Essay on Addiction

Essay on Addiction

            Addiction has been a menace for a long time, with experts putting all available efforts to solve the puzzle surrounding it. Myths and facts of all sorts have been developed on the issue leading to the development of several perspectives among interested parties. Debates have also been common due to the various perspectives held on the issue of addiction. “Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences. Prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases” (American Society Of Addiction Medication, 2020). The fact that addiction is treatable means that it is a disease and can be associated with the interruption of the functionality of the mind by substances that an individual is used to using.

One of the most common causes of addiction is the irresponsible use of drugs and harmful substances. Drug abuse is known to affect the way the brain works and eventually makes the victim addicted. Generally, drugs are believed to boost the functionality of the brain to give the user a better feeling that only comes with negative impacts. The passing of time sees the victim becoming unable to function without the help of the drugs (Koob & Volkow, 2016). When an individual cannot function without taking drugs, then they are said to be addicted. Also, addiction pushes a victim into continuing with the intake of harmful substances, even with the knowledge of the associated harm. The victim does not have control over the issue and is forced to give in to the desires brought about by the addiction. Moreover, addiction can be seen as a sign of poor self-discipline, although the reasons as to why an individual would engage in the harmful menace are diverse.

Self-discipline is essential in ensuring that people are responsible for their actions. However, some circumstances force people into engaging in actions that appear to other people as harmful and reckless. A person who has never struggled with illicit drug use may not understand why addiction is an issue. Some people may even believe that addiction is a personal choice and that no one can be addicted without their consent. However, addiction happens in different forms and does not need an individual’s consent to happen. The mind of the victim is the most affected part as most factors associated with addiction affects the psychological ability of the victim. Generally, most people do not expect the outcomes associated with addiction until it downs on them that they can no longer leave the practice at will. Also, the impacts of addiction are seen when the associated factors are leading to hazardous effects, but the victim cannot do anything to avoid further damage. The American Society of Addiction Medicine has, for several years, researched addiction and tabled several conclusions and recommendations.

The American Society of Addiction Medicine (ASAM) is an organization “founded in 1954, is a professional medical society representing over 6,000 physicians, clinicians and associated professionals in the field of addiction medicine,” (American Society Of Addiction Medication, 2020). One of the main goals of ASAM is to educate medical professionals and the public about addiction. Another goal of ASAM is increasing access to and providing a better quality of addiction treatment. The issue of addiction calls for the cooperation of several stakeholders in managing the care needed to help people in overcoming the menace, and ASAM has provided several tools.

ASAM has developed a diagnostic tool that is used to determine the level of care an individual needs may need for proper treatment. In my current role as a Licensed Clinical Addiction Specialist Associate (LCAS-A), the ASAM is the best tool that I have at the time of assessment. Currently, I have a caseload that consists of two separate Substance Abuse Regular Outpatient (SAROP) groups with 10-12 clients, and three times a week, I provide Comprehensive Clinical Assessments (CCA).

Six dimensions are used to determine the level of care. Each dimension scoring ranges from 0-4.  The first dimension is the withdrawal potential. In this dimension, the person’s substance abuse history is given. For example, if the person has an extensive history of Heroin or Opiate use, then their withdrawal potential could be scored at a 1 or 2. If a person reports an extensive history of Alcohol use or Benzodiazepines, their withdrawal potential would be higher between 2 and 4. The scoring increases if the person has had withdrawal-induced seizures. The second dimension is for biomedical conditions. Information in this dimension would include primary care physician and any medical conditions and daily medications. The dimension will be scored higher if the person has neglected medical conditions. The third dimension is behavioral or mental health concerns. In this dimension, any mental health diagnosis would be included, current mental health symptoms, medications, and mental health providers, as well as any suicide attempts or history of abuse. Unmedicated mental health or current severe mental health symptoms would increase the scoring.

The fourth dimension is related to the person’s resistance level to treatment and identification of triggers or coping skills. Also included would be supports and engagement in AA or NA. The fifth dimension is the most important. In this dimension, previous inpatient or outpatient treatment history is discussed, the longest length of sobriety, as well as risk factors that would lead to the continued use or relapse potential.  Lastly, dimension six is related to the social environment. It is also a summary of demographics and supports. The information included would be who the person lives with, the best support, and their social circle. ASAM levels of treatment begin at 0.5, which is the prevention level up to 4.0. ASAM scores of 3.2-4.0 indicate that the person would need to be in residential medically monitored treatment. All of the previous information was designed to provide a basic understanding of levels of care and establish the difference between inpatient and outpatient facilities. However, the attempts to develop care tools on addiction should include diverse factors since addiction is not only associated with substance dependence but also the inability to stop a certain activity.

