How does addiction start, and why do only a minority of people who start abusing drugs go on to develop full blown substance use disorder? This is an incredibly complicated question, and it’s one that we do not still don’t know the whole answer to.

However, what we do know is that certain risk factors can increase a person’s chance of illicit drug use and of ultimately developing drug addiction. We also know a fair bit about how addictive substances can change a person’s brain chemistry in a way that ultimately makes drug use more and more appealing, which can eventually result in drug dependence.

This article will explore both of these topics, hopefully giving concerned family members greater insight into the complex disease of drug addiction and a greater understanding of the path to a brighter future.

Risk Factors For Substance Abuse

Though some people may assume that only the drug involved is what caused addictive behavior in someone who abuses drugs, the truth is that addiction more accurately results from a complex interaction between a person, a drug, and that person’s environment.

While not everyone with drug addiction suffers from these risk factors and not everyone with these risk factors develops drug addiction, recent research suggests that, as a group, people who developed addictions are measurably different from those who did not in a number of meaningful ways.

For instance, a person’s risk of alcoholism and drug dependence is significantly higher if they also suffer from other mental health issues, such as depression, anxiety, or eating disorders. This is because people with mental disorders may use illicit drugs to help relieve their symptoms instead of visiting a qualified mental health professional for a more appropriate prescription medication.

This will only worsen symptoms and overall mental health in the long run as the person becomes more and more dependent on these harmful illegal drugs just to function. The National Institute on Drug Abuse suggests that about half of those with a substance use disorder also suffer from mental illness, and vice versa.

Another major risk factor for addictive behavior is a family history of drug addiction. This is thought to be partially because drug users who are parents may set a negative example as they suffer from addiction, abuse alcohol, and provide an unstable environment while their children are young. Children will “learn” that drug abuse is an acceptable way to deal with painful feelings, and will be at higher risk of experiencing trauma during their upbringing, another risk factor in and of itself.

However, family history is also thought to be such a powerful predictor of susceptibility to addiction because of genetic factors, especially in the case of specific drugs like alcohol, with the children of alcoholics being four times more likely to become alcoholics themselves. Family history could serve as a sign that a person will have a stronger reaction to an addictive substance, and may therefore be more motivated to keep using it even despite actual or potential negative consequences. To worsen matters, specific mental health issues that can trigger or exacerbate drug use may run in families as well.

Strong peer pressure to engage in psychoactive drug use is another major risk factor, as studies show that peer pressure is one of the most common reasons that teenagers report for using alcohol and other drugs. This is especially harmful when it creates the risk of early exposure, as people who start using alcohol and other drugs before age fifteen are three and a half times more likely than others to be dependent on drugs at age thirty-two.

There are also certain prescription drugs that come a particularly high risk of drug misuse, which can in turn progress to the use of other addictive substances. In particular, prescription drugs like opioid pain relievers exert such a powerful physical effect on brain chemistry that even some people who had no intent of abusing their prescription medication do eventually become addicted to it.

Because opiates work similarly on the brain’s chemistry to certain illegal drugs like heroin, which is basically a far more powerful version of the same drug, they can often serve as gateway drugs to these other substances, which are even more dangerous and addictive.

In particular, the National Institute on Drug Abuse suggests that more than twenty percent of people who use prescription opioids abuse them, and opioids serve as gateway drugs to heroin for four to six percent of those misusers.

The Science Of How Drug Addiction Begins

Drugs causing addiction basically all work on the brain’s system for reward related learning. The brain responds to substance abuse by releasing the neurotransmitter dopamine, particularly in the brain’s pleasure center, which is located in a collection of nerve cells lying underneath the cerebral cortex.

In a healthy brain, dopamine interacts with other brain chemicals to prompt someone to engage in behaviors that were associated with human survival and sustaining life during the early ages of human evolution. For instance, eating or a sexual encounter generally promotes dopamine release, as do secondary learned rewards like socializing, shopping, playing games, or listening to music.

Though these behaviors stimulate dopamine release, when someone consumes drugs, they exert a far stronger dopamine signal. This is what makes addictive drugs so pleasurable to use, but that’s not the only way that drugs affect the brain. Physical addiction can develop when, over time, if a person is habitually abusing drugs, drugs alter a person’s brain chemistry so that the brain comes to “expect” the drugs.

