Living with alcoholism and drug addiction

164 Pages·2009·12.579 MB·English

by  Nicholas Lessa, Sara D Gilbert

contentS
■ ■ 1  What Are Alcoholism and Addiction? 1
■ ■   Substances of Abuse 14
■ ■   Causes of Alcoholism and Drug Addiction 32
■ ■   Recognizing Alcoholism and Drug Addiction 44
■ ■ 5  Dangers of Alcoholism and Drug Addiction 54
■ ■ 6  Getting Support and Help 65
■ ■   Approaches to Treatment 77
■ ■   Managing Alcoholism and Drug Addiction:
Life After Treatment 92
■ ■   Helping a Friend or Relative 104
■ ■ 10  Paying for Care 115
■ ■ 11  What More Can You Do? 123
Appendix: Associations and Support Groups 132
Glossary 140
Read More About It 147
Index 151
1
What Are Alcoholism
and Addiction?
a
Alcoholism and addiction are more widespread among 
teens—and even preteens—than many realize. We’re not just talking
about the kind of beer parties that sometimes make the news, but
also about situations like these:
M Tommy keeps a bottle of cough syrup in his middle-school
locker. He sips from it between classes—but he doesn’t think
about being a drug addict.
M Mary Anne’s parents let her—and sometimes her friends—
drink beer and wine at their home. They are happy it’s “just
alcohol.”
M Lisa’s parents are alcoholics, and her grandparents too. At 14,
Lisa is determined to never be like them. She busies herself
with positive activities such as cheerleading and service clubs.
But one evening at a party, she is offered some pot. She takes a
couple of puffs and fi nds she likes the effects—and she knows
it won’t make her a “sloppy drunk” like some of her family
members.
M Jason’s junior high class learned about the dangers of hard
drugs, and they all hated smoking, but pills from his mom’s
medicine cabinet seemed safe—and fun.
Putting aside questions of illegality, each of these stories might
sound like mild examples of kids who have substance use “under
1
  Living with Alcoholism and Drug Addiction
control.” Unfortunately, they are all-too-common scenarios of teens
and preteens—some 8 million of them—on the road to alcoholism
and other kinds of drug addiction, which science now says causes
permanent changes in the developing brain. Many still think of alco-
holics as drunks sleeping in the gutter, or addicts as junkies nodding
out with needles in their arms, but here are some basic facts about
alcohol and drug addictions.
M A drug addict is not necessarily a strung-out street junkie—yet.
Addiction can begin with repetitive and inappropriate use of
something as seemingly innocuous as cough syrup.
M There’s no such thing as “just alcohol.” Alcohol, in addition
to being a dangerous substance on its own, is a potentially
addicting drug. Alcoholism is an addiction.
M Addiction runs in families, whether from socially learned pat-
terns, from genetic inheritance, or both.
M Alcoholism is not solely an adult problem. It doesn’t necessar-
ily take a long time to become an alcoholic or an addict, and
it can mean trouble for kids as young as 12.
M The abuse of prescription medications is increasing, and it is
potentially one of the more dangerous addictions.
Another fact that’s only recently gaining acceptance is that addic-
tion starts at a much younger age than was once thought. By high
school, it’s often already time for treatment. According to a survey by
the National Institute on Alcohol Abuse and Alcoholism, more than a
fifth of all eighth-graders have used illegal drugs; more than a quarter
have used alcohol; and a quarter report having been drunk at least
once.
The long-term dangers and effects of addiction are revealed by
recent research, as you’ll learn in detail in this book. The impact of
early use of alcohol and other drugs on the brain is more serious and
long-lasting than once thought.
The federal government tracks substance use among young people
and reports that for almost all types of drugs, use by eighth-, 10th-, and
12th-graders was down during the first few years of the 21st century.
Though surveys show that fewer teens are using drugs, large numbers
are still using. The numbers show that use increases with age: Twice
as many 12th-graders as eighth-graders use drugs. Twelve million
teens are regular substance users, and as many as 3 million qualify
as substance abusers or full-blown addicts.
