Understanding Addiction: What is it? How do I know? What can I do?
In this jam-packed post you’ll learn...
The 4 elements of addiction Warning signs to look for if you suspect your loved one is addicted What you can do start to do now to help (while not burning yourself out).
You’ve probably heard the term “addiction” a lot. It’s typical to hear people talk about “how they’re addicted” to all sorts of activities, chemicals, and even T.V. shows! But what is addiction really?
Over several decades of research, researchers have learned many important things about the process of addiction, how it works, and how we can best treat it. We know that people CAN and DO recover. Additionally, we’ve discovered that there are many things that family members can do to help their addicted loved ones.
The purpose of this post is to talk to you about what addiction is, and how you can identify whether the person in your family who is using drugs or alcohol is addicted. We also offer some resources and suggest resources for learning more about addiction, in case you want to educate yourself more about how it works.
What is Addiction?
There are four elements that are typical of addiction. These are the four signs to look out for when trying decide is something is a bad habit or an addiction. As you read the section below, you might think about whether any of these apply to any of your loved ones.
1. Continued use despite negative consequences. Addiction occurs when people continue to use drugs or alcohol, even after experiencing significant negative effects. For example, your son may continue to drink despite getting a DUI or your husband may continue to drink, despite all the problems it causes in your marriage.
2. Tolerance. Tolerance is when a person has to drink or use more and more to get the same effect from the substance. This is a good chance to reflect on your loved ones pattern of use over time. Has your loved one’s use increased over time? Here are some examples of what tolerance looks like:
The addicted person used to drink a couple of beers a day, but now drinks 6 beers a day
Your loved one used to get drunk off a couple of beers before, but now he/she has to drink 4 or 5 or even more before they start acting drunk
People say about the person that they “really know how to hold their liquor,” or “they can drink anyone under the table.”
While these are not always signs of tolerance, they probably are. If someone can “hold their liquor” (i.e., drink a lot without seeming drunk) that likely means that they have to drink more in order to get the same effect that may take others only a couple of drinks to achieve. Of course there are many factors that influence “how drunk” a person becomes, but tolerance is often the result of a pattern of drinking in which the body adapts to the alcohol and more is needed to become intoxicated.
While we focus mostly on tolerance of alcohol above, the same applies to developing tolerance of other drugs. For example, a person with an addiction to opioids, such as heroin or oxycodone, will start out with using smaller amounts of the drug and over time, and progress to using more and more in order to get a high.
3. Physical withdrawal. You’re probably familiar with withdrawal if you’ve ever seen any movies where a character is trying to stop using drugs or alcohol. Physical withdrawal refers to symptoms that show up when a person stops using drugs or alcohol after using regularly.
These effects are a result of our brain’s way of adapting to the substance. With repeated use, our brains become dependent on the drug in order to function “normally.” The drug stops producing so much of a high, but instead is used largely to keep away the painful symptoms of withdrawal. When a person stops taking a drug, the body reacts to not having it anymore in a variety of ways. Common physiological symptoms of withdrawal include:
seizures
anxiety or depression
vomiting, nausea, and dizziness
sleep disruption
sweating
muscle aches and bodily pain
headaches
The kinds of withdrawal symptoms that people experience varies a lot depending upon the drug. What is common is that the symptoms are painful and that the person is motivated to keep using the drug in order to keep the symptoms away. If your loved one has been using a drug or alcohol for a long period of time, it is a good idea to talk with a medical professional before they quit using. Depending on your loved one’s health, what substance he/she is using, and how long and how much he/she has been using, your loved one may require medical supervision or medications to safely withdraw from the substance.
4. Psychological withdrawal. In addition to the physical symptoms of withdrawal, there are also psychological symptoms. People with addictions often use substances to cope with negative emotions and stress. When the substance is no longer a go-to coping strategy, the negative emotions often will become more frequent or intense at first. Typically this occurs for a period of time until the person learns non-substance using ways to cope with negative emotions.
Examples of psychological withdrawal include:
Anxiety can increase when people who habitually use marijuana to relax stop using
Depression can temporarily increase when a loved one who drinks to escape stops drinking
Feelings of self-hatred or anger might increase when a person stops using opiates to escape feelings of self-loathing
Intense cravings or urges to often occur at times when the person normally uses, for example, right when the person gets home from work, if that’s when they typically drink.
If your loved has relied on alcohol or drugs as their primary coping strategy, he/she hasn’t had the chance to practice sober coping strategies. This is where you might be able to help! If your loved one uses alcohol or drugs to cope with difficult feelings, then offering him/her ways to de-stress that don’t involve alcohol (e.g., a massage, a hot bath, time away from the kids) can be part of a strategy of helping your loved one. In future posts, we will talk about how substituting positive activities for drug or alcohol use is a key part of helping loved ones develop motivation for sobriety.
How Do I Know If My Loved One is Addicted?
Changes in behavior. Signs of addiction usually include changes in behaviors that aren’t consistent with their usual behavior patterns. Not getting work done, not going to school, more frequent arguments, increased isolation, or increased secrecy can be signs of addiction. Think about how you would describe your loved one when he wasn’t drinking (or when he drank less); now think about how you would describe him at this time. Did he used to go to work on time and be more of a “go-getter” before he started drinking? Does he now show up to work late and seem to do the bare minimum to get by? Is he more withdrawn or seem to keep more information from you?
Changes in mood. Changes in mood can also be a sign of addiction. Was your husband a happy and loving partner, and now he is sullen and argumentative? His change in mood may be a sign of addiction. Sometimes the changes are more subtle, but if we take a moment to pause and reflect on our addicted loved one’s behaviors and moods, and how these have changed over time, that’s where we can sometimes find signs of an addiction.
