What is addiction?
Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.
It is considered a brain disease because drugs change the brain; they change its structure and how it works. These brain changes can be long lasting and can lead to many harmful, often self-destructive, behaviors.
What is drug abuse?
Drug abuse refers to any illicit use of a substance as a drug, including the nonmedical use of prescription drugs.
Is there a difference between “physical dependence,” dependence, and addiction?
Physical dependence is not equivalent to dependence or addiction.
Physical dependence may occur with the chronic use of any substance, legal or illegal, even when taken as prescribed. It occurs because the body naturally adapts to chronic exposure to a substance (e.g., caffeine or a prescription drug), and when that substance is taken away, symptoms can emerge while the body readjusts to the loss of the substance.
Physical dependence can lead to craving for the drug to relieve the withdrawal symptoms.
Drug dependence and addiction refer to drug or substance use disorders, which may include physical dependence but must also meet additional criteria.
What are some signs and symptoms of dependence?
Dependence generally involves some or all of the following:
- drug taking in larger amounts than intended;
- inability to cut down on drug use;
- a great deal of time spent in activities necessary to obtain the drug; and
- continued use despite knowledge of health or social problems caused by the drug.
Dependence may or may not include “physical dependence,” defined by withdrawal symptoms when drug use is abruptly ceased, and “tolerance,” the need for more drugs to achieve a desired effect. The DSM term “dependence” is what NIDA refers to as “addiction.”
Can addiction be treated successfully?
Addiction is a treatable, chronic disease that can be managed successfully. Research shows that combining behavioral therapy with medications, when appropriate, is the best way to ensure success for most patients. Treatment approaches must be tailored to address each patient’s drug abuse patterns and drug-related medical, psychiatric, and social problems.
What is relapse?
Relapse is not an isolated event, but rather a process whereby an individual becomes dysfunctional or unable to cope with life in sobriety, and thus can no longer avoid using alcohol or other drugs. This process of becoming dysfunctional may lead to renewed alcohol or other drug use, physical or emotional collapse, or even suicide.
The process is marked by predictable and identifiable warning signs that begin long before the return to use or collapse occurs.
Progressively increased distress levels in any one of the problem areas — physical, psychological or social — can lead to physical or emotional collapse, resulting in relapse. These symptoms increase and intensify unless the individual returns to the use of alcohol or other drugs (HHS/SAMHSA, 1996a).
One particular warning in early recovery occurs when a recovering person begins to seek out situations involving people who use alcohol or other drugs.
Does relapse mean that substance abuse treatment has failed?
The chronic nature of the disease means that relapsing to drug abuse is not only possible but also likely. Relapse rates are similar to those for other well-characterized chronic medical illnesses, such as diabetes, hypertension, and asthma, which also have both physiological and behavioral components. Treatment of chronic diseases involves changing deeply imbedded behaviors.
For the addicted patient, lapses back to drug abuse indicate that treatment needs to be reinstated or adjusted or that alternate treatment is needed.
What is Recovery?
In a December 2011 News Release, the Substance Abuse and Mental Health Services Administration (SAMHSA) announced a new working definition of “recovery,” when used in reference to either mental disorders or substance abuse disorders.
The definition is as follows:
“A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”
Relapse rates for drug-addicted patients are compared with those suffering from diabetes, hypertension, and asthma. Relapse is common and similar across these illnesses (as is adherence to medication). Thus, drug addiction should be treated like any other chronic illness, with relapse serving as a trigger for renewed intervention. Source: McLellan et al., JAMA, 284:1689-1695, 2000.
Frequently Asked Questions about Mental Health Wellness
Where can I find a list of public mental health service providers in my community?
Mental health services are available on the Network of Care website.
Where can I find more information about mental illness online?
There are many other great resources online:
Substance Abuse and Mental Health Services Administration (SAMHSA) | SAMHSA’s National Mental Health Anti-Stigma Campaign | Mental Health America | National Mental Health Information Center | On Our Own of Maryland | National Alliance on Mental Illness
How can I get medication assistance?
Doctors or the pharmaceutical company may be able to provide samples. BHSB has a medication assistance program for individuals receiving services within the Public Mental Health System with a major mental illness. Assistance is provided one time per year and is for psychiatric medications only.
Where can I find housing resources?
Information on housing resources is available on the Network of Care website. Click here for a map of emergency housing resources in Baltimore City.
How do I file a complaint about mental health services in Baltimore City?
BHSB believes individuals and families deserve the highest possible quality of care, and have the right to file a complaint if they believe they are not receiving this level of care. To file a complaint, visit the Complaints page.
What are advanced directives?
Information about advanced directives from the Maryland Attorney General’s office are available by clicking here.