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Addiction is a disease that involves more than psychoactive drugs but also compulsive behavioral issues. Repeated usage changes how the brain functions, which can result in long-term effects. A person can develop an uncontrolled use of a substance no matter the negative consequence. A person builds up a tolerance to the substance needing more of the drug to feel the effects. The heavy usage impacts a person’s ability to function daily due to the intense focus on wanting pleasure from that substance.

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Everything you think you know about addiction is wrong | Johann Hari | TED

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A Great Video Explaining What Causes Addiction.

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Meet an addict whose addiction started after being prescribed medication for a medical condition.

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Inside the struggle to live a normal life addicted to fentanyl

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In this short YouTube clip, Dr. Joseph Haraszti explains how and why people become addicted to processes and substances.

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How are process and substance addictions different and/or the same? 

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How are process and substance addictions different and/or the same? 

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Although process and substance addictions sound like two very different issues, research shows that the two are more similar than we may initially realize. The main difference between the two is that process addictions require repetition of an actual process or behavior to reach desired effects and substance addictions require the use of drugs and/or alcohol.

Both process and substance addictions activate the brain's reward pathways, by way of dopamine within the nucleus accumbens, to provide a chemical reward. With both types of addiction, changes begin to occur within the brain causing increasing tolerance as well as intense cravings and reduced restraint in the presence of triggers. With both forms of addiction, serious negative consequences can become present in an individual's life. Although substance addictions are much more obvious, a person either uses substances regularly or they do not, process addictions can also officially be labeled when an individual sees that their behaviors have led to serious negative consequences in their day-to-day lives.

Although process and substance addictions are different, they share many similarities and can be incredibly harmful for impacted individuals. Process addictions actually increase the chances of substance addictions, so understanding the signs and symptoms, as well as seeking the appropriate treatment, is of the utmost importance.

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Although the key that turns the door is different with each, process addiction and substance use disorder have a lot more in common than you might think. Both activate the brain's reward pathway, with dopamine acting on the nucleus accumbens to provide a chemical payoff. Over time, changes to the brain which occur in both addictions set the stage for intense cravings and increasing tolerance (as well as reduced willpower in the face of triggers). Eventually, as these addictions progress, serious, negative life consequences begin to occur.

The difference comes down to this: With process addiction, the individual repeats an activity or behavior to get the desired effect; with substance use disorder, drugs and/or alcohol are the vehicle of choice.

Unfortunately, an individual can become addicted to a process or behavior, just as they can with a substance.

Why It's Harder to Recognize a Process Addiction

Substance use disorder is obvious and straightforward: A person is either using a substance on a regular basis or not.

However, process addictions are much harder to spot because they involve behavior... behavior that is even socially acceptable.

For example, over 42 million travelers descend upon Las Vegas each year, many of whom participate in some type of gambling during their stay. In other places where gambling is legal, folks may visit a casino on a night out. Some others may play weekly bingo or buy a lottery ticket when the jackpot tops $10 million or more.

So gambling is legal, accepted, and even expected in some cases. Where do you draw the line?

Probably at the same place we do for substance use disorder: It crosses into addiction when there are serious malfunctions and consequences unfolding in an individual's life.

An inability to control the behavior/activity and to function in or fulfill obligations of their personal, family and work lives

Preoccupation with the behavior/activity

Repeated yet unsuccessful efforts to stop the behavior/activity

Significant portions of time are lost to the behavior

Insistence on continuing to participate in the behavior, even though significant negative consequences are occurring

A withdrawal from family and friends

Increasing negative effects as the addiction gets worse over time

In fact, some indicators of a substance use disorder can be observed in an individual with a process addiction. They are:

Does the above sound familiar to you? If you continue to participate in an activity or behavior, despite its serious negative effects, you may have a process addiction.

Gambling

Internet addiction

Sex addiction

Exercise addiction

Eating addictions

Process addictions can include:

According to the American Society of Addiction Medicine, all forms of addiction - whether it be an addiction to a behavior, an activity or a substance - are chronic brain disorders.

How Addiction Rewires the Brain

Addiction is not a matter of willpower. It is not a moral failing. Addiction hijacks the brain, changing its structure and its function.

In real life, you have to work to achieve a goal or reward. This achievement leads to a chemical reward in the brain, making us feel good and driving us to achieve more.

However, when we use a shortcut to that feeling - either through a drug or a behavior - the chemicals released can be overwhelming. In fact, drugs (and other activities such as gambling, etc.) can provide a quick jolt of up to five or ten times the amount of dopamine you'd get naturally.

This overstimulates this reward circuit, leading the brain to adapt to this onslaught by cutting down on its production of dopamine as well as its number of dopamine receptors.

Consequently, naturally occurring dopamine has less of an effect, as does the amount of drugs or time spent on the activity. Tolerance has increased, and now more of the drug or the activity is needed to achieve the same "high."

At the same time, addiction causes the prefrontal cortex to become less active. This area of the brain is responsible for decision making and judgment. It's our Chief Executive Officer, keeping us in check by putting the brakes on before we do something unhealthy or unwise. When the CEO slows down or becomes less active, it can lead to a loss of control over the addiction as well as an increased willingness to indulge in illegal behaviors in order to feed that addiction.

The hippocampus also reinforces the addiction by creating memories of the rush of pleasure felt when indulging in the addiction. Finally, whenever you are around certain stimuli such as a heroin needle or a slot machine, the amygdala will kick in with its preconditioned response, also driving you to indulge in the addiction.

