Addiction is defined as “A chronic, relapsing disease characterized by compulsive drug seeking and use—despite serious, even devastating consequences—and by long-lasting chemical changes in the brain.” When a person is addicted to a drug, finding and using that drug becomes the most important thing—more important than family, friends, school, sports, or money.
Not everyone will become addicted after they smoke a cigarette, drink alcohol, or take another drug, but even experimenting can raise your risk.
Have you heard about all these celebrities going in and out of rehab? That’s because addiction is a chronic, relapsing disease, like heart disease, hypertension, or diabetes that can be managed with treatment. And even though a person may beat their addiction with treatment, he or she is always at risk of relapse.
If you think you or a friend may be addicted to a substance, talk to a family member, medical professional, or other trusted adult to get help. You can also check out the Substance Abuse and Mental Health Services Administration’s Treatment Facility Locator for treatment services near you.
To learn more about addiction, check out NIDA’s publication, Drugs, Brains, and Behavior: The Science of Addiction.
Lots of teens have questions about drugs. Each year, NIDA scientists spend a whole day chatting online with high school students and answering their questions.
At the last “Drug Facts Chat Day,” a teen from Lima Central Catholic High School in Lima, Ohio asked:
What should I do if one of my friends is using drugs... What should I tell him to convince him to stop?
There are many ways to help and support your friend, but in the end, it will need to be your friend’s decision. And just by asking us this question, it’s easy to see you are a good friend. Sometimes our friends won’t appreciate advice they don’t want to hear—especially if they are using drugs—but telling the truth to help someone close to you is part of being a real friend, even when it’s hard to do.
Here’s some ideas of things to say and do to help:
What To Do:
- Find out if your friend is experimenting with drugs, or if he may be addicted. Neither one is good—but you may need more support if your friend is addicted.
- Understand that addiction is a brain disease. Just like you wouldn’t expect someone with cancer to be able to heal herself without the help of a doctor, the right treatment, and support from family and friends, you can’t expect your friend to heal herself.
- Know that it is never easy for anyone to admit that they have a drug problem. You will need to be patient—and not give up easily.
- Listen, encourage, share, and support. Sounds easy right? But it’s so hard. We provide further tips and resources in a previous post we wrote titled “How to Help a Friend in Need.”
- BTW, it's tough having a friend with addiction issues. So, if you need some support, visit: http://www.alanon.alateen.org/.
What To Say:
- Just telling your friend that you’re concerned can be a big help. Your friend may not want to talk about it, and the effects that drugs have on the brain may keep him or her from “hearing” you or acting on your advice.
- Assure your friend you are there for her and that she is not alone. People with drug problems often have gotten in with the wrong crowd—and they don’t want to turn away from these so-called friends for fear of being alone.
- Suggest that he or she speak to a trusted adult who will keep it confidential. Maybe there’s a family friend who could help.
- Turn to a professional for immediate help if the problem looks to be too big for you to handle alone, or if you’re worried your friend may have suicidal thoughts that she could act on.
- Use SAMHSA’s Substance Abuse Treatment Facility Locator or call 1–800–662–HELP to tap into a support network where you can find immediate and confidential help 24/7. They will also be able to direct you to local treatment options.
When the people we care about and have lots in common with make bad choices, it can be frustrating, confusing, and a little depressing. Still, we should be there for our friends, and also try to be a good role models for them by making smart choices ourselves.
Most people know that addiction, can be overcome with treatment. But like many other diseases, it is often a winding road to get there. So, what are the steps to a healthier, drug-free life?
Seek treatment. The first step to recovery is to decide to seek treatment. It’s hard for people to recognize or admit they have a problem, even when they are putting their lives – or the lives of others – at risk. It doesn’t help that the brain’s decision-making center is impaired when under the influence of drugs or alcohol. Treatment may mean medications, behavioral counseling, or a combination of the two.
