Commonly Asked Questions about Addiction and Treatment
How does a person become addicted to drugs?
Addiction to drugs is a complex process that involves a combination of biological, psychological, and social factors. It is not simply a matter of weak willpower or moral failing, but rather a chronic disease of the brain that can develop over time.
Here's a simplified explanation of how a person may become addicted to drugs:
- Initial Use: The path to addiction often begins with the voluntary act of taking drugs. This could be due to curiosity, peer pressure, seeking pleasure or relief from stress, or even for medical reasons under prescription.
- Pleasure and Reward: Drugs alter the brain's normal functioning, typically leading to intense feelings of pleasure or the elimination of uncomfortable feelings. They do this by overstimulating the brain's reward system - particularly by releasing large amounts of a neurotransmitter called dopamine, which plays a significant role in feelings of pleasure and reward.
- Repeated Use and Tolerance: Over time, as a person continues to use the drug, the brain adjusts to the excess dopamine by producing less of it or reducing the ability of cells in the reward circuit to respond to it. This reduces the high, leading the person to take more of the drug in an attempt to recreate the original experience. This is known as developing a tolerance.
- Dependence: As the brain becomes used to the drug, physiological changes occur that make the person's body require the drug to function "normally." When the drug is not taken, withdrawal symptoms may be experienced, driving the person to continue using the drug to avoid these uncomfortable or even painful symptoms.
- Addiction: At this point, seeking and consuming the drug becomes a compulsion. The person may want to stop using the drug, but they find it extremely difficult or impossible to do so on their own, even in the face of negative consequences to their health, relationships, or other aspects of their life. The brain's cognitive functions related to judgment, decision-making, learning, memory, and behavior control are significantly altered, leading to harmful behaviors and the cycle of addiction.
Are there racial inequities of the treatment of addictive disorders?
Yes, racial inequities do exist in the treatment of addictive disorders, reflecting systemic disparities that pervade many aspects of healthcare. These inequities can occur across multiple dimensions, including access to treatment, quality of care, and outcomes. Here are some ways in which these inequities manifest:
- Access to treatment: Racial and ethnic minority groups often face barriers to accessing substance use disorder treatment. These barriers can include factors like limited availability of treatment services in certain communities, lack of insurance or underinsurance, economic challenges, and lack of transportation.
- Quality of care: Even when individuals from racial and ethnic minority groups do access treatment, they may not receive the same quality of care as their white counterparts. This could be due to factors such as a lack of culturally competent care, bias or discrimination within the healthcare system, or treatment approaches that do not adequately consider cultural or community-specific factors.
- Treatment outcomes: Racial and ethnic disparities also exist in treatment outcomes for substance use disorders. For example, research has shown that African American and Hispanic individuals often have lower rates of successful completion of substance use disorder treatment programs compared to white individuals.
- Criminal justice involvement: There is a disproportionately higher rate of criminal justice involvement for substance use issues among people of color, particularly among African American and Hispanic populations. This can impact access to quality treatment, as well as long-term outcomes such as employment and social reintegration.
- Research gaps: Historically, much of the research on substance use disorders has primarily involved white participants, leading to a lack of data and understanding about the unique experiences, needs, and treatment responses of individuals from diverse racial and ethnic backgrounds.
Can alcohol withdrawal be fatal?
Yes, alcohol withdrawal can be fatal in severe cases, which is why it should always be managed under the supervision of healthcare professionals. This is especially true for individuals who have been drinking heavily for a long period of time or who have a history of severe withdrawal symptoms.
The most serious form of alcohol withdrawal is called delirium tremens (DTs), which occurs in approximately 5% of patients undergoing withdrawal. It typically starts 48 to 72 hours after the last drink, and symptoms can include severe confusion, hallucinations, high blood pressure, fever, heavy sweating, and rapid heartbeat. In addition to these, seizures can occur, which add to the risk.
Delirium tremens is a medical emergency and can be life-threatening if not treated promptly. Mortality rates without treatment are estimated to be as high as 35%, but with appropriate treatment, this rate drops to 5-15%.
Even less severe cases of alcohol withdrawal can be dangerous because they can lead to dehydration, severe vomiting, or other complications. Furthermore, withdrawal symptoms can make it difficult for an individual to maintain abstinence from alcohol, increasing the risk of a potentially dangerous relapse.