On top of this, dopamine interacts with glutamate, affecting the brain's reward learning system so that activities we must participate in (eating, for example) are inextricably linked with the feeling of pleasure or reward, so that we continue to live another day. When addictions come into play, this system is overloaded. As you can imagine, this is how a want (to do drugs, to gamble, etc.) becomes a need. The addict feels "I must get high," and it will be the priority one as long as he or she is in the throes of addiction.

All of is why addiction recovery is so challenging. You are literally fighting your own brain in attempting to overcome it.

RELATED: How Drugs and Alcohol Affect the Brain (and Can you Recover from the Damage?)

Having a Process Addiction Ups Your Chance of Developing a Substance Use Disorder

Addressing process addictions is not just about improving quality of life. Unfortunately, many people affected by addiction struggle with more than one.

Research shows that having a process addiction can make you anywhere from 15% to 64% more likely to have or develop a substance use disorder, depending on the type of process addiction you have. (Sex addicts have the highest rates of substance use disorder - 64% - than do those with other process addictions; exercise addicts have the lowest at 15 to 25%). Still, the rate of addiction in the general population is only 10%, so the difference in risk can be significant.

Having both a process and a drug or alcohol addiction also means that negative life consequences can get much worse, much more quickly. For example, those who gamble and are addicted to drugs or alcohol will take even greater risks and become even more impulsive.

Finally, having both a process addiction and a substance use disorder puts you at a higher risk of developing a mental illness such as anxiety or depression.

Treatment is the Answer

Addiction is addiction. People tend to focus on the substance or the behavior, but addiction operates in the brain in the same way no matter what a person is addicted to. Treatment is needed in order to break free, and many substance use disorder treatment centers will also treat any co-occurring process addictions. As you can imagine, the chances for achieving lasting recovery are greater when all addictions are treated. The key is to be honest with your addiction counselor, and to follow through with their recommendations. You will not be the first person, and likely far from the last, to recover from more than one addiction.

RELATED: Five Things an Addiction Counselor Wishes You Knew About Your Drug Addict Son or Daughter
Where to Get Help for Family Members of Drug Addicts
Before & After Drug & Alcohol Rehab Photos and Testimonials

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Justin Baksh, LMHC, MCAP, Chief Clinical Officer

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How Do Process Addictions Differ from Substance Use Disorders? - Foundations Wellness Center

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Although the key that turns the door is different with each, process addiction and substance use disorder have a lot more in common than you might think. Both activate the brain's reward pathway, with dopamine acting on the nucleus accumbens to provide a chemical payoff.

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The Development of Addiction: Risk Factors

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The Development of Addiction: Risk Factors

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The following infographic exhibits several factors which may increase the likelihood of developing a substance and/or process addiction.

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Early Behavioral & Psychological Signs of Substance Abuse

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Early Behavioral & Psychological Signs of Substance Abuse

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-Skipping class/work, failure to honor commitments
-Failing grades/poor work performance
-No longer participating in extracurricular activities, hobbies, sports, and/or exercise
-Complaints from teachers, coaches, supervisors, and/or peers
-Theft of money and/or valuables, missing prescription drugs
-Isolation
-Constantly borrowing money
-Sudden relationship changes
-Profound changes in personality or attitude
-Mood swings, anger
-Over-activity, agitation
-Feelings of fear and paranoia for no apparent reason

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When left untreated, drug or alcohol abuse can have harmful effects on the body and mind. Substance abuse also negatively affects home, work and school life, sometimes with profound consequences. It's important to spot the early warnings signs of substance abuse problems in order to seek help as early as possible.

According to the National Council on Alcoholism and Drug Dependence, there are signs and symptoms to look for if you suspect someone has a substance abuse problem:

Alcohol Abuse Early Warning Signs

Not being able to recall events while drinking, also called blackouts

Repeated conflicts with family members, friends or co-workers

Recurring episodes of mood swings, depression or feeling irritable

Using alcohol on a regular basis to relax, improve mood, sleep, deal with problems or feel "normal"

Having troublesome symptoms like headache, anxiety, sleeplessness or stomach upset when not drinking

Red-faced and ruddy complexion, broken capillaries on the face

Trembling hands

Bloody or black and tarry stools, vomiting blood, frequent diarrhea

Drinking alone or drinking in secret

Drug Abuse Early Warning Signs

School, work or home responsibilities are being neglected because of drug use

Using drugs under dangerous or high-risk conditions, such as driving while on drugs, using unclean needles or having unprotected sex

Legal problems such as disorderly conduct, DUI arrests or stealing to support a drug habit

Relationships conflicts, such as fights with loved ones and bosses, loss of friends

Substance Abuse in Teens and Young Adults

If you suspect a teen or young adult may be using drugs or alcohol, there are early physical warning signs to look for:

Bloodshot eyes, pinpoint or enlarged pupils

Nosebleeds that could be caused by snorting drugs

Appetite or sleeping pattern changes

Sudden weight loss or gain

Seizures

Deterioration of personal grooming habits

Loss of coordination resulting in unexplained injuries, accidents or visible bruising

Unusual odors on breath, person or clothes

Shakiness, trembling, incoherent or slurred speech

Behavioral signs of alcohol or drug abuse:

Cutting classes, failing grades

Missing work or declining job performance

No longer participating in extracurricular activities, hobbies, sports or exercise