Learn new habits. Relapse (or returning to drug use) is common with addiction and is an expected part of treatment. Returning to the people, places, or things associated with former drug use can actually trigger relapse—before the addicted person is even aware of it. Behavioral therapy can teach the person in recovery to avoid these triggers and learn new coping skills so they can make better decisions.
Take it one step at a time. Recovery takes time. Treatment works best when it is long-term, at least 90 days in most cases. And because people treated for drug addiction are vulnerable to relapse even after they’ve been off drugs for a long while, most treatment professionals would say that someone with a past drug or alcohol problem is “in recovery” for a lifetime.
Find treatment. If you are interested in finding drug abuse treatment for yourself or a friend or family member, look up facilities near you by using the Substance Abuse Facility Treatment Locator, provided by the Substance Abuse and Mental Health Administration.
If you’re like most people, you may try to avoid revealing anything about yourself that will make people think differently or negatively about you. Basically, you’re avoiding stigma—which is being marked by shame or disgrace.
But what if you have a drug problem and want to get help?
For a long time, our society has “stigmatized” drug use and addiction, judging people with drug or alcohol problems. Fear of being judged can be dangerous if it keeps someone from getting treatment.
One way to combat the stigma associated with drug addiction is to teach people the facts. NIDA science shows that addiction is a disease, just as cancer and asthma are diseases. It’s not just that the person chooses to take drugs. In fact, an addicted person no longer chooses to take drugs—rather, their brains have been altered by drugs to the point where free will has been cruelly “hijacked,” and the desire to seek and use drugs is beyond their control. Addiction is a disease of the brain that manifests itself in compulsive behaviors. Helping people understand this sad truth may lead to more support for those battling addiction.
It’s also important to stop labeling people as one thing or another. Try to avoid saying “addicts.” This label makes it easier to dismiss people as not worthy of help or notice. It’s better to say, people with “drug use problems” or “substance use disorders.” It may be a mouthful, but this phrase makes it clear that these are people who are facing challenges. They are more than just drug addicts.
Do you avoid certain hobbies, interests, or even potential new friends because you’re afraid of what your current friends will think? What would you say to someone who needs drug abuse treatment but isn’t getting it for fear of being judged?
Ever wonder how “real” those grueling scenes on reality TV shows are when actors and other celebrities check in for addiction rehab and are shown going through withdrawal? After all, these folks are all in show biz!
SBB was curious about exactly how withdrawal happens. Withdrawal is defined as: symptoms that occur after chronic use of a drug is reduced or stopped.
But that’s just where the story begins. The symptoms of withdrawal vary a lot by drug, including how harsh they are and how long they last.
Consider prescription opioids, or painkillers. These are drugs like oxycodone (better known as Oxycontin) or hydrocodone (Vicodin). Opioids are typically prescribed for someone having severe pain, from the ache after a root canal to a chronic condition like back pain from an injury. When opioids are taken as prescribed, they can provide temporary relief from severe pain. But, they are also highly addictive and must be taken only as prescribed.
Some people will abuse a prescription drug by taking more than prescribed, or in ways not intended, which can lead to serious problems, including slowed heartrate and breathing and even addiction. And just like with “illegal” drugs, quitting is hard and can bring on withdrawal symptoms. Opioid withdrawal symptoms can include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps ("cold turkey"), and involuntary leg movements. Yikes.
Taking away the chemicals that alter your brain through drugs of addiction is a pretty harsh reality. Your body and brain react strongly, even violently sometimes, because of missing the chemicals they’ve come to depend on through repeated drug use.
If a person knew from the start that quitting drugs would be so difficult, would they think twice before trying them? Probably so… Know the facts.
My name is Sarah and before my high school senior year, I spent a summer at NIDA as an intern with the Center for Clinical Trials Network (CCTN). Never heard of it? Neither had I. I discovered that the goal of the CCTN is to improve the quality of drug abuse treatment throughout the whole country by doing safe and interesting scientific studies with humans. By the way, human studies are called “Clinical Trials.” These are trials or tests done to evaluate the effectiveness and safety of different medications or approaches by monitoring their effects on large groups of people, like a big “clinic” full of patients, but in a research setting.