Addiction is not only associated with substance dependence but also the inability to stop an activity or activities. Generally, activity addictions are not common because research on them has not been sufficient over the years. According to DSM-5, gambling is the only documented activity addiction, and other addictions are subject to research. For example, people have reported sexual addictions, gym addictions, or even shopping addictions. Most of the activity addictions have been left out as potential diagnostics, and research on them goes on continuously (Montag & Reuter, 2017). For example, internet gaming disorder is viewed as an addiction because affected people cannot stop gaming as easily as one would think. The impact of drugs and activities on the brain is associated with dopamine. Anything that can affect the dopamine levels in the brain can lead to addiction. Dopamine determines the levels of pleasure that an individual can have in a given time. Some activities, such as eating and sex, can have significant impacts on dopamine, leading to addiction. Drugs such as Cocaine and Heroin are known to increase Dopamine levels among victims to the extent that they can no longer survive without the drugs. Activities such as sex work in the same manner and can lead to addiction. Therefore, sex addiction exists, and research is needed to ascertain its authenticity. Moreover, addiction is a disease and is addressed differently among different people.

The treatment of addiction takes different forms for different people. Understanding the type of addiction and the level of damage to the victim is crucial in addressing the victim’s problems. First, treating addiction is equivalent to treating the effects caused by the substances misused, or the activities responsible for addiction. Each substance or activity has a different level of impact on the mind of the victim. Medical treatment comes in to correct the damages done on the brain in terms of producing dopamine. Understanding the process of addiction may be difficult because the levels of addiction may differ. Also, denial may push people into believing that they are not addicted even when they are addicted. However, viewing addiction from the perspective of the impact on the victim’s mental capacity and not the use of the said substance or activity is essential in understanding activity addiction. Therefore, addiction occurs when brain chemistry is affected, and treatment should begin by assessing the extent of brain damage already done. Addiction is a disease and can be treated using medical procedures such as Medication Assisted Treatment- Methadone.

Medication-Assisted Treatment (MAT) programs are a very controversial topic in the addiction world. “Medicated-Assisted Treatment (MAT) is the use of FDA-approved medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders.”(US Dept of Health and Human Services, 2020) When most people hear MAT programs, they automatically think of Methadone Clinics. Methadone was one of the first FDA approved medication for MAT. Methadone clinics have become pretty common. Most cities have at least one. The way methadone clinics work is quite simple. The person or client comes in for an assessment and meets the requirements of an opiate use disorder. At that point, the client would meet with the medical staff to have a Urine Drug Screen. After the urine drug screen results, the client meets with staff who will help determine their daily dose of medication. However, I hold several disagreements with methadone clinics because of the way victims are handled.

One of the most common disagreements that I have with methadone clinics is that there does not seem to be a timetable in which they work to help the client establish sobriety. It seems because they are a cash-based system; they want the client to keep coming back daily. Most methadone clinics have levels of treatment. Once a client establishes a period with clean urine drug screens, they are given a month of medication at a time, and no longer had to be at the clinic daily.

Methadone itself is highly addictive and can be abused. On more than one occasion, I have seen clients come in for an assessment, and they are nodding off and say they have just left the clinic. I think that the methadone clinics should monitor more closely the dosages that are given to clients. There should be no reason for a client to be on 200mg plus daily of methadone. It is my opinion the clinics continue to give individual high doses to keep them there longer. Another treatment option for addiction is the use of Suboxone.

Suboxone comes in as another option in the treatment of addiction. Suboxone helps victims of opioid addiction, which may come from illegal use or even prescription. Opioids have been used widely among victims of cancer and other painful conditions, but their impacts are disastrous. The addiction risks associated with opioids and weak policies governing their use leads to the importance of Suboxone as it minimizes the threat posed by the substances. Suboxone medication is easily available to victims as it does not require specialized practitioners for prescriptions. A personal doctor can prescribe a dose for their client and help them in developing a treatment plan. Suboxone is meant to treat short-term addictions since long term addictions may require complex medication. The treatment of addiction using Suboxone is carried out through several phases that include a well-structured procedure to ensure that the victim does fail to complete the treatment procedure. The withdrawal phase in the Suboxone treatment is usually uncomfortable, and the victims require support from their doctors to get through it. After the withdrawal phase, the victim is taken through the maintenance period, where the doctor maintains the dosage in a bid to eliminate most of the symptoms. The end of the treatment process is not abrupt, and the victim has to be treated gradually until the treatment is no longer treatment. Addiction can also be addressed through non-medical options such as harm reduction.

