be treated and reversed through therapy, medication, exercise, and other treatments.

MYTH 3: Addicts have to hit rock bottom before they can get better. Recovery can begin at any point in the addiction process—and the earlier, the better. The longer drug abuse continues, the stronger the addiction becomes and the harder it is to treat. Don’t wait to intervene until the addict has lost it all.

MYTH 4: You can’t force someone into treatment; they have to want help. Treatment doesn’t have to be voluntary to be successful. People who are pressured into treatment by their family, employer, or the legal system are just as likely to benefit as those who choose to enter treatment on their own. As they sober up and their thinking clears, many formerly resistant addicts decide they want to change.

MYTH 5: Treatment didn’t work before, so there’s no point trying again. Recovery from drug addiction is a long process that often involves setbacks. Relapse doesn’t mean that treatment has failed or that you’re a lost cause. Rather, it’s a signal to get back on track, either by going back to treatment or adjusting the treatment approach.

Signs and symptoms of drug abuse and drug addiction Although different drugs have different physical effects, the symptoms of addiction are similar. See if you recognize yourself in the following signs and symptoms of substance abuse and addiction. If so, consider talking to someone about your drug use.

Common signs and symptoms of drug abuse.

You’re neglecting your responsibilities at school, work, or home (e.g. flunking classes, skipping work, neglecting your children) because of your drug use.

You’re using drugs under dangerous conditions or taking risks while high, such as driving while on drugs, using dirty needles, or having unprotected sex.

Your drug use is getting you into legal trouble, such as arrests for disorderly conduct, driving under the influence, or stealing to support a drug habit. 

Your drug use is causing problems in your relationships, such as fights with your partner or family members, an unhappy boss, or the loss of old friends.

Common signs and symptoms of drug addiction.

You’ve built up a drug tolerance. You need to use more of the drug to experience the same effects you used to attain with smaller amounts.

You take drugs to avoid or relieve withdrawal symptoms. If you go too long without drugs, you experience symptoms such as nausea, restlessness, insomnia, depression, sweating, shaking, and anxiety.

You’ve lost control over your drug use. You often do drugs or use more than you planned, even though you told yourself you wouldn’t. You may want to stop using, but you feel powerless.

Your life revolves around drug use. You spend a lot of time using and thinking about drugs, figuring out how to get them, and recovering from the drug’s effects.

You’ve abandoned activities you used to enjoy, such as hobbies, sports, and socializing, because of your drug use.

You continue to use drugs, despite knowing it’s hurting you. It’s causing major problems in your life—blackouts, infections, mood swings, depression, paranoia—but you use anyway.

Warning signs that a friend or family member is abusing drugs Drug abusers often try to conceal their symptoms and downplay their problem. If you’re worried that a friend or family member might be abusing drugs, look for the following warning signs:

Physical warning signs of drug abuse Bloodshot eyes, pupils larger or smaller than usual Changes in appetite or sleep patterns. Sudden weight loss or weight gain Deterioration of physical appearance, personal grooming habits Unusual smells on breath, body, or clothing Tremors, slurred speech, or impaired coordination.

Behavioral signs of drug abuse Drop in attendance and performance at work or school Unexplained need for money or financial problems. May borrow or steal to get it. Engaging in secretive or suspicious behaviors Sudden change in friends, favorite hangouts, and hobbies Frequently getting into trouble (fights, accidents, illegal activities)

Psychological warning signs of drug abuse Unexplained change in personality or attitude Sudden mood swings, irritability, or angry outbursts Periods of unusual hyperactivity, agitation, or giddiness Lack of motivation; appears lethargic or “spaced out” Appears fearful, anxious, or paranoid, with no reason.

Warning Signs of Commonly Abused Drugs

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

Depressants (including Xanax, Valium, GHB): Contracted pupils; drunk-like; difficulty concentrating; clumsiness; poor judgment; slurred speech; sleepiness.

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.

Warning signs of teen drug abuse While experimenting with drugs doesn’t automatically lead to drug abuse, early use is a risk factor for developing more serious drug abuse and addiction. Risk of drug abuse also increases greatly during times of transition, such as changing schools, moving, or divorce. The challenge for parents is to distinguish between the normal, often volatile, ups and downs of the teen years and the red flags of substance abuse. These include:

Having bloodshot eyes or dilated pupils; using eye drops to try to mask these signs Skipping class; declining grades; suddenly getting into trouble at school Missing money, valuables, or prescriptions Acting uncharacteristically isolated, withdrawn, angry, or depressed Dropping one group of friends for another; being secretive about the new peer group Loss of interest in old hobbies; lying about new interests and activities Demanding more privacy; locking doors; avoiding eye contact; sneaking around.

Getting help for drug abuse and drug addiction Finding help and support for drug addiction Visit a Narcotics Anonymous meeting in your area. See Resources & References below. Call 1-800-662-HELP in the U.S. to reach a free referral helpline from the Substance Abuse and Mental Health Services Administration.