The brain will get “used” to having more dopamine around, so it will need more and more dopamine just to function. This will result in the person needing to use drugs just to feel normal, and needing to use more and more of the drug if they want to get high. This creates a vicious cycle as tolerance is pushed higher and higher, and creates cravings as the brain tries to maintain equilibrium.

A deeper look at addiction and the brain includes areas involved in withdrawal symptoms as well as those involved in the increasing desire for drugs. Another part of the brain called the amygdala will send signals indicating that not using drugs is dangerous, which is why a person will feel anxious and irritable if they do not satisfy their drug craving. The National Institute on Drug Abuse offers a more in depth exploration of these ideas here.

Using The Marchman Act On Someone Who Has Lost Control Of Their Drug Abuse

Though early approaches to drug abuse involved punishing miscreants for their “selfish” behavior, we now know that drug addiction is a disease that requires treatment rather than a moral crime that requires punishment. The Diagnostic and Statistical Manual of Mental Disorders recognizes addiction as a legitimate mental health disorder, and thinking of it that way allows us to maintain empathy for those who struggle with it rather than thinking of them as deliberately hurting themselves and those around them with their behavior.

Overcoming addiction is always possible, and therapy and support groups can help people with drug addiction start to make their way back toward a healthy life. The National Institute on Drug Abuse explains that addiction is a chronic but treatable disorder, and also explains how addiction treatment works to help patients stabilize and begin to change their mindset.

However, some people with drug addiction may be reluctant to begin treatment, as they may not be able to imagine life without drugs and may be fearful of experiencing emotionally and physically painful withdrawal symptoms, though these can often be managed by the appropriate use of medication in an appropriate treatment setting.

In these cases, and if trying to reason with the person is unsuccessful, it may sometimes be necessary to use the Marchman Act, a Florida law that allows for the involuntary commitment of a person who is so severely impaired by substance abuse that they are incapable of making a rational decision about their treatment.

If you would like to learn more about the Marchman Act, or about how one of our professional intervention counselors can guide you through the Marchman Act process, feel free to call us anytime at (833) 995-1007 or to contact us online anytime here.

Substance Use Disorders According To The Diagnostic And Statistical Manual Of Mental Disorders

Substance use disorders are defined by the Diagnostic And Statistical Manual Of Mental Disorders (DSM-V) as a problematic pattern of drug use that an individual continues to engage in despite experiencing negative consequences. Last updated by the American Psychiatric Association in 2013 and published by American Psychiatric publishing, the DSM–5 is the gold standard for professionals when it comes to diagnosing any mental health disorder, including substance use disorder, which is more colloquially referred to as drug addiction.

Someone who has or is developing substance use disorder may exhibit these signs and symptoms:

• Frequently getting high for longer periods than they intended to or taking more of a drug than they intended to
• Being unable to handle their usual responsibilities due to their drug use
• Spending a lot of time using the drug, obtaining the drug, or recovering from the drug’s effects
• Giving up social or recreational activities that one formerly enjoyed in order to spend more time using drugs
• Using drugs despite the fact that it is causing relationship problems, financial problems, or legal problems
• Using drugs even in circumstances where drug use is dangerous
• Needing to use more and more of the drug to achieve the high that they want (tolerance)
• Experiencing withdrawal when they are not using the drug
• Experiencing intense cravings to use the drug
• Having trouble staying drug free without outside help

For someone to meet the full criteria for substance use disorder, these symptoms of substance use also have to be causing clinically significant impairment to the person. The Diagnostic And Statistical Manual Of Mental Disorders also includes a separate category for substance induced disorders, which are a separate category of substance related disorders than substance use disorders.

Addictive disorders are also referred to more specifically by the specific type of drug misuse the person is struggling with, such as in opioid use disorder or alcohol use disorder. To learn more, you can check out this breakdown from the American Psychiatric Association.

Recognizing The Symptoms Of Substance Use Disorder

Along with the clinical behavioral symptoms of substance use disorder explored above, it is also possible to recognize a substance use disorder from more visible signs and symptoms present in someone who you suspect is suffering from drug addiction.

For instance, you can often recognize someone who is misusing drugs by the signs of intoxication, which can vary based on the type of drug use they are struggling with. For instance, someone who has been taking opioids may appear drowsy while someone who has been using cocaine or other stimulants may be more likely to present as unusually “wired” and energetic.

