How addiction is formed
Psychoactive substances dramatically increase the activity of the brain's reward system - more than any natural stimulus. The brain adapts: its own production of neurotransmitters decreases, and without the substance a person feels emptiness, depression and tension. At the same time, a strong connection is formed between use and relief, so cravings arise automatically when seeing familiar places, people and objects. Over time, more substance is required for the same effect, and the motive is no longer pleasure, but the desire to avoid feeling bad.
- Rewiring the Brain's Reward System
- Increasing tolerance and increasing doses
- Cancel state when terminated
- Automatic traction based on familiar signals
- Loss of control over quantity and frequency
- Continued use despite harm
Signs that loved ones notice
Changes usually increase gradually and affect all aspects of life. Behavior changes: secrecy, new company, night absences, incomprehensible expenses and loss of money or things appear. Study and productivity decline, a person abandons his previous hobbies. Mood swings are noticeable, periods of unusual activity are replaced by drowsiness and apathy. External signs depend on the substance: constricted or dilated pupils, redness of the eyes, traces of injections, sudden changes in weight, untidiness, a specific smell.
- Secrecy, lies, new company
- Lost money and things from home
- Sudden changes in mood and activity
- Decline in academic performance and absenteeism
- Change in pupil size, redness of the eyes
- Injection marks, abrasions, poor hygiene
- Weight loss and sleep disturbances
- Loss of former interests
What are the health hazards?
The risks depend on the substance and method of use, but the general rule is the same: harm affects both the body and the psyche. Injections are associated with the transmission of HIV, hepatitis B and C, abscesses and blood poisoning. Stimulants overload the heart and blood vessels, causing rhythm disturbances, high blood pressure, heart attacks and strokes even in young people. Opioids depress breathing, which makes overdose deadly. On the mental side, psychosis, severe depression, anxiety, and a persistent decrease in memory and attention are possible.
- HIV, hepatitis B and C by injection
- Abscesses, phlebitis, sepsis
- Heart rhythm disturbances, heart attack, stroke
- Overdose with respiratory arrest
- Psychosis and severe depression
- Liver and kidney damage
- Tooth decay and weight loss
Examination and first visit to a narcologist
The doctor evaluates what substances were used and for how long, whether there is a withdrawal state, and concomitant mental and physical illnesses. An obligatory part is an examination for HIV and viral hepatitis, an assessment of the liver, kidneys, and heart, since these problems are often detected for the first time. It is important to tell the doctor the truth: the safety of treatment depends on it, especially when combining several substances and alcohol. The first visit does not have to end in hospitalization, and discussing possible options for help in itself is a step forward.
- Interview and assessment of addiction severity
- Tests for psychoactive substances
- Testing for HIV and hepatitis B and C
- Liver tests, complete blood count
- ECG and cardiac assessment
- Detection of depression, anxiety, psychosis
- Discussion of treatment plan and family involvement
Treatment and family support
Treatment consists of several stages, and none of them works alone. First, the acute withdrawal state is relieved under the supervision of a physician. The main part is psychotherapy and rehabilitation: working with cravings, learning to cope with stress, restoring routine, changing the environment, and for opioid addiction, maintenance therapy prescribed by a narcologist. Relapses happen and do not mean failure: this is part of a chronic disease, after which it is important to return to treatment. The family needs its own support to help without destroying itself.
- Relieving withdrawal states under medical supervision
- Psychotherapy, including cognitive behavioral
- Long-term rehabilitation program
- Maintenance therapy as prescribed by a narcologist
- Treatment of comorbid depression and anxiety
- Change of environment and daily routine
- Self-help groups and family work
- Returning to treatment after a breakdown