Physical signs. You can also see physical signs of addiction. Common physical signs include:
glassy eyes
dilated pupils
slurring words
lethargy
difficulties sitting still
shaking of legs
pacing
difficulties talking
Use your senses. Alcohol leeches out of the pores, so if you smell it, it’s likely he/she drank. Marijuana has a distinctive smell, so if you smell it on your loved one, he/she probably smoked. If your loved one’s pupils are dilated and he/she didn’t get an eye exam, they may be under the influence. If they are constantly scratching, moving, shaking their legs, and pacing, they may be using (again, the key here is a change from normal behavior. I know plenty of people who don’t use drugs who can’t sit still).
For additional resources on the signs of addiction, check out the Mayo Clinic website, the Psych Central website, and the National Institute of Health (I really like their signs of addiction in teenagers).
What Can I do?
Now that we have a better understanding of addiction and how to identify it, what can we do to help our addicted loved ones? In the beginning, there are two very important things to do to help our loved ones, and they both focus on you. In upcoming months we’ll talk about many ways to help your addicted loved one, but before we can do any of that, you need to do the following two steps because they will form the foundation of your plan to help your addicted loved one.
Identify your own views about addiction and then seek help for yourself
This may sound obvious, but it is important to reflect on what you believe about addiction. It can be difficult to get the most of a resource if your views are in conflict with the ideas promoted by that resource.
Generally speaking, there are two main views about addiction (this is a major simplification, and beliefs are often complex and layered):
View #1 Addiction is a disease - That addiction is a disease is a pretty popular belief. In the disease model, addiction is viewed like a physical disease that has biological reasons and effects. In this model addiction is viewed as similar to a chronic health condition like diabetes in that treating addiction is a long-term process (sometimes a lifetime) that requires consistent attention and action to keep it from reoccurring or worsening. If you believe that addiction is purely a disease, then you’re probably likely to find the philosophy behind 12 step approaches to helping family members (Al-Anon, Nar-Anon) agreeable. These approaches largely state that alcohol and drug use is something that people with addiction are out of control and coach family members to disengage from their family members and focus on their own welfare. In fact, the 1st step of Al-Anon begins by stating that you are “powerless over alcohol.”
View #2 Addiction is learned - The belief that addiction is learned does not discount the biological causes and effects of addiction. Instead, it adds that there are things in the environment, our current situations, and our past that contribute to becoming addicted. It also argues that changing a person’s environment and circumstances can help them recover from an addiction. If you believe that addiction is partly a learned behavior, then you may find cognitive-behavioral approaches, like CRAFT or CRAFT-influenced therapies, more helpful. These approaches focus on identifying the things in your loved one’s environment that you can change in order to influence their addictive behavior. If addiction is learned, then the idea is that people can learn new patterns of behavior depending upon what they experience and are taught by the people they’re around.
Don’t Give Up!
This may sounds simple, but it’s not. Addiction is a tiring, frustrating, and overwhelming process at times. You will need motivation to keep you going through the dark days and the times that you feel like giving up. We will talk more about how to build your motivation in future posts, but for now, here are some facts and ideas that may help you stay motivated as you start your journey to free yourself from your loved one’s addiction. While not all addictions experts agree on how recovery from addiction occurs, some things are clear:
Treatment works. One thing we know for certain is that treatment works, whether that’s based on the 12-step model or on a CBT model. The rates of recovery are much higher for people who get into treatment compared to those who never seek treatment.
Many people need to go through treatment multiple times. It often doesn’t stick the 1st time. If your loved one has been in treatment before and then relapsed, that’s quite common. It doesn’t mean that they’re hopeless or that treatment won’t work the next time, if they tried again. It’s important for them to get engaged in addictions treatment again. Each time they return, the chances that they learn what they need to in order to have a more enduring recovery is improved. It typically takes 7 attempts to quit before you can change a habit for good. Recovery from drugs and alcohol is typically a lifelong journey.
This leads to 2 conclusions:
#1 - It’s important to figure out ways to get your loved one into treatment. Each time they enter treatment, it’s another shot to learn the skills they need to get sober.
#2 - It’s important to continue to support your loved one when they relapse. Relapse is more typical than not, and so it’s important to have strategies for how to deal with it. It’s important that you get support in sustaining your motivation for coping with slips and with relapses.
You deserve a break.
Taking a break to care of yourself is not giving up. Resting when you feel exhausted, taking a brief vacation from trying to help your loved one, and re-engaging in your life does not mean that you’ve given up or that the battle is lost. Loving an addicted family member or friend can be a long and difficult journey; you will need the energy and stamina to push through. It’s essential that you take the time to care for yourself.
Sometimes people think taking a break or doing self-care takes too much time, is a luxury they just can’t afford, is ineffective, or is selfish. None of these are true. One way to start is to simply find 5 minutes each day to do something a little nice for yourself. Sometimes the nicest things we can do for ourselves are free. Easing up on critical or negative self-talk is free, but can be incredibly helpful. Even just acknowledging that you’re in a difficult situation and doing the best that you can do right now is an act of self-care.
As far as self-care being ineffective, think about this. When training for competitions such as marathons, rest and recovery weeks are built into the training. Why? Because without them people are more likely to get injured. Similarly, going full-speed all the time without taking a break can lead to psychological injuries. To be effective, we need to take breaks from time-to-time.
In regards to self-care being selfish, we know that when people are experiencing high levels of stress that they have more difficulties with learning new tasks, doing things effectively, or managing their emotions in helpful ways. If taking some time to engage in self-care reduces stress, this can actually be a very un-selfish thing to do because you will be better able to help those around you.
Here’s where you can learn more about how to get support for you and your loved one...
If you want to learn more about the kinds of options that are out there to help you with addiction in your family, you can read more about that here.
What are your views on addiction? How has it shown up in your family? We’d love to hear your thoughts below...