Navigation: What is Drug Addiction?, The Brain on Drugs, Is Addiction Itself a Mental Illness?, Co-Occurring Disorders: When Addiction and Mental Illness Overlap, The Self-Medication Hypothesis, Prescription Drug Abuse, Addiction: A Disease or a Choice?, Approaches to Treatment: Treating Drug Addiction and Mental Illness Together
Today’s society has become a lot more open when it comes to conversations regarding mental health and addiction. People are now encouraged to share their experiences and seek support without the stigma that once accompanied such discussions.
This increased visibility and openness allows for more candid dialogues about drug use and its complex relationship with mental health. As most people may know, these two things have a complicated connection. Those who struggle with substance use often struggle with mental health issues at the same time.
Now the conversations are shifting towards understanding the motivations behind drug use. There is less stigma and more focus on prevention and harm reduction. Thanks to this evolving discourse, people are more likely to make informed choices about their own health and well-being.
But one question that many are still uncertain about is whether taking drugs qualifies as a mental illness. Here we will dive into what addiction is, how it affects the brain, and the lines that separate drug use, dependence, and mental health disorders. Let’s take a closer look.
What is Drug Addiction?
Drug addiction, also known as substance use disorder, is a chronic and relapsing condition that is often characterized by the compulsive use of harmful substances despite their consequences. Simply put, an addicted individual will keep taking the drug or drinking alcohol even if they are already suffering from its effects. [1]
Addiction often involves a complex interplay of biological, psychological, and social factors, meaning it can affect anyone regardless of age, gender, or background.
While the term “addiction” is commonly used interchangeably with “dependence”, they are not technically the same thing. Dependence refers to the body’s inability to function normally without the substance. A drug dependent person will experience withdrawal symptoms when they reduce their intake or stop taking the drug. This is because their body has adjusted to its constant presence. [1]
On the other hand, addiction is more of a compulsive need to use drugs even though it is already causing physical and mental health problems. Both of these conditions tend to be accompanied by significant changes in behavior, impaired judgment, and a decline in overall health.
The Brain on Drugs
So is taking drugs a mental illness?
To answer this question, we need to look at how drugs affect the brain. The effects of drugs on the brain can vary significantly depending on the substance in question.
Drugs, whether they are prescription medications or illicit substances, interact with the brain’s neurotransmitters. These are chemical messengers that transmit signals between neurons. For example, stimulants like cocaine and amphetamines increase the levels of dopamine, leading to heightened feelings of euphoria. Dopamine is the neurotransmitter associated with pleasure and reward.
However, this surge in dopamine can result in addiction, as users may try to chase the initial high. This ultimately alters their brain’s chemistry and functioning. Chronic use of these substances can cause long-lasting changes, impacting everything from decision-making and impulse control to emotional regulation. [1]
On the other hand, depressants like alcohol and opioids can inhibit brain activity by enhancing the effects of gamma-aminobutyric acid (GABA). This is a neurotransmitter that promotes relaxation and reduces anxiety.
While these drugs may provide temporary relief from stress or pain, they can also impair cognitive functions and lead to physical dependence.
Continued use of certain drugs often leads to tolerance, which means the body requires larger doses just to achieve the same effects. This creates a devastating cycle that leads to various health problems ranging from cognitive decline to emotional disturbances. [1]
Is Addiction Itself a Mental Illness?
The American Psychiatric Association (APA) and the World Health Organization (WHO) have recognized addiction as a mental disorder. In fact, addiction is included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which psychiatrists and psychologists use to diagnose mental health conditions.
The DSM-5 Criteria for Substance Use Disorders
The DSM-5 defines substance use disorders (SUD) with several criteria, including:
- Craving or a strong urge to use the substance
- An inability to cut down despite a desire to stop
- Continued use despite negative consequences in life, such as relationship problems or job loss
- Spending significant time obtaining, using, or recovering from the substance
These criteria are evaluated on a spectrum of mild to severe, depending on how many criteria the individual meets. The severity can dictate how closely the addiction resembles other mental health disorders, especially in terms of emotional distress and impaired functioning.
Co-Occurring Disorders: When Addiction and Mental Illness Overlap
Co-occurring disorders, often referred to as dual diagnosis, describe the intersection of substance use disorders and mental health conditions. This phenomenon is increasingly recognized as a critical area of concern in both mental health and addiction treatment.
It is very common for people struggling with addiction to also face mental health challenges such as depression, anxiety, bipolar disorder, or schizophrenia. This overlap can complicate treatment, as these conditions tend to worsen one another. For instance, a person with anxiety may use substances to self-medicate, leading to an increased dependency that further heightens anxiety levels. [2]
Similarly, substance use can lead to changes in brain chemistry, potentially triggering or worsening underlying mental health issues. It is worth noting that these two conditions do not necessarily cause one another. However, they have a tendency to co-occur because they are influenced by similar risk factors like genetics and a person’s environment. [2]
Effective treatment for co-occurring disorders requires a comprehensive approach that addresses both the addiction and the mental health condition at the same time. It is not enough to tackle one problem while ignoring the other as this will only increase the risk of relapse.