Chances are, you know at least one person your age (in addition to
one or more substance-using adults in your life) who is dealing with
What Are Alcoholism and Addiction?  
a drug or alcohol problem. Each of these teens has parents, siblings,
and friends who are significantly affected by their problem.
You’ve probably already been confronted with literature and lec-
tures designed to scare young people away from drinking and drug-
ging. The bad effects of alcohol and drugs are indeed something to be
scared of, but as you probably also know, using fright to keep young
people away from substance abuse often has the opposite effect—it
makes danger seem attractive.
Instead, this book presents facts about these widespread, serious
disorders to help you figure out the best way to deal with them,
whether you experience them in yourself, in a friend, or in a family
member.
You’re also surrounded by opportunities and even encouragement
to at least try alcohol or another chemical substance. Even if your
friends don’t use, TV shows, ads, and movies all make drugs and
alcohol seem like a natural part of life.
The more you know about alcoholism and addiction, the better you
will be able to cope with them, whether they affect you directly or
indirectly. In the first half of this book, you’ll learn about addiction
and how it works. The second half of the book shows ways to deal
with alcoholism and addiction, including, at the end of the book,
resources for further support and information.
SubStance uSe DiSorDerS
Mary Anne, whose family let her drink at home, wouldn’t ever think of
“using drugs.” Lisa, who chose pot at that party, believed it was much
less messy than booze. They share the common misconception that
“alcohol is not a drug.” In fact, alcohol is one of many psychoactive
drugs—substances that affect the brain in very specific ways, includ-
ing causing addiction. People can become addicted to alcohol just as
they can become addicted to the whole range of other drugs—from
pot to heroin to nicotine or even caffeine. Substances like some cough
syrups or prescription medications contain a variety of ingredients
that create an addictive reaction. Addictive substances may differ, but
addictions themselves have so much in common that members of the
medical profession use the term substance use disorder (SUD) to refer
to any kind of dependence on an external chemical substance. The
most common types of SUD are alcoholism and drug addiction.
Addiction is a physical, mental, and emotional dependence on
chemicals known as psychoactive drugs. Alcoholism, for example, is
an addiction to alcohol. Addiction is a disease that includes the fol-
lowing four symptoms:
  Living with Alcoholism and Drug Addiction
M craving—a strong and often overpowering urge to use a psy-
choactive drug
M loss of control—not being able to stop using once a drug has
been introduced to the body
M physical dependence—the need to maintain the level of drugs
in the body in order to avoid withdrawal symptoms, such as
nausea, sweating, shakiness, and anxiety
M tolerance—the need to use increasingly large quantities of a
drug to get the same sensation
Alcoholism and addiction are considered “biopsychosocial” dis-
orders, in which biological (physical), psychological (mental), and
social (interpersonal) factors are intertwined. Physical dependency on
a chemical can lead to behavior that is extremely painful to the sub-
stance abusers and to all those connected to them. In some cases, a
preexisting mental or psychological problem can cause an individual
to self-medicate with an addictive drug. A social aspect of the dis-
order can refer to the impact of family on addiction, and vice versa.
Since in today’s world “society” extends way beyond one’s home, a
wide range of influences, including the media, have an impact on
attitudes and addiction—and substance abusers can affect a wide
range of social groups.
A unique characteristic of both alcoholism and addiction is a
process called denial. Denial is an inability on the part of substance
abusers (as well as, often, their family and friends) to admit that the
addiction exists. It adds to the puzzle of living with addiction, so we’ll
be going into that important aspect of the disease in depth further
along in the book.
How SubStance uSe DiSorDerS work
Addiction and alcoholism were once thought to be “moral failings.”
People thought that an alcoholic or addict simply had a “weak will”
or a “bad character” and that punishment or moral improvement was
the best way to handle them. Even today, despite the fact that sub-
stance abuse is a widely researched illness, many people continue to
believe that people who struggle with alcohol or drugs are “weak,”
“evil,” or “sinful.”