Complaints from teachers, coaches, coworkers, supervisors or classmates

Theft of money or valuables, missing prescription drugs

Constantly borrowing money

Isolation

Fixation with music, clothing and posters related to drugs or alcohol

Sudden change in relationships, friends, favorite hangouts and hobbies

Psychological warning signs of alcohol or drug abuse:

Profound changes in personality or attitude

Mood swings, anger

Over-activity, agitation

Vacant affect

Fearful and paranoid for no apparent reason

Getting Help for Substance Abuse

As a parent, family member, friend or coworker, it's difficult to watch substance abuse problems ravage a person you care about. When early warning signs are spotted, an outpatient rehab program can be quite effective in the initial stages of drug or alcohol abuse. Substance abuse treatment on an outpatient basis helps participants create personalized and flexible rehab schedules. They receive the help they need in recovering or maintaining sobriety while also being able to attend work or school.
References

1. https://www.ncadd.org/about-addiction/signs-and-symptoms/signs-and-symptoms

2. https://www.ncadd.org/about-addiction/signs-and-symptoms/what-to-look-for-signs-and-symptoms

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Spot the Early Warning Signs of Substance Abuse | Rehab After Work

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When left untreated, drug or alcohol abuse can have harmful effects on the body and mind. Substance abuse also negatively affects home, work and school life, sometimes with profound consequences. It's important to spot the early warnings signs of substance abuse problems in order to seek help as early as possible.

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Try to answer these 5 questions to see if you are aware of Addiction Behaviors.

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Google Forms - create and analyze surveys, for free.

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Create a new survey on your own or with others at the same time. Choose from a variety of survey types and analyze results in Google Forms. Free from Google.

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Addictive Behaviors are defined by compulsive drug or usage of any kind despite negative physical and social consequences and the craving for effects other than pain relief.

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Behavioral Addictions, What Are They and How Does One Develop?

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Behavioral Addictions, What Are They and How Does One Develop?

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https://www.addictioncenter.com/community/behavioral-addictions/

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Do You Think You Could Be Addicted? Answer This Questions!

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Do You Think You Could Be Addicted? Answer This Questions!

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1. Has someone close to you commented on your use?

2. Do you find yourself preoccupied with the thoughts of drinking or using drugs?

3. Is your home life unhappy because of your alcohol or drug use?

4. Are you in jeopardy of losing your job or family because of use?

5. Do you need to drink or use to have fun or to enhance your social life?

6. Do you hide your use or lie about the amount you drink or use?

7. Do you drink or use while you are alone?

8. Do you suffer from loss of memory as a result of drinking / drug use?

9. Do you drink or use to cope with feelings of pain, anger, anxiety or depression?

10. Do you take more medication, or feel the need for more than is prescribed?

11. Do you go to multiple physicians to get the same medications?

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The Substance Addicted Brain: Cocaine, Meth, Alcohol, and Heroin 

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The Substance Addicted Brain: Cocaine, Meth, Alcohol, and Heroin 

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Substance addictions, like process addictions, rewire the brain and hijack the natural reward pathways, thus inhibiting the natural production of dopamine, a neurotransmitter which plays a role in our emotional responses and how we feel pleasure, and decreasing the response of the overall dopamine system (National Institute on Drug Abuse).

The linked photo from the National Institute on Drug Abuse showcases the effects of dopamine receptor availability in brains of individuals addicted to cocaine, meth, alcohol, and heroin. Dopamine receptors are visibly lower in addicted brains.

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Research shows that addiction rewires the brain, thus changing its overall structure and function. Through addictive behaviors, we can shortcut our brain's reward system and signal a contrived dopamine release (Baksh, 2019). This process overstimulates the brain's reward circuit and causes the brain to adapt by reducing the overall production of dopamine and the number of dopamine receptors present in the brain (Baksh, 2019).

The linked video highlights the different responses to gambling photos in the addicted brain versus the non-addicted brain. The insular areas as well as the frontal cortex light up in the addicted brain, showcasing the effects of addiction on the brain's craving and reward centers.

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Centre for Gambling Research at UBC on Global News Hour Vancouver

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Addictions not only affect adults but children as well. The Nationwide Children's have provided insight on what to look for in your own home.

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It is preventable disorder, yet one of the most challenging to cure. Addiction knows no age limit. And our children could be at risk unless we know what to look for, and how to protect them from it. And, sometimes, from themselves.

What is Addiction?

Addiction refers to a wide range of compulsive behaviors. Traditionally, addiction refers to the excessive use of substances, including alcohol; prescription and illegal drugs; cigarettes; and food.

Today addiction has a wider meaning for children and adolescents. It also includes an out-of-control attachment to the Internet and video games. To pornographic violence and sex. Even to texting on cell phones.

Behavior goes from normal to addictive when it becomes an uncontrollable habit. Once it becomes an addiction, that habit can lead to negative and harmful consequences.

In many cases, the behavior becomes physically and psychologically addictive. The young person's body begins to crave the "high" that comes from using the substance. Or the "rush" that's part of the behavior. With each use, more of the substance, or more of the behavior, is needed to achieve the feeling of that first use.

People of almost any age can become addicted to almost any pleasurable activity or stimulation. The desire for pleasure is normal and essentially human.

But when a person - of any age - loses control and needs the substance or behavior instead of simply wanting it, then it becomes an addiction. And it becomes an illness, one that most likely won't go away without treatment. Or the commitment to beat it.