Then, other drugs like hallucinogens may result in someone who looks as if they are out of touch with reality entirely. To learn more about the signs and symptoms of intoxication from specific drugs, you can check out each’s dedicated topic page on the National Institute of Drug Abuse website.

However, some general signs and symptoms of intoxication include slurred speech, erratic behavior, impaired control of motor functions, trouble maintaining consciousness, and uncharacteristically risky behaviors. Additionally, other symptoms of substance use disorder can be recognized from the physical appearance of someone who has been engaging in illicit drug use.

These physical signs include sudden weight loss, dilated pupils, and “track marks” on one’s skin from injecting unknown substances. Since injecting illegal drugs carries the risk of transmitting pathogens that can cause serious health problems like hepatitis B and HIV, these specific disorder signs definitely should not be ignored.

Causes Of Substance Use Disorders

The causes of substance use disorder can be quite complex, and it is almost impossible to predict which of the many people who experiment with drug use will go on to develop full blown substance use disorder.

After all, in substance use disorder, substance is not actually the cause of the disorder; rather, it results from the interplay of that substance with the person’s underlying vulnerabilities and specific circumstances.

However, according to the National Institute on Drug Abuse, some factors do seem to predispose a person to developing problems with substance use. For instance, drug availability and peer pressure at school can be a significant factor in whether children are exposed to drugs. Then, children who yield to peer pressure and begin their drug use at an early age are at higher risk, while children who have more parental supervision are more protected.

Another major risk factor is family history: in other words, someone whose family members struggled with drug addiction is more likely to have trouble controlling their drug use as well. This may be partially due to social factors, as children may learn from family members that drug use is an “acceptable” way to deal with one’s problems.

However, a significant portion of the association may also be due to genetic predisposition. For instance, the person’s genes may lead them to find drug abuse more pleasurable, or may contribute to the development of a mental illness that predisposes them to resort to drug abuse to manage negative feelings caused by the disorder.

As explained by the National Institute on Drug Abuse, having an underlying mental health condition is another major risk factor for developing addiction. This is referred to as “comorbidity” or a dual diagnosis. Post traumatic stress disorder, depression, bipolar disorder, and anxiety disorders have all been shown to increase the risk of developing problems with substances.

Understanding Withdrawal Symptoms

One reason that substance use disorder can be so hard to overcome is because of the severe withdrawal symptoms that can be caused by drug abuse. Frequent drug use can change the brain’s chemistry and the brain’s structure in such a way that a person’s brain and body begins to “expect” them to take the drug and to “need” it to function normally.

This will result in intense cravings if the person does not take the amount of the drug that they are used to. It can also result in withdrawal symptoms, which can cause such severe emotional distress and physical symptoms that a person may be motivated to take drugs just to avoid them. Depending on the substance that someone is using, withdrawal may also be physically dangerous, so consulting a doctor before going cold turkey may be advisable.

Treatment Approaches for Substance Use Disorders

Drug addiction treatment can take many forms, but almost always incorporates behavioral therapies. In behavioral therapy, a licensed alcohol or drug counselor helps patients to learn healthier ways to cope with life’s troubles and with any underlying mental illness.

Most rehab centers also offer some form of group therapy, in which patients share experiences and feelings with one another or are educated together about addiction related topics. These support groups serve an important role in helping patients to realize that they are not alone in their struggles with substances, giving them a much needed sense of belonging and alleviating feelings of loneliness.

After a person completes addiction treatment, outside support groups like Alcoholics Anonymous and Narcotics Anonymous can have much the same effect, helping patients to maintain their sobriety long term as they work towards the shared goal of recovery with the help of a supportive community.

Using The Marchman Act To Help Someone With A Substance Use Disorder

If someone with a substance use disorder is unwilling to consider drug addiction treatment, but obviously meets the criteria for a severe substance use disorder to the extent that they are a danger to themselves or others, you may be able to use the Marchman Act require them to be involuntarily committed to addiction treatment.

While causing legal trouble for a family member to ensure that they get the help they need should obviously be a last resort, in some cases, it may be the only step you can take to save their life. To learn more about the Marchman Act and how one of our skilled intervention counselors can help you to confront your loved one or to guide your family through the Marchman Act process, feel free to call us anytime at 833-995-1007 or to contact us online here.