Integrated treatment models are often the most effective, combining therapeutic interventions like cognitive-behavioral therapy (CBT) with medication management and support groups tailored to address both issues. [2]
The Self-Medication Hypothesis
Speaking of self-medication, many people with mental health issues turn to drugs in order to cope with their difficult emotions and symptoms. These substances alleviate their symptoms for a short while, and this temporary relief pushes them to keep taking drugs or drinking alcohol. [3]
Substances may temporarily numb emotional pain or provide a fleeting sense of euphoria, causing people to think they can manage their symptoms on their own. However, this coping mechanism is often counterproductive because the drugs only exacerbate the underlying mental health conditions over time.
While drugs may provide short-term relief, they can create a vicious cycle of dependency and worsening mental health.
The consequences of self-medication can be severe, both physically and psychologically. Substance abuse typically causes a range of health complications, including addiction, liver disease, and cardiovascular problems, along with the risk of overdose. [3]
Additionally, the reliance on substances to cope with mental health issues can hinder people from seeking proper medical assistance. The stigma and their own feelings of guilt and shame can prevent them from going to rehab.
Breaking this cycle often requires comprehensive treatment approaches that address both mental health and substance use disorders, emphasizing the importance of seeking help from qualified professionals who can provide the support and resources needed for recovery.
Prescription Drug Abuse
There is a misconception that prescription drugs are completely safe to abuse simply because they are given by doctors. However, prescription drug abuse can be just as dangerous—this is why patients are encouraged to stick with their prescription in order to avoid the dangers of misusing them.
Prescription drug abuse is a growing concern in many parts of the world, particularly in the US. This issue arises when a person takes medications that are prescribed to them or others, either recreationally or as a form of self-medication.
Even taking your own prescription can be considered drug abuse if you do not follow your doctor’s instructions. Taking too much of a prescription drug or taking them too often are forms of substance abuse.
Opioids, benzodiazepines, and stimulants are among the most commonly abused prescription drugs. The ease of access to these medications, often due to overprescription by healthcare providers, contributes to the rising rates of abuse.
Many people initially use these drugs as directed, but over time, they may develop a tolerance or dependence, leading them to misuse the medications for recreational purposes or to cope with emotional or physical pain.
The consequences of prescription drug abuse can be severe, affecting not only the individuals involved but also their loved ones. Users may experience a range of health problems, including addiction, overdose, and even death.
Prescription drug abuse even affects society as a whole, since it contributes to increased healthcare costs, lost productivity, and criminal activity. Efforts to combat this crisis include stricter regulations on prescribing practices, increased public awareness campaigns, and improved access to addiction treatment programs.
Addiction: A Disease or a Choice?
This question is still one of the most debated topics when it comes to addiction. Critics of the “addiction as a mental illness” model argue that people ultimately choose to use drugs and, therefore, bear full responsibility for their actions. However, research in neuroscience shows that while the initial decision to use drugs is often a choice, prolonged use can fundamentally alter brain function in ways that undermine free will and self-control.
In the “disease model” of addiction, addiction is seen as a chronic disease, similar to diabetes or heart disease. Just like these conditions, addiction involves genetic, environmental, and behavioral factors. This model suggests that addiction’s neurological basis limits the ability to choose, especially as the disease progresses. It’s hard to imagine that people would willingly ruin their health, relationships, and their lives if quitting drugs was really that simple. [4]
Those in favor of this model argue that viewing addiction as a disease helps reduce stigma and opens the door for effective treatments that focus on managing symptoms and relapse.
Approaches to Treatment: Treating Drug Addiction and Mental Illness Together
When drug addiction and mental illness overlap, treatment becomes more complex. An integrated treatment approach that addresses both mental health issues and addiction is often the most effective. This is referred to as dual diagnosis treatment. Here are some of the primary treatment options used today:
Therapy and Counseling
Therapies like CBT, dialectical behavior therapy (DBT), and motivational interviewing (MI) are widely used to treat both mental health issues and addiction. These therapies help patients understand the root causes of their substance use, develop healthy coping mechanisms, and improve emotional regulation. [2]
Medication-Assisted Treatment (MAT)
Medication-assisted treatment or MAT combines medication with counseling and therapy to treat substance use disorders. For example, medications like methadone or buprenorphine can reduce withdrawal symptoms for opioid addiction, while naltrexone can help reduce alcohol cravings. [2]
Support Groups and Peer Support
Support groups like Narcotics Anonymous (NA) and Alcoholics Anonymous (AA) provide a community of support, which can be crucial in recovery. Peer support is also available through programs like SMART Recovery, which focus on empowering individuals to take control of their recovery journey.
Holistic Approaches and Lifestyle Changes
Treatment approaches that incorporate exercise, nutrition, mindfulness, and healthy lifestyle choices can improve both mental health and addiction outcomes. These approaches help individuals address underlying causes of addiction, reduce stress, and build a more balanced life.
While drug use itself is not a mental illness, addiction is recognized as a mental health disorder. Drug use can lead to addiction, which alters brain function, disrupts mental well-being, and meets many criteria of mental health disorders. Moreover, addiction often overlaps with other mental health issues, making it more complex to treat.
If you or someone you love is struggling with substance use disorder or a mental health disorder, look for a rehab near you today and find out more about available treatment programs. The journey to recovery begins today.
Sources:
[2]: https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health
[3]: https://americanaddictioncenters.org/adult-addiction-treatment-programs/self-medicating
[4]: https://americanaddictioncenters.org/rehab-guide/is-drug-addiction-a-disease
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