Drug and Alcohol Addiction

If drug abuse is using too much of a substance, or for nonmedical purposes, or having a few too many drinks now and then, what is addiction? When does social drinking become something more, or “recreational” use become dependency?

It is possible to be dependent upon a drug, like blood pressure or heart medication, without abusing it or becoming addicted. Addiction is accompanied by intense emotional need that goes far beyond whatever actual physical requirement the body may have. Per the American Psychiatric Association’s The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), there are three stages of addiction, recognizable by:

• Preoccupation/anticipation: constant craving, preoccupation with obtaining the substance
• Binge/intoxication: using more of the substance than necessary in order to experience the intoxication effects
• Withdrawal/negative effect: withdrawal symptoms, increasing motivation to return to “normal” life and previous activities

Addiction, in other words, is when an addict cannot stop thinking about the drug, is constantly scheming and planning to obtain more of it, and disregards warnings and advice to stop. The person is fixated on experiencing the “high,” the pleasurable feeling that now only the drug or alcohol can bring, for with addiction comes chemical changes in the brain. Drugs or alcohol have replaced the normal chemicals that arouse feelings of pleasure; the brain depends on them in order to produce these sensations. Without them, feelings of anxiety, depression, and other emotional “crash” symptoms occur, usually accompanied by unpleasant physical side effects as well, such as sweating, nausea, cramps, heart palpitations, shakiness, or muscle tremors. Addiction entails both a physical and an emotional need for the substance that goes far beyond simple willpower alone to break.

Abuse—overindulging in alcohol, taking two pills instead of one to get to sleep—very often leads quickly to dependency. If you find yourself reaching from habit for pills when you don’t really need them, or if you find yourself dreaming about that drink after work, stop and ask yourself why, and don’t disregard that niggling little voice that tells you that just maybe you have a problem. You probably do.