Research into body chemistry and the brain itself has revealed
scientific facts that show that addiction is, in simplest terms, a brain
disease. Alcohol and drugs have a major impact on nerves controlled
by the brain, for example. One area that heavy drinking affects is our
ability to manage stress. Alcohol, often taken to relieve stress, can
What Are Alcoholism and Addiction?  5
What’s the Problem?
At 14, Jamie tried marijuana at a party, since his friends told him
smoking cigarettes was not cool. Now, at 16, Jamie smokes marijuana
every day, because he “needs” it to chill from his problems, including
his Dad’s drinking and his own dropping grades. He says he can’t be
an addict because marijuana isn’t a “real” drug. Besides, he (almost)
always smokes with his friends, which makes it “social.” So what’s the
problem?
1. Jamie is under legal age, so any drug use (including tobacco)
is illegal.
2. A daily need for a substance to ease problems is a clear sign
of addiction.
3. Marijuana is a real drug, which is addictive, and his use has
increased.
4. Jamie’s family history of alcohol problems is a sign of likely
addiction.
5. Jamie’s drug use is causing problems, not solving them.
6. Calling drug use “social” is a form of denial—fi nding an excuse
to use a substance.
Not seeing there’s a problem is a good clue that there is a problem.
actually make the brain feel more stress. Other drugs create changes
in the brain’s centers for pleasure and other emotions, as well as for
memory and motivation, and can create a need for more drugs, lead-
ing to addiction. Different types of drugs have different effects on the
chemistry of the brain, and over time repeated use alters brain struc-
ture and activity, so that effects last long after use has stopped.
Chapter 2 describes these brain connections and explains much
more about this exciting new fi eld of research. The knowledge of
how alcohol and drugs act on the brain will help improve treatment
of the disease of addiction. More importantly, this brain research has
also shown that young people are especially affected by addiction:
6  Living with Alcoholism and Drug Addiction
By the Numbers
The federal government keeps track of substance use among young
people and reports that for almost all types of drugs, use by eighth-,
10th-, and 12th-graders is down over the past few years. But 65 per-
cent of all 12th-graders have smoked cigarettes, and almost a quarter
smoke every day. Other drugs on the rise are steroids, prescription
drugs, and nonprescription cough medicine. For the whole picture,
check out http://www.monitoringthefuture.org, a service provided by
the University of Michigan and funded by the National Institute on Drug
Abuse (NIDA).
Since your brain is still developing and will continue to until you’re
about 21, the addiction to any foreign substance can alter your brain’s
healthy development and result in serious and long-term changes in
how it works.
wHy aDDiction iS a DiSeaSe
Harry, 16, needs to smoke a joint before school and during lunch,
and Angela, 17, needs a beer at breakfast, at mid-morning, and at
lunch. The two of them have the same problem—and it’s not just
that both substances are illegal. Angela might not think of smok-
ing, and Harry can’t stand the idea of beer. But both are displaying
addictive behavior, and as the previous section noted, addiction and
alcoholism are two versions of the same disease—substance use
disorders.
It’s not hard to see that these teens are in trouble, and that it
doesn’t matter whether it’s drugs or alcohol causing the problem.
But the idea that they have a “disease” is not always easy for some
to accept. The National Institutes of Health considers alcoholism and
addiction diseases, as does the American Medical Association and
the insurance companies that pay for their treatment. But to many it
may still seem like a “cop-out” to say, “I have a disease.” According
to a dictionary defi nition of disease, it’s “a condition of the living ani-
mal . . . that impairs normal functioning and is typically manifested
What Are Alcoholism and Addiction?  
by distinguishing signs and symptoms.” Government health experts
agree that alcoholism and addiction are brain diseases.
Drug addiction is a complex brain disease. It is characterized by
compulsive and at times uncontrollable drug craving, seeking, and
use that persists even in the face of extremely negative consequences.