As the name implies, the CCTN works as a network that includes scientific investigators all over the country. These investigators work together to develop and carry out clinical trials to evaluate behavioral and medical treatments for drug addiction, and to discover new ways to make existing treatments more effective.
So what did I learn about clinical trials? Clinical trials provide the best standard for demonstrating that a certain behavioral treatment or medicine really works and is also safe for humans. In the area of drug addiction, there is a great need for safe and effective treatments that are tailored to the specific addiction, such as heroin, cocaine, or marijuana.
I also learned that drug addiction is a chronic, relapsing condition. It may be easy to break one cycle of addiction, but it is very difficult to keep the patient from falling into another. One analogy is to think about the obese patient who can lose weight in the short run, but over time experiences many cycles of weight loss and gain, without really achieving an ideal body weight.
In a similar way, the addicted patient will receive successful treatment to break the addiction, but will continue to have cycles of relapse, requiring further treatments. The addicted patient might have a relapse towards the initial drug, but it can also be for a new substance or a combination of substances (e.g. initial addiction to marijuana, then addiction to opiates, then addiction to opiates and prescription drugs). Thus I discovered the true goal of the CCTN is to promote the development of treatments, or a combination of treatments, that will not only treat the addiction, but will also prevent future relapses.
More on clinical trials
While clinical trials are a way to develop new treatments and advance the scientific and clinical knowledge base from humans who volunteer to participate, I also learned that the volunteers themselves can benefit from their participation in clinical trials. For example, patients with difficult diseases like cancer can participate in a clinical trial in hopes of finding a cure, or at least a more effective treatment.
For more information on clinical trials, NIH maintains a clinical trials registry known as ClinicalTrials.gov, which contains information on trials supported by federal funds. There you can find information about a trial's purpose, who may participate, locations, and more.
So you’re friends with 100 or more people on Facebook, right? What are the chances that someone you know or a family member is in trouble with drugs or alcohol? Or thinking about trying something they wouldn’t do if they knew the facts?
You could try talking to your friend, or asking if they need help. But what are the chances they’d listen? Would you know the right thing to say?
That old cliché—tell an adult—may sound like good advice. But you don’t want to rat out your friend. So what do you do?
Today you can reach out in ways that didn’t even exist 5 years ago. Interactive online social networks and blogs like this one let you help without feeling you’ve betrayed your friend. You can even get involved in the conversation, like commenting here on SBB.
Using resources like this blog, you can get the latest science on drugs, alcohol, and addiction, and link people to additional science-backed information—anonymously. Facebook, including NIDA’s Facebook page, is another way to find and share trusted information.
Here are some other recommendations for Facebook friends that SBB trusts—and you can, too.
Government agencies with Facebook pages:
- NIDA – http://www.facebook.com/#!/NIDANIH
- National Drug Facts Week - http://www.facebook.com/NIDA.Drug.Facts.Week
- ONDCP – http://www.facebook.com/#!/pages/ONDCP/110715232289697
- CDC – http://www.facebook.com/#!/CDC
- NIMH – http://www.facebook.com/nimhgov
- Substance Abuse Mental Health Services Administration’s Treatment Locator – http://findtreatment.samhsa.gov/
- CADCA – http://www.facebook.com/group.php?gid=5870000204
- The Partnership at Drugfree.org - http://www.facebook.com/partnershipdrugfree
Many of these organizations are also tweeting and blogging. You can find a blogroll of those talking about drugs, alcohol, and addiction issues on the Sara Bellum Blog home page by scrolling down and looking in the blogroll to the right of this post: http://teens.drugabuse.gov/blog/
So when you’re wondering what you can do to support a friend or family member, here’s an update for your own Facebook status: Friends don’t let friends stay in the pit with drugs.
