It’s no secret that we are in the midst of an opioid epidemic. Drug overdose rates have skyrocketed, shattering records in both 2016 and 2017 according to CDC estimates. Given the capacity of drug addiction to ruin (and end) lives, it’s critical that we understand what drives it. Education is key to prevent (and hopefully reduce) the alarming rate at which we are losing people to overdose.
Mental Illness
Simply put, mental illness is a malfunctioning of the brain. It can be inherited genetically or it can develop due to environmental factors. Because mental illness can stem from life events or other factors encountered in our everyday lives, many people can be susceptible to mental illness at some point.
On top of that, mental illness has a strong association with substance use disorders. In fact, half of all of those with a mental illness will develop a substance use disorder.
If you have ever seen someone in the throes of drug addiction, ruthlessly chasing their next high, you’ll understand why drug addiction also actually qualifies as a mental illness.
“Addiction changes the brain,” explains Justin Baksh, LMHC, LPC, MCAP and Chief Clinical Officer for Foundations Wellness Center. “Suddenly using drugs is priority number one. This overrides everything else, including meeting your natural needs as a human being, such as eating when hungry, drinking when thirsty, and seeking safe shelter. That’s why you’ll find drug addicts who are homeless, shivering in the cold or roasting in the heat, but aren’t worried about anything but the next fix. It’s the fundamental changes in the brain that are driving this behavior.”
Given the high co-occurrence of mental illness and substance use disorder, Baksh recommends that those with mental illness in their family history continuously monitor their mental well-being, even engaging in proactive therapy if need be.
Those of us who don’t have mental illness in our genetic background also need to be wary, however. Life events, like experiencing trauma, can also bring on mental illness as well.
Trauma
“Trauma is another component of addiction,” said Baksh. “However, it is also very unique to the individual. It’s about how you interpret an event, and not necessarily how someone else would.”
Baksh indicates that PTSD, or post-traumatic stress disorder, is not just experienced by war veterans. Obviously, physical and sexual abuse are traumatic events. However, a divorce can also be traumatic, and so can a bullying incident, a death in the family, or even a move to a new place.
Experiencing PTSD has been linked with the development of alcohol and drug addiction. In fact, people with PTSD are two to four times more likely to have a substance use disorder, according to the National Comorbidity Survey.
Another study published in the Journal of Consulting and Clinical Psychology and later cited in The Behavior Analyst Today found that about half of all people receiving inpatient treatment in a substance abuse center met the PTSD criteria.
With such a wide range of precipitating events, it can be tough to prevent all forms of trauma in life.
“It’s not about preventing trauma, though,” cautions Baksh. “That would be impossible! It’s about dealing with it properly when it does occur.” That includes seeking out proper treatment from a qualified professional.
“We are seeing great results with a new therapy called Rapid Resolution Therapy,” said Baksh.
Stress
Stress contributes to addiction – and also relapse in individuals who have recovered.
“Your experience of stress is linked to your perception,” said Baksh. “It’s similar to trauma in that the degree of stress is unique to the individual. What one person may find stressful, another may not.”
When we encounter something we perceive as stressful, cortisol is released into the bloodstream by adrenal glands. Our heart rate goes up and our blood pressure increases. We feel a rush of energy that helps us either “fight” the stressor or “fly” from it. Unfortunately, if you live in this mode, you can experience negative effects. Chronic stress can cause you to develop anxiety, depression, headaches, stomach problems and more. It also causes your risk of developing addiction – perhaps in an attempt to self-medicate – to increase.
Thankfully, there are ways to reduce cortisol naturally such as through diet, exercise and proper sleep. Therapy can also help you deal with the patterns of thinking that have caused you to stress too much on too regular of a basis. However, some turn to illicit drugs to quickly relieve the stress they feel…and unfortunately wind up addicted to them.
Prolonged Use (or Abuse) of Prescription Medication
A 2013 study found that approximately eight in ten people who are heroin users started by abusing prescription opioids.
With pain medications, in particular, you can see patients getting hooked on the drug. When it’s discontinued, some will turn to street drugs to continue the feelings they had and to avoid negative feelings they get when discontinuing the drug.
Baksh feels that medical doctors are more cognizant of this possibility today, however, opioid pain medications are still being prescribed. “A new sublingual opioid has just been approved in 2018,” Baksh indicated. “Unfortunately, just using opioids is a risk factor for developing addiction.”
Experimentation
There are those who become addicted to drugs and alcohol out of curiosity or peer pressure.
“Even without mental illness or PTSD, kids can end up addicted after casually using a drug or drinking,” said Baksh. “This is brought on by the changes in the brain that occur when using or drinking. Also, some drugs are much more addictive than others, and can ‘hook’ users very quickly.”
Opioids, in particular, are very addictive, notes Baksh.
There is a light at the end of this tunnel, however. Most people who abuse drugs begin during adolescence, starting before age 18, develop a substance use disorder by age 20. In fact, the early teen years are when individuals are most at risk of developing an addiction if they start using. If we can devise strategies to keep kids from trying drugs during those critical years of 13 to 18, the odds are in our favor that a lifelong drug addiction will not develop.
Many Roads, Same Conclusion
As you can see, there is no one road to drug addiction. It is too-common a destination for too many of us. Once there, treatment can be the answer. Of course, the easiest drug addiction to cure is the one that never starts. Hopefully, by being aware of the triggers, we can seek help before turning to an illicit substance. After all, there are only two ways out of a drug addiction: recovery or death.