Dependence is defined as an adaptive state that develops in response to repeated drug administration, and is unmasked during withdrawal, which occurs when drug taking stops. Dependence from long-term drug use may have both a somatic component, manifested by physical symptoms, and an emotional–motivation component, manifested by dysphoria. While physical dependence and withdrawal occur with some drugs of abuse (opiates, ethanol), these phenomena are not useful in the diagnosis of addiction because they do not occur with other drugs of abuse (cocaine, amphetamine) and can occur with many drugs that are not abused (propranolol, clonidine). Practice Demonstration - Substance Abuse Counseling
One study performed in Norway demonstrated that brief advice given early can affect gamma glutamyl transferase levels and reported alcohol consumption. Early warning makes a difference to persons who drink heavily. In a study of 200 workers with alcoholism, recalling a physician's warning about drinking at the beginning of the study was associated with a better prognosis 2 years later. Unfortunately, less than 25% had received warnings from their physicians, again illustrating the problem of missed diagnosis.
Many rehab patients continue to receive treatment for their addictions after leaving rehab. They may have regular clinic visits with a doctor to manage physical symptoms. Patients may also meet with a counselor on a regular, outpatient basis to refine coping skills. In addition to the love and support of family and friends, patients may also attend support group meetings after leaving a drug rehab treatment facility. All of these aftercare services help patients remain drug free and avoid relapse.
Determine the patient's readiness for change. Motivating a reluctant patient is one of the great challenges in treatment. To enhance the prospects of successful treatment, the clinician needs to have a basic concept of the stages of change. The 5 stages of change (Prochaska,) provide fundamental guidance for enhancing motivation. The Substance Abuse and Mental Health Services Administration, the Center for Substance Abuse Treatment presents this concept in detail through a Treatment Improvement Protocol titled "Enhancing Motivation for Change in Substance Abuse Treatment." The 5 stages of change are precontemplation, contemplation, preparation, action, and maintenance. Specific strategies aligned with each of the 5 stages help a clinician motivate and prepare the patient for change. The 5 stages of change represent a cycle, permitting and explaining behavior that moves in both progressive and regressive directions.
Although Ecstasy declined in popularity after its introduction to the underground club scene in the 1980s and 1990s, a new generation of young users has discovered the drug. Many teens and young adults perceive Ecstasy as a non-addictive, relatively harmless psychedelic drug. However, Ecstasy can cause dangerous side effects, including nausea, vomiting, high blood pressure, dehydration, liver and kidney damage, an irregular heartbeat, and aggressive impulses.
Integrated alcohol treatment programs are designed for patients who meet the criteria for a substance use disorder and a form of mental illness. In a national study of co-occurring disorders, the Journal of the American Medical Association found that 37 percent of individuals with alcohol dependence also suffered from a mental health disorder, while over 50 percent of individuals who abused drugs also had a psychiatric illness. These patients face unique obstacles in recovery, such as low motivation, anxiety about new situations, poor concentration and delusional thinking. Integrated treatment, which targets both the patient’s mental illness and substance use disorder within the same program, is the most effective way to achieve a full recovery. Services for both issues are provided at a single facility, and delivered by staff members who are cross-trained in substance abuse treatment and mental health.
You should also speak with an addiction specialist who can give you a wider-range view of treatment options both in your area and further away (some people choose to place quite some distance between their recovery and the environment in which they have been abusing drugs), and who will be able to give you the benefit of more specialised experience and insight than your GP.
Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.† It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control, and those changes may last a long time after a person has stopped taking drugs.11
The path to drug addiction begins with the voluntary act of taking drugs. But over time, a person's ability to choose not to do so becomes compromised. Seeking and taking the drug becomes compulsive. This is mostly due to the effects of long-term drug exposure on brain function. Addiction affects parts of the brain involved in reward and motivation, learning and memory, and control over behavior.

Two factors have been identified as playing pivotal roles in psychological dependence: the neuropeptide "corticotropin-releasing factor" (CRF) and the gene transcription factor "cAMP response element binding protein" (CREB).[9] The nucleus accumbens (NAcc) is one brain structure that has been implicated in the psychological component of drug dependence. In the NAcc, CREB is activated by cyclic adenosine monophosphate (cAMP) immediately after a high and triggers changes in gene expression that affect proteins such as dynorphin; dynorphin peptides reduce dopamine release into the NAcc by temporarily inhibiting the reward pathway. A sustained activation of CREB thus forces a larger dose to be taken to reach the same effect. In addition, it leaves the user feeling generally depressed and dissatisfied, and unable to find pleasure in previously enjoyable activities, often leading to a return to the drug for another dose.[17]
Outpatient treatment is the next step down in a continuum of care. It is also a rehabilitation option for individuals whose addiction is less severe and doesn’t require inpatient treatment. Clients in this phase of rehab drug treatment visit the facility regularly, but do not stay overnight. This approach allows the individual to receive drug treatment while maintaining family and job responsibilities. Drug Addict Is Terrified When He Sees the Rehab Car | The Jeremy Kyle Show
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