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Addiction refers to a wide range of compulsive behaviors. Traditionally, addiction refers to the excessive use of substances, including alcohol, drugs, cigarettes and food. Addiction has a wider meaning for children and teens, including attachment to things like the Internet and video games.

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Addiction is not a negative, but a positive experience? Meet Dr. Carl Hart

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Addiction is not a negative, but a positive experience? Meet Dr. Carl Hart

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Dr. Carl Hart, a tenured department chair of Psychology at Columbia, has showcased research that addiction is not a brain disease and drugs are not the enemy, government policies are. In his newest book, Drug Use for Grown-Ups, he discusses how responsible drug use can be beneficial.

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Prof. Carl Hart saw drugs as destroyers of communities. Then he saw the positive side. "We have miseducated the public," he said.

Carl Hart of Columbia University says that most of the millions of Americans who use illegal drugs have overwhelmingly positive experiences. Credit... Simbarashe Cha for The New York Times

Carl L. Hart, a neuroscientist at Columbia University, fielded questions the other day about his new book, which makes an unconventional case for drug use.
Dr. Hart, are you on anything now?
"No. I'm in interview season now," he said on a recent afternoon. "Why would you waste your substance on an interview? You have to concentrate and focus."
Uh, to deal with the stress or boredom of interviews?`
Well, perhaps if we were at an academic reception, he said. "Now, you might take something that will help you get through it," he said. "Like a low dose of opioids and a low dose of stimulant, or something of that nature."

Dr. Hart, 54, the first tenured African-American science professor at Columbia, is a gadfly among drug researchers and a rock star among advocates for decriminalizing drugs. In " Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear," he confides that he has used heroin regularly for the last four years and describes the time he took morphine daily for three weeks in order to experience withdrawal.

Every adult, he said, should have the freedom to do the same. "The pursuit of happiness, liberty," he said.

In a telephone interview from his home in Westchester County, where he is on sabbatical, Dr. Hart lauded New York's new law legalizing marijuana as a sign that some drug taboos are waning. But others, he said, remain deep-seated.

In Minneapolis, defense lawyers for Derek Chauvin, the former police officer on trial in the killing of George Floyd, emphasized Mr. Floyd's drug use to conjure a stereotype that Dr. Hart calls "the crazed Negro drug fiend."

For Dr. Hart, it was an old story.

"This happens all the time when a Black person is killed by police," he said. "Drugs are the ideal scapegoat, because most Americans believe drugs make people crazy and it makes them less than human. Or superhuman."

Dr. Hart argued that most of what you think you know about drugs and drug abuse is wrong: that addiction is not a brain disease; that most of the 50 million Americans who use an illegal drug in a given year have overwhelmingly positive experiences; that our policies have been warped by a focus only on the bad outcomes; and that the results have been devastating for African-American families like his own.

Much of the blame, he said, falls on his own profession. "We in the field are overstating the harmful effects of drugs," he said. "We have miseducated the public, and that is wholly un-American and wrong."

Critics of Dr. Hart - and there are many - call these assertions both wrong and dangerous.

"He is fast and loose with the science to advance the case," said Bertha K. Madras, a professor of psychobiology at Harvard Medical School and director of the Laboratory of Addiction Neurobiology at McLean Hospital in Belmont, Mass.

"You don't ignore the adverse consequences - the parents, the families, the spouses who've had to live and deal with opioid use disorder. Traffic fatalities, workplace errors, absenteeism, workman's compensation, drug-fueled violence, school dropouts, drug-related crimes and murders. I just don't see Carl ever wanting to address these things."

Dr. Hart began his relationship with drugs growing up in the Carol City neighborhood of Miami Gardens, Fla. Like many of his peers, he dabbled in selling drugs and carried a gun. He was also an accomplished athlete and party D.J.

After he left that environment - first for the Air Force, then for college and graduate school - he blamed drugs for the crime and social decay in the community. With a doctorate in neuroscience, he set out to understand the problem of addiction and to improve life in places like Carol City.

At Columbia, he began conducting experiments with drug addicts, recruiting them through ads in the Village Voice. With grants from the National Institute on Drug Abuse, Dr. Hart and his colleagues administered millions of dollars' worth of crack, methamphetamine, cannabis and other drugs in laboratory settings.

He expected his subjects to be like the people he heard about at conferences on drug abuse, or the crazed zombies in movies about addicts, he said: "Somebody who was essentially a slave to the drug. And that person I had never seen in all of my research."

Instead, he said, subjects were diligent in reporting on time for the experiments, and when offered alternatives to drugs - a dollar in one experiment, $5 in another - they made rational choices, rather than compulsively feeding their addictions.

"But that's the mythology in the field," he said. "Then I started to pay attention to our data, and you start to see that people are actually happy, and they are responsible. They show up for these demanding schedules."

It led him to ask different questions: If most drug users had few or no negative consequences, what was the best way to alleviate the suffering of those who did?

"If people have a co-occurring psychiatric illness, then that's where the focus should be," he said. "Not on the drug the person is taking. Or if this person now doesn't have a sense of worth because they lost a job that was placing that person's family in the middle class. If the treatment doesn't focus on making sure that is replaced, then the treatment is a waste of time."

So began his war on the war on drugs. It turned his career around, moving him away from heavy lab work and toward legal advocacy.