Many of you probably heard that the European tour just launched by the talented Amy Winehouse has been canceled after fans watched the diva stumble under the lights in Serbia. Reports say audience members in Belgrade booed her off the stage Saturday night just a few songs into the first concert of the tour when she couldn’t even remember the lyrics to her own songs. The Grammy winner was scheduled for a dream tour—to Istanbul, Athens, Spain, Switzerland, Italy, Austria, Poland, Hungary and Romania—but those dates have all been cancelled. The Serbian media called the concert a "scandal," with Belgrade’s daily newspaper calling it "the worst performance in the history of Belgrade."
It is ironic that Amy Winehouse became famous for her song "Rehab," where she sang: "They tried to make me go to rehab. I said 'No, no, no.'" After the song became a hit, she actually said “yes” to drug and alcohol rehab in London, where she stayed for a month. If she has turned again to drugs, people will ask the same questions about if rehab works, and why big stars risk everything for drugs…
We’ve talked about rehab before, but Amy Winehouse’s struggle highlights what rehab is all about: addiction is a chronic disease, which means it has to be managed throughout your whole life. People relapse to drug addiction just like they do with other chronic illnesses like diabetes, hypertension, and asthma. To successfully treat a chronic disease, you have to change deeply imbedded behaviors—and that takes practice. For example, a diabetic has to learn how to manage a restricted diet, just as a person struggling with addiction has to learn how to manage cravings. Relapse does not mean treatment failure, but that treatment needs to be adjusted or changed altogether.
Sadly, many people are able to hide their addiction from the world and never get help. For famous people, every slip is recorded by fans and posted for millions to see. But famous or not, being successful in recovery takes a lot of support—which it sounds like Amy Winehouse has. Her representative put out this statement: "Everyone involved wishes to do everything they can to help her return to her best and she will be given as long as it takes for this to happen."
R.I.P Amy Winehouse 1983-2011
Figuring out what to do when a friend or someone you know is having trouble with drugs or alcohol can be tricky. You want to help, but you might not know how to bring it up. Here are some tips.
Listen. If he talks to you, just be there for him. Admitting a problem—never mind talking to someone about it—is really hard. Listen to what he has to say about his drug use without making judgments.
Encourage. Suggest that she talk to an adult she trusts—a coach or teacher, a school counselor, a relative, or a doctor.
Share. Maybe your friend doesn’t see his or her drug use as a bad thing. But plenty of real scientific information about what drugs can do to a person is on the NIDA Web site. Once your friend understands how drugs affect the brain, body, and life, it might open their eyes.
Inform. When he’s ready to make a change and seek treatment, help him find a doctor, therapist, support group, or treatment program. You can use SAMHSA’s Substance Abuse Treatment Facility Locator or call 1–800–662–HELP.
Support. Don’t give up on your friend, even if she isn’t ready to get help. Keep reaching out. Encourage them to get treatment, and support them along the way—that’s the best way to help someone you care about who is struggling with addiction.
You might have heard the news that former first lady Betty Ford recently died at the age of 93. Many of you reading this might never have heard of Betty Ford; after all, she became First Lady way back in 1974. But maybe you’ve heard of the Betty Ford Center, a rehab center in Rancho Mirage, California, where many celebrities have gone to seek treatment for their addictions. You also may not know why she built the center.
Not long after Richard Nixon resigned from office during the Watergate scandal, Jerry Ford suddenly became President and the family got thrust into public life. Betty Ford wrote in her memoirs that her family never wanted that level of fame, but accepted it to help the country through difficult times.
Over the years, as the spotlight on Betty Ford and her family grew, she began to drink more heavily on top of a dependency on pain pills, which started in 1964 when she got a prescription to relieve constant pain from a neck injury and a pinched nerve. We now know that mixing pills and alcohol is a big mistake. Once she was First Lady, people began to notice that when she spoke she was slowly slurring her words and she seemed to have no energy. After her husband’s presidency was over, Betty Ford left public life and soon announced she was addicted to pills and alcohol. In her memoirs, she tells the story about how her family confronted her about her addiction, which at first she was not happy about. Later, she thanked them and became a champion for people struggling with the disease.