Recognizing that you have a problem is the first step on the road to recovery, one that takes tremendous courage and strength. Facing your addiction without minimizing the problem or making excuses can feel frightening and overwhelming, but recovery is within reach. If you’re ready to make a change and willing to seek help, you can overcome your addiction and build a satisfying, drug-free life for yourself.

Support is essential to addiction recovery Don’t try to go it alone; it’s all too easy to get discouraged and rationalize “just one more” hit or pill. Whether you choose to go to rehab, rely on self-help programs, get therapy, or take a self-directed treatment approach, support is essential. Recovering from drug addiction is much easier when you have people you can lean on for encouragement, comfort, and guidance.

Support can come from: family members close friends therapists or counselors other recovering addicts healthcare providers people from your faith community.

When a loved one has a drug problem If you suspect that a friend or family member has a drug problem, here are a few things you can do:

Speak up. Talk to the person about your concerns, and offer your help and support, without being judgmental. The earlier addiction is treated, the better. Don’t wait for your loved one to hit bottom! Be prepared for excuses and denial by listing specific examples of your loved one’s behavior that has you worried.

Take care of yourself. Don’t get so caught up in someone else’s drug problem that you neglect your own needs. Make sure you have people you can talk to and lean on for support. And stay safe. Don’t put yourself in dangerous situations.

Avoid self-blame. You can support a person with a substance abuse problem and encourage treatment, but you can’t force an addict to change. You can’t control your loved one’s decisions. Let the person accept responsibility for his or her actions, an essential step along the way to recovery for drug addiction.

But Don’t Attempt to punish, threaten, bribe, or preach. Try to be a martyr. Avoid emotional appeals that may only increase feelings of guilt and the compulsion to use drugs. Cover up or make excuses for the drug abuser, or shield them from the negative consequences of their behavior. Take over their responsibilities, leaving them with no sense of importance or dignity. Hide or throw out drugs. Argue with the person when they are high. Take drugs with the drug abuser. Feel guilty or responsible for another's behavior. 

When your teen has a drug problem Discovering your child uses drugs can generate fear, confusion, and anger in parents. It’s important to remain calm when confronting your teen, and only do so when everyone is sober. Explain your concerns and make it clear that your concern comes from a place of love. It’s important that your teen feels you are supportive.

Five steps parents can take:

Lay down rules and consequences. Your teen should understand that using drugs comes with specific consequences. But don’t make hollow threats or set rules that you cannot enforce. Make sure your spouse agrees with the rules and is prepared to enforce them.

Monitor your teen’s activity. Know where your teen goes and who he or she hangs out with. It’s also important to routinely check potential hiding places for drugs—in backpacks, between books on a shelf, in DVD cases or make-up cases, for example. Explain to your teen that this lack of privacy is a consequence of him or her having been caught using drugs.

Encourage other interests and social activities. Expose your teen to healthy hobbies and activities, such as team sports and afterschool clubs.

Talk to your child about underlying issues. Drug use can be the result of other problems. Is your child having trouble fitting in? Has there been a recent major change, like a move or divorce, which is causing stress?

Get Help. Teenagers often rebel against their parents but if they hear the same information from a different authority figure, they may be more inclined to listen. Try a sports coach, family doctor, therapist, or drug counselor.

Next step...Is Recovering from drug addiction. Addiction is a complex problem that affects every aspect of your life. Overcoming it requires making major changes to the way you live, deal with problems, and relate to others. Learn about the tools that can help you on your journey to sobriety. Read Overcoming Drug Addiction.

Understanding Addiction How Addiction Hijacks the Brain

What Is Addiction? + The word “addiction” is derived from a Latin term for “enslaved by” or “bound to.” Anyone who has struggled to overcome an addiction—or has tried to help someone else to do so—understands why.

Addiction exerts a long and powerful influence on the brain that manifests in three distinct ways: craving for the object of addiction, loss of control over its use, and continuing involvement with it despite adverse consequences.

For many years, experts believed that only alcohol and powerful drugs could cause addiction. Neuroimaging technologies and more recent research, however, have shown that certain pleasurable activities, such as gambling, shopping, and sex, can also co-opt the brain.

Although a standard U.S. diagnostic manual (the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition or DSM-IV) describes multiple addictions, each tied to a specific substance or activity, consensus is emerging that these may represent multiple expressions of a common underlying brain process.

Key Points + Addiction involves craving for something intensely, loss of control over its use, and continuing involvement with it despite adverse consequences.

Addiction changes the brain, first by subverting the way it registers pleasure and then by corrupting other normal drives such as learning and motivation.

Although breaking an addiction is tough, it can be done.

New insights into a common problem Nobody starts out intending to develop an addiction, but many people get caught in its snare. Consider the latest government statistics: Nearly 23 million Americans—almost one in 10—are addicted to alcohol or other drugs. More than two-thirds of people with addiction abuse alcohol. The top three drugs causing addiction are marijuana, opioid (narcotic) pain relievers, and cocaine.

In the 1930s, when researchers first began to investigate what caused addictive behavior, they believed that people who developed addictions were somehow morally flawed or lacking in willpower. Overcoming addiction, they thought, involved punishing miscreants or, alternately, encouraging them to muster the will to break a habit.