After receiving regular research grants totaling more than $6 million from the National Institute on Drug Abuse, Dr. Hart found himself cut off after 2009. "Because I'm asking questions that do not focus on pathology, it's harder to get funding," he said.

A spokeswoman for the agency said it did not comment on its decision-making process for grants.

As he drew criticism from the scientific mainstream, he attracted a new, receptive audience, including private donors for his research. "For harm reductionists or prison abolitionists, or policing abolitionists, he is a hero," said Dorothy E. Roberts, a law professor and director of the Penn Program on Race, Science & Society at the University of Pennsylvania. "He's been willing to say, with a lot of expertise backing him up, that these policies are harmful."

Unlike past academic advocates for drug use, like Timothy Leary and Baba Ram Dass, who both experimented with L.S.D. at Harvard University, Dr. Hart rejects as "self-serving" the distinction between so-called good drugs, like psychedelics, and more maligned substances, like heroin and methamphetamine. All, he said, have their place.

Some parts of the world may be starting to agree. On Feb. 1, Oregon decriminalized possession of small amounts of all drugs. But Dr. Hart objected that decriminalization alone does little to make the drugs safe. If people do not know what they are buying, they cannot use it without risking overdose.

A next step, Dr. Hart said, should be setting up testing sites nationwide where users can determine the purity and strength of their drugs - anathema to researchers like Dr. Madras, who say that anything that "normalizes" drug use leads to more use by adolescents - but essential for saving lives, Dr. Hart said.

He held out little hope that such sites would appear any time soon.

But he noted a twist during his time in the field. When he started, his students wanted to explore the dangers of drugs. Now they see more harm in drug prohibitions, he said.

"So I have to be the person to push them in the direction that they're not going," he said.

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This Heroin-Using Professor Wants to Change How We Think About Drugs

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Prof. Carl Hart saw drugs as destroyers of communities. Then he saw the positive side. "We have miseducated the public," he said. Carl L. Hart, a neuroscientist at Columbia University, fielded questions the other day about his new book, which makes an unconventional case for drug use.

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The most significant developmental stages are childhood and adolescence. It allows you to defer emotional impulses, make wise decisions, and better understand relationships. According to Mental Help, addiction is caused by a level of immaturity and developmental delay.

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Psychologists are concerned with distinguishing normal human behavior from abnormal behavior. In order to make these distinctions psychologists study human development. This makes intuitive sense. A normal behavior for a five year old is usually quite different from the normal behavior of an adult. For example, in the United States, it is normal and average for a five-year-old child to believe in Santa Claus. The child eagerly anticipates the Christmas gifts Santa will bring. It is certainly not normal for a 40-year-old adult to hold these same beliefs.

According to the developmental model, immaturity or developmental arrest causes addiction. While human development occurs across the lifespan, the most significant portion of this development occurs during childhood and adolescence. As human beings mature, they increase their capacity to: 1) defer acting upon immediate selfish desires and emotional impulses, 2) use rational thought to make wise choices, and 3) consider their actions in the larger context of their relationships and society as a whole. Conversely, a lack of development results in an immature pursuit of selfish desires, difficulty making wise choices, and a failure to consider the "big picture." The capacity to understand ourselves in relation to a larger context (i.e., the big picture) is what "develops" in development. That capacity is at the root of all motivation to overcome addiction.

The acceleration of developmental maturity expands the capacity to understand self-in-relationship-to-the world. This mature capacity enables us to make wise choices that ultimately benefit both our fellow human beings and ourselves. If someone only focuses on the immediate pleasure or value of the addictive behavior, the decision to continue or discontinue is obvious- Yes continue! It is by focusing on the larger context that a different choice emerges. What happens after the high? What happens to the people I care about? What happens to my projects and activities in life? What happens to my health and my future? In other words, our appreciation of the larger context in which we live allows us to rise above immediate gratification. This appreciation is central to recovery from addiction.

Questions for personal reflection from the developmental model: How do my choices reflect maturity or immaturity? How often do I consider the "big picture" when choosing to engage in addictive behavior? Would my choices be different if I had a greater capacity to consider the effect of my choices on other people? What choice would I make if I considered the effects on my health, well-being?

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Developmental Model of Addiction and Recovery Implications

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Psychologists are concerned with distinguishing normal human behavior from abnormal behavior. In order to make these distinctions psychologists study human development. This makes intuitive sense. A normal behavior for a five year old is usually quite different from the normal behavior of an adult.

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Helpful resources for families from SAMSHA

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Helpful resources for families from SAMSHA

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Very helpful for anyone helping a family member!

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While there is no one-size-fits-all solution for helping a family member who is drinking too much, using drugs, or dealing with a mental illness, research shows that family support can play a major role in helping a loved one with mental and substance use disorders.

When a family member is experiencing a mental or substance use disorder, it can affect more than just the person in need of recovery. Evidence has shown that some people have a genetic predisposition for developing mental and substance use disorders, and may be at greater risk based on environmental factors such as having grown up in a home affected by a family member's mental health or history of substance use. Families should be open to the options of support groups or family therapy and counseling, which can improve treatment effectiveness by supporting the whole family.

It is also important to remember that the unique challenges that come from helping a loved one with a mental or substance use disorder can be taxing, so caregivers should take steps to prioritize their own health as well.

Family members may be more likely to notice when their loved ones are experiencing changes in mood or behavior. Being able to offer support, family members can connect those in need with treatment, resources, and services to begin and stay on their recovery journey.