Her openness about her addiction was shocking to some people. Forty years ago, people tried to hide the fact they had an addiction problem, but she bravely brought it into the light, giving others the courage to ask for help with their own drug abuse and addiction problems. She entered rehab and, with treatment, learned to manage her addictions. A few years later she opened a rehab center in her name to help other people. Today the Betty Ford Center is a thriving treatment center, and because of its closeness to Los Angeles, it has become a rehab center for many famous people, including Drew Barrymore, Robert Downey, Jr., Johnny Cash, Elizabeth Taylor, and many others.
So SBB says thank you Betty Ford for having the courage to use your personal story to educate people about addiction, and for bringing it from the darkness into the light, from shame and despair to treatment and hope.
How did she have the courage to bring her addiction out in the open? She has been quoted as saying, “The public needed to know that this didn’t have to be swept under the rug anymore, that this needed to be open and discussed.”
Are you a fan of Degrassi: the Next Generation, on Teen Nick? Well, I've got news for you. In the first show of the season, which aired last Friday, one of the characters got into trouble abusing drugs. I can't tell you much more than that, but I do know that when someone decides to take a drug the first time, it can be for many reasons, like to get a buzz, to experiment, or just to fit in. But, if you keep taking drugs, they can change the chemicals in your brain so that you may not be able to stop.
Degrassi star Jamie Johnston has recorded a special message about drug abuse that played during the show. But, hey, since you're here, why not view it now on NIDA's YouTube channel.
While we are still not sure exactly what killed Amy Winehouse, many people are speculating that it had something to do with her admitted drug and alcohol abuse. As we blogged a few weeks ago, Winehouse was booed off the stage in her last concert. Now she may be among what some call the “27 Club”—famous people who died at the age of 27 from drug and alcohol abuse, including Kurt Cobain, Jimi Hendrix, Janis Joplin and Jim Morrison, all major music heroes of their times. Coincidence?
Not really. As their fame and wealth increased, so did their access to drugs and so maybe, too, their belief that they were outside the rules, invincible. But that wasn’t true. By the time they were in their mid-twenties it is likely their bodies started to rebel, screaming enough is enough!
Going to rehab is a smart move, even if it takes several tries. Rehab is hard. It calls for major changes in an addicted person’s life beyond stopping drug use—like a change of friendships (maybe even of a best friend or partner), not to mention a change of lifestyle and even where you live. When you’re “on top,” too much change might be harder to accept.
Still, the alternative is worse—just ask the people who loved Amy Winehouse. She was a great talent who could really have moved the world. To quote one of our 2010 GRAMMY winners from their video "Drug Free State of Mind," "…we all shootin’ stars basically waitin’ to be seen…"
What is your talent that is waiting to be seen? Make a plan not to waste it!
Relapse…If you keep up with the SBB you know by now that addiction is a chronic (long-lasting) disease that takes hold in some people who abuse drugs. You may also know that some people can quit their drug use. But often a person will return to using drugs after they have quit. This is what NIDA Scientists call a relapse.
Why does it happen? Addiction changes the wiring of the brain to cause uncontrollable craving and compulsive drug use—despite the consequences. For someone with an addiction, going without the drug for periods of time can make that person feel so anxious and stressed that they need the drug just to stop feeling bad.
A person who is addicted to a drug usually needs professional treatment to quit drug use. This can include medication or "talk therapy (PDF, 1.19 MB)," or a combination of both. It also helps to have support in the family and the community. While quitting drug use is possible, addiction is a long-lasting disease, and treating it takes time-and just because someone gets treatment and stops using a drug does not mean that these strong cravings go away for good, especially when certain cues are present. These cues vary from person to person and can trigger a relapse.
Imagine that your best friend is addicted to cigarettes and says she smokes to relieve stress, but that she recently quit because her boyfriend hates the smell of cigarette smoke. Since she has connected cigarette smoking with stress relief, the next time your friend faces a stressful situation, like a fight with parents or final exams, she will most likely crave a cigarette, increasing her risk of a relapse. Her use of cigarettes, which led to an addiction to nicotine, has also caused her to associate "relaxation" with cigarettes.