Drug-seeking becomes compulsive, in large part as a result of the
effects of prolonged drug use on brain functioning and on behavior.
For many people, drug addiction becomes chronic.
Alcoholism is a chronic disease with genetic, psychosocial, and envi-
ronmental factors influencing its development and manifestations. The
disease is often progressive and fatal. It is characterized by continuous
or periodically impaired control over drinking, preoccupation with the
drug alcohol, and use of alcohol despite adverse consequences.
So why is it hard for some people to call them diseases? Perhaps
it’s because it seems to be something that people choose to inflict
on themselves. It may be that the bad behavior that alcoholism and
addiction can trigger makes people so angry that it’s hard to take a
clear look at the illness. Also, studies show what many nonprofes-
sionals have observed—that there is an element of mental illness that
runs through addiction, and that frightens some.
Mental illneSS
Alcoholics and addicts feel a compulsion to ingest chemicals known
to be dangerous despite experiencing progressively more negative
and painful results. A compulsion is an overwhelming urge to take
an action that makes no sense. For example, Angela and Harry need
those daytime hits—they don’t necessary want them. A fundamen-
tal element of this compulsion is the fact that users use despite the
adverse consequences. They keep using even though they know that
it will lead to problems in physical health, psychological function-
ing, relationships, the workplace, and finance. Few people who are
addicted to alcohol and drugs want to admit that they are mentally
ill, but the American Psychiatric Association considers addiction a
mental illness that causes significant impairments in a person’s abil-
ity to function.
Another key feature of substance use disorders is denial, which
the National Council on Alcoholism and Drug Dependence defines
as a defense mechanism disavowing the significance of events, and
a range of psychological maneuvers designed to reduce awareness of
the fact that alcohol use is the cause of an individual’s problems. In
other words, an alcoholic or addict knowingly hurts him or herself
but then is unable to see or admit the problem.
  Living with Alcoholism and Drug Addiction
reSearcH
The 21st century has an additional way of looking at substance use
disorders, thanks to breakthroughs in the scientific study of the brain.
Today, addiction is seen as a chronic but treatable brain disorder,
according to NIDA. People who are addicted cannot control their need
for alcohol or other drugs, NIDA explains, even in the face of negative
health, social, or legal consequences. This lack of control is the result
of alcohol- or drug-induced changes in the brain. Those changes, in
turn, cause behavior changes, especially those related to motivation,
decision-making, and pleasure-seeking. In other words, the source of
a lot of the behavior that addicts, alcoholics, and their friends and
family have observed over many years can be seen inside the brain.
Whatever the label, alcoholism, addiction, or any kind of sub-
stance abuse is not something people choose. What’s key is to realize
that people like Harry or Angela, who “need” to use a drug during
their day at school, are not troublemakers or slackers who are simply
making bad choices. They are troubled and suffering from forces they
can’t control.
Some people don’t like the idea that they may have a disease
because they may think of diseases as being dirty or catching. For
them the term disorder may be more acceptable. A disorder implies
a system that just doesn’t work right—diabetes, for example, or high
blood pressure. These are conditions in which an internal system is
out of order, through no “fault” of the sufferer. The source may be
inherited, and the condition may be worsened by lifestyle—just as
in addiction and alcoholism. Like diabetes or high blood pressure,
alcoholism is chronic, meaning that it lasts a person’s lifetime, usu-
ally follows a predictable course, and has symptoms. The risk for
developing alcoholism is influenced both by a person’s genes and by
his or her lifestyle.
DiSability
Alcoholism and addiction also can be considered a disability. Federal
law, under the Americans with Disabilities Act, includes alcoholism
and addiction as disabilities. It defines a disability as a physical or
mental impairment that substantially limits or restricts the condition,
manner, or duration under which an average person in the population
can perform a major life activity, such as walking, seeing, hearing,
speaking, breathing, learning, working, or taking care of oneself.
Does this mean that if you drink too much you get federal financial
support? Of course not—but the long-term effects of substance abuse
can cripple people.