Drug addiction as a disease is an issue that affects nearly everyone, either through personal or family experience with drugs and alcohol, or by connections with others in social, occupational, and academic circles. As such, it is important to understand the many issues that are associated with substance abuse. This paper will provide an overview of these topics, and will include causes, treatment modalities, and the implications of substance abuse for at-risk populations such as pediatric and geriatric patients.
Drug addiction has been defined in many different ways, but the American Psychiatric Association has defined it as a chronic relapsing disease characterized by a compulsion to seek and take the drug of choice, loss of the ability to limit intake of the substance, and the emergence of negative emotional states when access to the drug is limited (Koob, 2007.) As a group, people who are addicted to drugs are a heterogeneous group and are characterized by many different roadways that lead to addiction. Various sources of vulnerability including stressors from the environment as well as genetics result in tremendous individual differences in reference to the tendency to become addicted. In addition, drug addiction always occurs in combination with a significant level of co-morbidity pertaining to psychopathological conditions as well as poly-drug use. The addiction occurs during the last stage of an ongoing process, making it a chronic relapsing disease (Koob , 2007.)
The treatment for addictions involves both medication and behavioral therapy, and is designed to allow the affected person to accomplish and maintain sobriety, physical and mental health, and maximize his or her ability to function (Treatment, 2013.) There are many different modalities that are used in the treatment of addictions, ranging from psychiatric evaluations, physical exams, detoxification, individual counseling, treatment for co-morbid physical or behavioral complications, self-help support such as a 12 step program, and medication management to assist in both detoxification and maintaining sobriety. In addition, monitoring of sobriety compliance is an essential part of addictions treatment, so that the collection and analysis of blood and urine is conducted, sometimes on a regular basis and other times on an unexpected basis in order to minimize the chances of changing the results. Such monitoring and follow-up are vital to addictions treatment both for the purposes of the individual’s ability to maintain sobriety and for the evaluative component of any addictions program.
Medications that are used for the treatment of addictions vary according to the substance being treated. During the period of withdrawal, medications are often used to suppress the symptoms that accompany the discontinuation of the drug. Other medications that are used to treat addictions for substances include: methadone, and naltrexone are often used effectively to treat addiction to opiates; in order to treat tobacco addiction, there are a variety of nicotine replacement therapies, in addition to bupropion and varenicline; for alcohol, there are three FDA approved medications: naltrexone, acamprosate, and disulfiram in addition to a new medication, topiramate, that is considered to be promising (Drug Facts: Treatment Approaches for Drug Addiction, 2009.)
There are certain considerations that must be taken into account in order to treat drug addiction in pediatric and geriatric patients, including medication sensitivities. For younger people with addiction problems, the fact that the brain is still developing must be considered when prescribing medications to address substance abuse, although substance abuse itself can have a detrimental effect on the young brain. With geriatric patients, medications must be prescribed with care also, because such patients may also have physical problems related to aging that make prescribing such medications contraindicated.
- Drug Facts: Treatment Approaches for Drug Addiction. (2009, September). Retrieved from National Institute on Drug Abuse: http://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction
- Koob, M. & LeMoal, G. (2007). Drug Addiction: Pathways to the Disease and Pathophysiological Perspectives. European Neuropsychopharmacology, 277-293.
- Nordqvist, C. (2009, March). All about Addiction. Retrieved from Medical News Today: http://www.medicalnewstoday.com/info/addiction/
- Treatment. (2013). Retrieved from American Society of Addictions Medicine: http://www.asam.org/advocacy/find-a-policy-statement/view-policy-statement/public-policy-statements/2011/12/16/the-treatment-of-patients-with-alcoholism-or-other-drug-dependencies-and-who-have-or-are-at-risk-for-aids