Download audio and video files, and other resources for families.

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Resources for Families Coping with Mental and Substance Use Disorders

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Every family is unique, but all families share a bond that can be used to support one another during trying times.

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Childhood traumas are rarely considered by doctors when evaluating a patient. Childhood traumas not only affect us physically, but also mentally and emotionally leaving doctors to respond to the symptoms (like high blood pressure, stress, depression, etc.) rather than exploring the cause.

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How childhood trauma affects health across a lifetime | Nadine Burke Harris | TED

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The daily struggles of an addict.

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According to the American Addiction Centers, here are the best practices for an intervention.
Step 1: Get outside help
Step 2: Form a team
Step 3: Make a plan
Step 4: Gather information
Step 5: Write impact statements
Step 6: Offer help
Step 7: Set boundaries
Step 8: Rehearse
Step 9: Manage expectations
Step 10: Follow up

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An intervention is an important event, created by family and friends of a person struggling with addiction, to help the person realize they have a problem, they need help, and they have support. While reality television shows have popularized interventions in recent years, these depictions often offer a false sense of how an intervention should be conducted. While interventions should always provide encouragement and incentive for the person struggling with addiction to seek help, they come in more forms than the classic family meeting frequently displayed in popular media.

What Is an Intervention?

An intervention is a carefully planned process. It is important that the friends and family involved avoid spontaneity in what they say, when they gather, and where they gather. This helps all team members to stay on topic, and to avoid placing blame, making accusations, or saying other hurtful things, which may lead the person to refuse help.

The intervention should focus on the positive. Although it is important for a person struggling with addiction to understand that their condition affects the mental and emotional health of their loved ones, the point is not to blame them for causing harm. Instead, it is to point out that the addiction causes negative changes in behavior, and there is a solution: detox and a comprehensive rehabilitation program.

Family and friends who want to stage an intervention can make a plan for one on their own, or they can consult with a professional interventionist. This professional will structure the planning process, guide the intervention team, and lead the overall event.

Steps Involved in an Intervention

When considering an intervention to help a loved one struggling with drug or alcohol addiction, there are some important steps that can guide the process.

Step 1: Get help. This may involve contacting a professional interventionist, social worker, or doctor. It could also involve contacting other family and friends. Support for the process is important, and it is important not to do all the work alone.

Step 2: Form the intervention team. This is the core group of organizers, and it may or may not include a professional interventionist. Generally, only close family members, friends, and coworkers should be included on the intervention team. If a person is currently struggling with their own substance abuse issues, they should not be included on the team.

Step 3: Make a plan. This includes scheduling a specific day, time of day, location, and guest list. It also includes an outline of how the process will work and what everyone will say. This is the overall guide to the event.

Step 4: Gather information. Learn about the substance of abuse, addiction, and the recovery process. Gather information about detox and rehabilitation programs, particularly those that suit the personality and needs of the person struggling with addiction.

Step 5: Write impact statements. Everyone at the intervention should have something to say about the person's struggles with addiction. These should be personal statements, detailing how the addiction has harmed the person they love. Relationships can be deeply hurt by substance abuse. Written statements about the impact on relationships can help the person struggling with addiction to understand that their struggle does not impact them alone. These statements should be emotionally honest and focus on love. There is no place for personal attacks in these statements.

Step 6: Offer help. People attending the intervention should be willing to support their loved one in some capacity while the person goes through detox, rehabilitation, and long-term recovery. For example, offer rides to treatment once a week, or offer to attend family therapy sessions or support group meetings with the person.

Step 7: Set boundaries. If the person refuses treatment, relationships with friends and family must change. Everyone present should commit to ending codependency and enabling behaviors. Be clear that there will be consequences if the person refuses help.

Step 8: Rehearse. Emotions run high regarding substance abuse and addiction. To avoid taking too much time, blaming the loved one, or falling into self-pity, rehearse the whole intervention with everyone at least once before it actually occurs. Then, each team member will have an idea of what to say, when they will speak, and when to cede the floor.

Step 9: Manage expectations. While television nearly always shows the person at the center of the intervention accepting help, this is not always the case in real life. Even with a well-planned intervention and clear offers of help, the individual may not accept help for a variety of reasons. If they do not, then follow through on the outlined consequences.

Step 10: Follow up. Whether the person accepts help or not, it is important to uphold statements made during the intervention. Otherwise, the person may experience excessive stress, which could slow down their rehabilitation process, lead to relapse, or deepen substance abuse problems. [/callout]

Things to Avoid at an Intervention

Even with preparation, there are important points to avoid during an intervention. These include:

Labels like "alcoholic," "addict," "junkie," etc.: These can be taken as accusatory. Instead, opt for neutral terms and avoid defining the person by their addiction.

Too many people: Pick a core group of close friends and family, and stick to a small number of people.

Being upset during the intervention: Find ways to manage personal feelings so the event doesn't become overrun by strong emotions.

An intoxicated subject: If the subject of the intervention is intoxicated when the event is supposed to occur, it is not likely to be effective. Be prepared to wait for the person to sober up.

To fully understand what an intervention should accomplish, it can be important to know what an intervention should not entail. According to the Association of Professional Intervention Specialists, an intervention is not:

The only way for interventions to be successful is if they are based in love, honesty, and support.

Discussions about emotional hurt, anger, fear, or concern should only come up if they reflect the love of family and friends.

