The truth about drug addiction is that no addict has a choice about using drugs once he is addicted. Addiction by definition means no more choice — even though his addiction started with a voluntary choice to experiment with drugs. Certain people because of their genetic make-ups will become addicted, while others can experiment and not use again, unless by choice. This is what makes addiction so hard to understand to outsiders. You may think that if this person really loves you and would try harder or whatever, he could quit using drugs. The truth is once a person becomes addicted, he can’t.
The new way of thinking is that drug addiction is a disease similar to hypertension, asthma, or diabetes in the sense that it is a factor of genetics, behaviors, and environment. Studies of identical twins indicate that all three incurable diseases are partly genetic. Whether the person learns to manage their condition and live a healthy life depends on if they follow their doctors’ orders and change their lifestyles. In the management of diabetes, for example, a patient has to learn to monitor his blood sugar, take insulin, eat in a healthy way, exercise, and maintain a healthy weight for the rest of his life or else he could die from insulin shock, and/or risk amputations of his limbs and blindness. Drug addicts have to learn to abstain from using drugs or else they will become addicted again.
Scientists have only learned in the last decade or so that drug addiction causes irreversible changes in the function and structure of the brain, causing a person to experience pleasure in an abnormal way. Once these changes take place, the person will become depressed without her drugs and unable to feel normal, everyday pleasure. These are about permanent chemical changes that have taken place in the brain, and have to do with certain chemicals involved in neurotransmission. All this research into brain chemicals, neurotransmission, and drug addiction is very recent, since scientists are only beginning to use magnetic resonance imaging (MRIs) to observe how addiction actually works in the brain.
Drug addicts condition themselves to respond to certain people, situations, and feelings by using drugs. For example, every time he feels angry, he uses heroin; every time she goes to a party, she uses cocaine. These “conditioned responses” become hard-wired in the brain, making it very difficult not to respond to familiar cues without taking drugs again. Part of drug treatment, therefore, is about learning how to deal with these cues or “triggers” — such as getting angry or going to a party– without taking drugs again.
Drug rehabilitation programs often include activities such as drawing and painting, working with horses, participating in sports, and learning to calm down through meditation. Many people do not believe these are real medical treatments; however, these are what is available now as the best state-of-the-art treatments. Until we better understand the biochemistry of the brain and drug addiction, and until we invent more effective medications, treatment will involve learning new behaviors and psychological counseling. Today there are a few promising drugs available for the treatment of opiate addiction, alcohol, and nicotine, but very few pharmaceutical options for addictions to stimulants, such as methamphetamine and cocaine.
Whether a person fully recovers from drug addiction depends on how well he follows the advice of his doctors and treatment program professionals. Most people have to stay in a drug-free facility for a few months, and then attend self-help meetings afterwards. Drugs addicts recover at about the same rate as people with other chronic diseases, such as diabetes, asthma, and hypertension. Support from family and friends is important to recovering from drug addiction.
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