Commonly Asked Questions about Addiction and Treatment
Why do drug abusers live in denial?
"Denial is a common characteristic of many people struggling with substance abuse. It involves refusing to accept the reality of their addiction and its damaging consequences. There are several reasons why this denial occurs:
Fear: Admitting a problem means confronting the reality of addiction, including the perceived pain of withdrawal, the work of recovery, and potential stigma. Fear of these challenges can drive a person to deny their problem.
Guilt and Shame: Addiction often brings feelings of guilt and shame. Denial serves as a defense mechanism to avoid these difficult emotions.
Cognitive Impairment: Substance abuse can physically alter brain function, impairing judgment, memory, and self-awareness, making it harder for individuals to recognize or admit they have a problem.
Perception of Normality: If substance use is a daily occurrence, it can seem normal to the person doing it. They may think everyone else is doing the same or that their usage is acceptable or controlled.
Rationalization and Minimization: Individuals with substance use disorders often rationalize their behavior ("I only use on weekends") or minimize the consequences ("I still have my job, so it's not a problem").
Avoidance of Responsibility: Acknowledging the addiction implies a responsibility to change. Denial helps avoid this responsibility.
Can I go cold turkey to stop abusing opioids?
While going "cold turkey," or suddenly stopping the use of opioids, might seem like a fast way to begin recovery, it's generally not recommended due to the severity of withdrawal symptoms and potential health risks.
Opioid withdrawal can be intensely uncomfortable and, in some cases, hazardous. Symptoms can include severe cravings, restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes, and involuntary leg movements. In severe cases, withdrawal can lead to serious dehydration or electrolyte imbalances.
Furthermore, abruptly stopping opioid use can significantly increase the risk of relapse. The discomfort of withdrawal symptoms may make it more difficult to stay abstinent, and an individual may be tempted to use again just to relieve these symptoms. If a person relapses and takes the same dose they were previously accustomed to, the risk of overdose is high because the body's tolerance to the substance has decreased.
For these reasons, opioid withdrawal should ideally be managed under the supervision of healthcare professionals. Medication-assisted treatment (MAT), which includes medications like methadone, buprenorphine (Suboxone), and naltrexone, can be used to help reduce withdrawal symptoms and cravings. These medications work by acting on the same brain receptors targeted by opioids, but they do so in a safer manner that helps to manage withdrawal and reduce the risk of relapse.
In addition to MAT, counseling and behavioral therapies are typically part of a comprehensive treatment program for opioid use disorder. These approaches can help individuals develop the skills and strategies needed to maintain recovery in the long term.
Why do people abuse addictive substances?
People may abuse addictive substances for a variety of reasons, often involving a complex interplay of biological, psychological, and social factors. Here are some common reasons:
Biological Factors: Certain individuals may be genetically predisposed to addiction. This could involve inherited traits that affect the way substances interact with their brain or influence their susceptibility to mental health disorders, which can increase the risk of substance abuse.
Psychological Factors: Many people turn to addictive substances as a way to cope with mental health issues such as depression, anxiety, or post-traumatic stress disorder. Substance use may provide temporary relief from these conditions, though in the long term it often exacerbates them.
Social Factors: Peer pressure, especially among young people, can lead to substance abuse. If an individual is in an environment where drug or alcohol use is common, they may feel compelled to partake in order to fit in.
Environmental Factors: Stressful or traumatic environments can increase the risk of substance abuse. This can include living in poverty, experiencing abuse or neglect, or being exposed to violence.
Curiosity and Experimentation: Particularly among adolescents and young adults, the desire to try new experiences can lead to substance use.
Self-Medication: Some people use substances to self-medicate physical pain. For example, the opioid crisis has been fueled in part by individuals who initially used prescription opioids to manage pain and then developed an addiction.
Escapism: People may use substances to escape their reality, numb emotional pain, or simply to feel good. Addictive substances often provide a temporary sense of euphoria or relaxation, which can be enticing.
Co-occurring Disorders: Individuals with co-occurring mental health disorders are at a significantly higher risk of substance use disorders. This is because these individuals might use substances as a form of self-medication.