The scientific consensus has changed since then. Today we recognize addiction as a chronic disease that changes both brain structure and function. Just as cardiovascular disease damages the heart and diabetes impairs the pancreas, addiction hijacks the brain. This happens as the brain goes through a series of changes, beginning with recognition of pleasure and ending with a drive toward compulsive behavior.

Pleasure principle The brain registers all pleasures in the same way, whether they originate with a psychoactive drug, a monetary reward, a sexual encounter, or a satisfying meal. In the brain, pleasure has a distinct signature: the release of the neurotransmitter dopamine in the nucleus accumbens, a cluster of nerve cells lying underneath the cerebral cortex (see illustration). Dopamine release in the nucleus accumbens is so consistently tied with pleasure that neuroscientists refer to the region as the brain’s pleasure center.

All drugs of abuse, from nicotine to heroin, cause a particularly powerful surge of dopamine in the nucleus accumbens. The likelihood that the use of a drug or participation in a rewarding activity will lead to addiction is directly linked to the speed with which it promotes dopamine release, the intensity of that release, and the reliability of that release.

Even taking the same drug through different methods of administration can influence how likely it is to lead to addiction. Smoking a drug or injecting it intravenously, as opposed to swallowing it as a pill, for example, generally produces a faster, stronger dopamine signal and is more likely to lead to drug misuse.

Addictive drugs provide a shortcut to the brain’s reward system by flooding the nucleus accumbens with dopamine. The hippocampus lays down memories of this rapid sense of satisfaction, and the amygdala creates a conditioned response to certain stimuli.

Learning process Scientists once believed that the experience of pleasure alone was enough to prompt people to continue seeking an addictive substance or activity. But more recent research suggests that the situation is more complicated. Dopamine not only contributes to the experience of pleasure, but also plays a role in learning and memory—two key elements in the transition from liking something to becoming addicted to it.

According to the current theory about addiction, dopamine interacts with another neurotransmitter, glutamate, to take over the brain’s system of reward-related learning. This system has an important role in sustaining life because it links activities needed for human survival (such as eating and sex) with pleasure and reward.

The reward circuit in the brain includes areas involved with motivation and memory as well as with pleasure. Addictive substances and behaviors stimulate the same circuit—and then overload it.

Repeated exposure to an addictive substance or behavior causes nerve cells in the nucleus accumbens and the prefrontal cortex (the area of the brain involved in planning and executing tasks) to communicate in a way that couples liking something with wanting it, in turn driving us to go after it. That is, this process motivates us to take action to seek out the source of pleasure.

Do you have addiction? Determining whether you have addiction isn’t completely straightforward. And admitting it isn’t easy, largely because of the stigma and shame associated with addiction. But acknowledging the problem is the first step toward recovery.

A “yes” answer to any of the following three questions suggests you might have a problem with addiction and should—at the very least—consult a health care provider for further evaluation and guidance. Do you use more of the substance or engage in the behavior more often than in the past? Do you have withdrawal symptoms when you don’t have the substance or engage in the behavior? Have you ever lied to anyone about your use of the substance or extent of your behavior?

Development of tolerance Over time, the brain adapts in a way that actually makes the sought-after substance or activity less pleasurable.

In nature, rewards usually come only with time and effort. Addictive drugs and behaviors provide a shortcut, flooding the brain with dopamine and other neurotransmitters. Our brains do not have an easy way to withstand the onslaught.

Addictive drugs, for example, can release two to 10 times the amount of dopamine that natural rewards do, and they do it more quickly and more reliably. In a person who becomes addicted, brain receptors become overwhelmed. The brain responds by producing less dopamine or eliminating dopamine receptors—an adaptation similar to turning the volume down on a loudspeaker when noise becomes too loud.

As a result of these adaptations, dopamine has less impact on the brain’s reward center. People who develop an addiction typically find that, in time, the desired substance no longer gives them as much pleasure. They have to take more of it to obtain the same dopamine “high” because their brains have adapted—an effect known as tolerance.

Compulsion takes over At this point, compulsion takes over. The pleasure associated with an addictive drug or behavior subsides—and yet the memory of the desired effect and the need to recreate it (the wanting) persists. It’s as though the normal machinery of motivation is no longer functioning.

The learning process mentioned earlier also comes into play. The hippocampus and the amygdala store information about environmental cues associated with the desired substance, so that it can be located again. These memories help create a conditioned response—intense craving—whenever the person encounters those environmental cues.

Cravings contribute not only to addiction but to relapse after a hard-won sobriety. A person addicted to heroin may be in danger of relapse when he sees a hypodermic needle, for example, while another person might start to drink again after seeing a bottle of whiskey. Conditioned learning helps explain why people who develop an addiction risk relapse even after years of abstinence.

Recovery is possibleIt is not enough to “just say no”—as the 1980s slogan suggested. Instead, you can protect (and heal) yourself from addiction by saying “yes” to other things. Cultivate diverse interests that provide meaning to your life. Understand that your problems usually are transient, and perhaps most importantly, acknowledge that life is not always supposed to be pleasurable.



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