An intervention is not a place to embarrass, shame, or scold the person struggling with addiction; these tactics are more likely to make the person retreat further into substance abuse patterns.

Different Types of Interventions

There are many different types of interventions to choose from. Many professional interventionists have a preferred intervention style they use.

Family Systemic Intervention: This style not only focuses on the person struggling with addiction, but also on their family. All relationships are affected by substance abuse, and spouses, parents, children, and other close family members and friends can be dramatically impacted by these patterns of abuse. A Family Systemic Intervention catalyzes the whole family to seek help in the form of individual and family therapy, specific support groups, and other forms of treatment.

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Recovery Requires Social Support

Regardless of what style of intervention is used, the point of the process is to help someone struggling with alcohol or drug addiction realize that they have support to overcome this condition and real help is available. Support comes in many forms, including medical care, therapeutic help, and social support from loved ones.

Can a Professional Interventionist Be Helpful?

If friends and family feel too emotionally charged while working on a DIY intervention, they can consult a professional interventionist, social worker, therapist, or other counselor at any time for help. They may ask the person to lead the intervention or simply seek guidance in planning the event. Professional assistance at any level can be extremely helpful, as an outside perspective can guide the process toward the most beneficial conclusion and keep everyone focused.

In some instances, hiring a professional is essential. Professional interventionists are highly recommended if the person who is the subject of the intervention has displayed any of the following:

Serious mental illness, such as schizophrenia, bipolar disorder, etc

A history of violence, such as domestic abuse or verbal abuse

A history of suicidal talk or attempts, or other self-harming behaviors

Polysubstance abuse

How to Find a Professional Interventionist

There are several ways to find a professional interventionist.

Ask trusted friends or family for recommendations.

Get a referral from a doctor or therapist.

Find a social worker, often through a nearby hospital, rehabilitation center, or therapy office.

Search local options online.

Contact health insurance providers to see if there are options covered by insurance.

Contact a community, religious, or spiritual leader for recommendations.

Search for options via the Association of Intervention Specialists.

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Tips for a Successful Intervention

Interventions are most successful when they are planned and implemented well. If the meeting is structured, especially with help from a professional, interventions can be up to 90 percent successful in convincing the person to get the help they need. For a successful intervention, keep the following in mind:

The intervention is about the person who needs help overcoming substance abuse; it is not about anyone else. It is not a plan to vent about past wrongs.

Interventions are for education and showing love; they are not about lashing out, shaming, or abusing the person struggling with addiction.

Professional help can guide the intervention process in all instances. They are particularly helpful if loved ones are too emotionally involved to create a solid plan or if the subject has a history of violence or mental health issues.

Those struggling with substance abuse may be in denial about the harm they are causing themselves or others, but an intervention can help them understand that their behaviors are hurting those they love, not just their own physical and mental health. If the subject of the intervention knows they have support as they enter medical detox and a comprehensive rehabilitation program, they are more likely to agree to treatment.

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Staging an Intervention - How To Step By Step Guide

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An intervention is an important event, created by family and friends of a person struggling with addiction, to help the person realize they have a problem, they need help, and they have support. While reality television shows have popularized interventions in recent years, these depictions often offer a false sense of how an intervention should be conducted.

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Adverse Childhood Experiences (ACEs) can have tremendous impacts on growth and development. It's not uncommon for ACEs to be the root of addiction for many.

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Whether it's a broken bone, perpetually scraped knees or a healthy fear of the dark, no one leaves childhood unscathed. At some point, we were all faced with events in our past that left us scarred, scared or both. These events, though frightening at the time, help the body and brain development and mature. Unfortunately, some children suffer from far more traumatic experiences than others. As children are exposed to things like neglect, abuse or addiction in the home, these adverse childhood experiences (ACEs) can cause lifelong stress, pain and suffering. Children struggling to cope with ACEs often grow into adults who abuse substances to numb the pain of their past.

"Trauma plays an incredibly huge part in addiction," states Maeve O'Neill, Vice President of Compliance at Vertava Health. "There are people that would say that's the root of addiction."

With approximately 35 million children in the United States suffering from at least one traumatic childhood event, it's more important than ever to understand how easily childhood trauma can turn into an addiction.

What Are Adverse Childhood Experiences?

Childhood experiences, both positive and negative, have a tremendous effect on lifelong health and happiness. Due to this, significant time and resources have been poured into the study of how early life events impact adults, specifically how adverse childhood experiences influence future behaviors.
According to the Centers for Disease Control and Prevention, adverse childhood experiences have been linked to:

risky health behaviors

chronic health conditions

low life potential

early death

The more a child is exposed to traumatic events, the higher the likelihood is of them experiencing one of these unfortunate outcomes.

Adverse childhood experiences can be single, acute events or repeated trauma sustained over time. These events occur any time before the age of 18. A child does not need to remember a traumatic childhood experience to suffer from the effects of it.
ACEs can include any number of the following events:

Physical abuse

Emotional abuse

Sexual abuse

Neglect

Witnessing physical or mental abuse at home

Witnessing substance abuse at home

Mental illness at home

Parental separation or divorce

Incarcerated family member

Death of a parent

Community violence

Living in poverty

While children who suffer through these events are more likely to face the negative effects of ACEs, there isn't a definitive way to know what type of experience will cause lifelong trauma for a child.

What Is The ACE Score?