Not everyone will relapse once they have quit drug use; it depends on the person, their genes, their environment, and many other factors, including personal commitment and family support.
You may think you know what addiction is—lots of people have many different opinions about addiction and different ways of defining it. Here are some myths you may have heard:
- Getting over addiction to drugs is a choice.
- In order for treatment to work, the person has to hit “rock bottom.”
- People have to choose to get treatment or it won’t be effective, such as when a judge sends a person to treatment facility instead of jail.
The truth is that addiction is a complex brain disease that scientists are still figuring out. For instance, one person may use a drug once or many times and nothing bad happens, while others may overdose with the first use. Some people use drugs regularly and never become addicted, while others try drugs once or twice and do become addicted. There is no way of knowing in advance how a person may react to these dangerous substances. Whether or how quickly addiction takes hold in individuals depends on many factors, including:
- Genes: Research shows that some people’s genes may leave them more susceptible to addiction than other people’s.
- Environment: Kids who are exposed to drug use in their families or neighborhoods are at greater risk of engaging in drug abuse themselves.
- Age at first use: The younger a person uses drugs, the more vulnerable he or she is to addiction in adulthood. Since the brain continues to develop well into a person’s twenties, using drugs in the teen years can set a person up for later drug problems.
What scientists know for sure is that many drugs “turn on” the brain’s reward circuit, which is part of the limbic system. The person then learns to associate the drug with pleasure and starts to crave it more and more, leading to compulsive drug use and often to addiction. In an addicted person, the brain changes in ways that cause compulsive drug seeking and use, despite negative consequences, so even if they want to quit, they can’t without treatment and support. That’s why addiction is considered a brain disease. Other activities in life also activate the brain’s reward circuit and can cause “driven” behaviors, such as compulsive overeating or video game playing. However, scientists are still trying to figure out why this happens in non-drug contexts—it may be connected to dopamine levels in the brain. Learn more about the science behind drug addiction by visiting http://nida.nih.gov/scienceofaddiction/.
In April NIDA is having its “Blending” conference. No, this is not a conference about smoothies…So what does “Blending” mean to NIDA?
Let’s start back a little ways. First of all, doctors and treatment providers (the people who provide treatment to help addicted patients recover) don’t learn everything they need to know in medical school or college about taking care of patients. Scientists are constantly testing new ideas for improving treatments—but once they find treatments that work, how do they get them to the doctors and others who are actually treating patients?
Maybe in an ideal world, every doctor, social worker, or psychologist could read every good research finding in a medical or scientific journal and automatically know how to make it work for their patients. But real life isn’t that easy. A decade ago, it took more than 17 years to turn scientific research results into actual treatments used for real people! At the National Institutes of Health, scientists are working to change that, including NIDA scientists.
The NIDA “Blending” thing is part of this. We bring scientists together with the people who are actually treating patients with drug problems and “blend” their knowledge and expertise, testing treatments with actual patients and adjusting them to work better. The treatments that work the best are shared with others around the country, who are trained to use them. This “Blending” helps speed up the process of getting treatments that work to the patients who need them.
Here are a couple examples of new treatment ideas that providers will learn about at this year’s Blending conference in Albuquerque:
- New Treatments for teens and young adults who are addicted to opioids (drugs like Vicodin, Oxycontin or even heroin). There is a medication called Buprenorphine that has been successful with adults and now research is showing it may work for teens.
- Treatment Vaccines. We usually think of vaccines as something we take to avoid disease, but vaccines are being developed that can help people quit smoking and quit doing illegal drugs like cocaine (stay tuned for more on vaccines.)
So if you are reading this, you now know as much about “Blending” as many of the people who will attend the conference. Congratulations! And keep reading this blog to learn what we are learning about better ways to help people who struggle with addiction.