Harm reduction is one of the methods that can be used to address addiction through nonmedical means. Although harm reduction has been viewed as an unacceptable approach to addressing social issues, it has proved more than once that it has more positives than the negatives associated with it. Most societies base their morals on the fact that wrongful actions cannot be tolerated (Andreassen et al. 2017). Most societies have mentioned drug abuse and immoral sex as immoral actions. Therefore, individuals engaging in such activities are believed to be going against moral standards. However, dividing the society along moral lines has only led to stigmatization and worsening of the addiction dilemma. Victims have been left to struggle on their own while the society stands aside to judge them for engaging in activities that later lead to addiction. Harm reduction presents an alternative way of addressing the addiction issue. The misconception around harm reduction is that it promotes harmful behaviors and ignores the risks of engaging in the behaviors. Moreover, harm reduction has been effective when it is done with the aim of helping the society to overcome the severe impacts of addiction.

Most societies are battling the impacts of drug and sex addiction, and harm reduction can be of help. The reason that most societies are against harm reduction is that it is the view from the perspective that it can promote harmful behaviors (Talley et al. 2017). For example, most people believe that sex is not a problem as long as children, who are seen as irresponsible, do not get to know about it. However, the world is flooded with information, and children will have knowledge of sex even if no one talks about it. Therefore, society should avoid denial and instead develop strategies that can help in protecting society from extreme impacts of the said menace. For example, safe sex education can be introduced to ensure that individuals do not find themselves on the verge of sexual addiction. Therefore, societies should not pretend that everyone abstains and leave out the risk of unwanted pregnancies and diseases associated with irresponsible sex. Moreover, addiction to drugs can be addressed through harm reduction by growing closer to the addicts and helping them to overcome the menace.

The challenge facing addicts is the perception held by the society about them. Stigmatization leads to rejection and, thus, ineffective measures to curb the menace. Harm reduction can help in reducing the impacts of stigmatization and improve the measures taken to curb addiction. When addiction victims are cared for, they feel a sense of belonging, and helping them to overcome addiction will be made easier. If stigmatization is allowed, then the victims have pushed away, and reached out to them for rehabilitation may be a great challenge. Harm reduction can be made through methods such as educating drug users on self syringe usage to avoid other effects such as the spread of diseases. If drug users are allowed in the community, they recognize the supportive nature of their society, and they can eventually recover from addiction. My current work for an outpatient treatment facility, Cognitive Connection, has exposed me to several addiction cases, and I am opined into believing that harm reduction is necessary.

In sum, addiction is treatable and is thus a disease and can be associated with the interruption of the functionality of the mind by substances that an individual is used to using. Understanding the type of addiction and the level of damage to the victim is crucial in addressing the victim’s problems. Since addiction is a disease, it can be treated using medical procedures such as Medication Assisted Treatment- Methadone. Suboxsone can also help victims of opioid addiction, which may come from illegal use or even prescription. Addiction can also be addressed through non-medical options such as harm reduction. Generally, addiction is real, and societies should cease denying its existence by allowing methods such as harm reduction.

References

Amercian Society Of Addiction Medication. (2020, Janurary 14). Retrieved from ASAM.org:             https://www.asam.org/resources/definition-of-addiction US Dept of Health and Human    Services. (2020, Janurary 15). Substance Abuse and Mental Health Service    Administration. Retrieved from SAMHSA: https://www.samhsa.gov/medication- assisted-treatment

Andreassen, C. S., Pallesen, S., Griffiths, M. D., Torsheim, T., & Sinha, R. (2018). The     development and validation of the Bergen–Yale Sex Addiction Scale with a large      national sample. Frontiers in psychology, 9, 144.

Koob, G. F., & Volkow, N. D. (2016). Neurobiology of addiction: a neurocircuitry analysis. The Lancet Psychiatry, 3(8), 760-773.

Montag, C., & Reuter, M. (2017). Internet addiction (pp. 143-150). Springer International             Publishing.

Talley, B., Dube, S., Chandora, R., Nayak, P., & Eriksen, M. P. (2017). Addiction, Cessation, & Harm Reduction: Primary Care Provider Knowledge & Perceptions of Electronic       Nicotine Delivery System. Osteopathic Family Physician, 9(2).

van Holst, R. J., Sescousse, G., Janssen, L. K., Janssen, M., Berry, A. S., Jagust, W. J., & Cools,   R. (2017). Increased striatal dopamine synthesis capacity in gambling addiction Short             Title: Dopamine synthesis capacity in gambling addiction.