Addiction is a brain disease which results from drug or alcohol use. No one who comes into our treatment programs ever says they took prescription medications or smoked or started taking drugs with the idea that they would become addicted. They can usually tell you when they started, but not when they lost control and became addicted.

A continued impulse

Addiction, or continued compulsive use of a drug despite numerous, obvious, harmful consequences, is generally a chronic and relapsing disease without a specific cure. Prevention is the single most effective “treatment” but often ignored or misunderstood. Telling someone who has a mother or father who suffered from the disease of addiction to not smoke or drink, is prevention. Helping pregnant women and mothers avoid drugs, smoking, and alcohol is prevention.

Similarly, it is important to understand that use often becomes abuse, which often becomes addiction seamlessly and without warning.

"Focusing on prevention and intervention goes a long way toward fighting the stigma and denial associated with the disease."

Our repeated experience with one drug epidemic after another should encourage us to consider that all drugs of abuse, including prescription medications, are dangerous until proven safe and effective. Early intervention and prevention are essential to recovery and to survival. Furthermore, focusing on prevention and intervention goes a long way toward fighting the stigma and denial associated with the disease.

Scientific advancements

Basic science has helped us understand more precisely how and where drugs of abuse act or work in the brain. Scans now allow us to see where the drugs meet the brain in real time. Science has also helped us understand dependence and withdrawal. But while now commonplace, successful treatments for withdrawal have not cured addicts or addiction. If detoxification was a cure for addition, we would have cured alcoholism decades ago.

Scientists have even come to understand that withdrawal is not necessary for addiction to occur and that elimination of withdrawal, while a first step, is not recovery. We understand where, in the brain, drugs “hijack” the user and distort the perceived importance of the user’s family, friends, health, motivation and relationships. But, we cannot seem to figure out when the switch goes off and addiction occurs.

Risk factors

Not all people have the same risks. Some risks are genetic and others environmental. Some are related to psychiatric illnesses or trauma and others to intrauterine or secondand thirdhand exposure early in life. Some are related to pain. Drugs harm the abuser but also those who happen to be driving nearby or even riding a bicycle or walking. We all know about DUIs and driving under the influence of alcohol, but are learning about driving and illicit drugs causing accidents and emergencies for the users and innocent bystanders. Addiction, untreated, is often fatal.

Medical progress and treatment works but cannot ensure success without the user working the program. Unlike strep throat or other infectious diseases, we do not have a medicine or medicines that can be given, even against the person’s will, and cure the disease. In addiction treatment, there is nothing more critical or important in the long run, than motivation to change. It takes years for drugs to change the person, so we should not be surprised if it takes years for them to return back to their old self. Craving for cocaine or other drugs is an acquired, new drive in users.

Treatment can help separate craving from use. Our work with impaired health professionals has helped us understand that treatment and recovery are difficult, involve time, energy and work and the best outcomes are found when the treatment can be given for years. In impaired physicians, nationwide, treatment works and it is expected that over 80 percent of the treated physicians can be drug-free and back to work.

"In examining the effects of tobacco and other drugs on the unborn, we see that early exposure can change risk of abuse and dependence."

How you can support

So, if you know someone using drugs, suggest that they stop and go to a meeting. Suggest that we do not know who can use and stop and who will progress to addiction.

It took nearly 500 years from when Christopher Columbus brought tobacco smoking to our shores to recognize that tobacco caused addiction, cancer, heart disease and so on. It took even longer to realize the second and third-hand effects on the rest of us. Now, in examining the effects of tobacco and other drugs on the unborn, we see that early exposure can change risk of abuse and dependence.

Some of us may be born with a high risk of alcohol or drug abuse, but some of the risk may not be due to genes per se but rather exposure changing gene expression. We are, in essence, making drug craving, liking and wanting more common and not providing equally compelling alternatives like healthy eating, exercise, prayer, sports, music and helping others. Everyone knows someone who has been in addiction treatment and for whom recovery has worked. Unfortunately, recovery is personal and is anonymous. So it is up to all of us to prevent, de-stigmatize, and intervene.

Help someone find the strength to quit, go to an AA meeting, find treatment and recovery.