In 1998, the stunning results of The Adverse Childhood Experiences Study were published. The report uncovered a definitive link between childhood trauma and chronic diseases and mental illnesses that people develop over time as an adult.

With this new information, the study's researchers then designed a test to determine a person's ACE score. An ACE score is made up of 10 questions that cover everything from physical and sexual abuse to divorced parents to the incarceration of a family member. For each type of traumatic event listed that a person suffered through before the age of 18, they are assigned one point. The higher the ACE score, the greater the risk of future medical and emotional problems.

While the ACE score can be a great diagnostic tool, it cannot predict the future, nor does it take into account positive events in a person's childhood that may have offset their traumatic experiences or helped them build resilience.

How Does Trauma Affect A Child?

Some stress is normal and can even be beneficial to a child's development. However, the type of stress that occurs when a child experiences ACEs can be toxic. When the body is forced to live in fight or flight mode for a prolonged period of time or respond to an acute traumatic event without the buffer of a supportive, protective adult, children will find an alternative way to cope.

"When those ACEs happen, we try to find ways to make that pain feel less hurtful," says O'Neill. "Children will exhibit risky or bad behaviors as a way to cope with what they've been through."

O'Neill also notes that experiencing trauma at a young age completely changes the brain and stunts emotional growth. If a person has an adverse childhood experience at the age of five, parts of their brain may become stuck at that age-unable to make progress in their coping skills, emotional intelligence or ability to manage stressful events in the future.

According to a study published by a group of pediatric doctors at Harvard University, chronic exposure to stress during childhood will actually shrink the size of the hippocampus, the area of the brain responsible for processing emotions, creating memories and handling stress. Children with ACEs also show weaker connections from one part of their brain to the other, which means they are at a greater risk of developing mental illnesses like anxiety and depression.

The effects of ACEs can extend beyond just stunting mental growth. They can also be physically harmful. Adverse childhood experiences erode the protective caps at the end of DNA strands, causing people to age faster, develop diseases more easily and die sooner.

Children exposed to traumatic events often become adults with unhealthy coping mechanisms, limited emotional capacity and a decreased ability to deal with everyday stress. Due to this, adults who have adverse childhood experiences often turn to drugs and alcohol as a coping mechanism.

Adverse Childhood Experiences And Addiction

"Adverse childhood experiences are the root cause of many addictions," explains O'Neill. "We often see people in our treatment facilities that use drugs and alcohol to numb the pain and not deal with the past."

As O'Neill points out, it's not uncommon for those with adverse childhood experiences to start using substances at earlier ages to deal with their traumatic past. The Substance Abuse and Mental Health Services Administration reports that ACEs increase the likelihood of lifetime illicit drug use, drug dependency and self-reported addiction up to four times. They also increase the chances of early alcohol, prescription drug and tobacco abuse.

When adults use drugs and alcohol as a means to cope, especially when they start at an early age, their coping mechanism can quickly spiral into an addiction. The more they use substances to numb their emotions, the more damage they're causing to their brain and body. As substance abuse and ACEs work in tandem, it's an incredibly difficult cycle to break.

The more adverse childhood experiences a person suffers through, the higher their chance of developing an addiction becomes. According to one study, for each additional ACE score, the number of prescription drugs used increased by 62 percent.

"In the early 1990s, when I was treating children for trauma-related issues that came from fragmented, dysfunctional homes, I had up to three years to provide care for them. Steadily, that was broken down to six months and then to three months," explains Vinnie Strumolo, CEO at The Treehouse, Vertava Health' Texas facility. "Fast forward 20 years later, and I'm seeing them in rehab."

The unfortunate reality is that while addiction can happen to anyone, adults who suffered from trauma at a young age are more at risk for developing an addiction.

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Can Adverse Childhood Experiences Cause Addiction?

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Whether it's a broken bone, perpetually scraped knees or a healthy fear of the dark, no one leaves childhood unscathed. At some point, we were all faced with events in our past that left us scarred, scared or both. These events, though frightening at the time, help the body and brain development and mature.

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Addictions and teen cognitive development

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Addictions and teen cognitive development

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National Institute on Drug Abuse (NIDA/NIH)

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Between the childhood and adolescence stages of development, the brain is still young and not fully developed. Research based programs have been scientifically proven to show results in reducing the use of harmful substances.

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Why is adolescence a critical time for preventing drug addiction?

As noted previously, early use of drugs increases a person's chances of becoming addicted. Remember, drugs change the brain-and this can lead to addiction and other serious problems. So, preventing early use of drugs or alcohol may go a long way in reducing these risks.

Risk of drug use increases greatly during times of transition. For an adult, a divorce or loss of a job may increase the risk of drug use. For a teenager, risky times include moving, family divorce, or changing schools. When children advance from elementary through middle school, they face new and challenging social, family, and academic situations. Often during this period, children are exposed to substances such as cigarettes and alcohol for the first time. When they enter high school, teens may encounter greater availability of drugs, drug use by older teens, and social activities where drugs are used. When individuals leave high school and live more independently, either in college or as an employed adult, they may find themselves exposed to drug use while separated from the protective structure provided by family and school.

A certain amount of risk-taking is a normal part of adolescent development. The desire to try new things and become more independent is healthy, but it may also increase teens' tendencies to experiment with drugs. The parts of the brain that control judgment and decision-making do not fully develop until people are in their early or mid-20s. This limits a teen's ability to accurately assess the risks of drug experimentation and makes young people more vulnerable to peer pressure.

Because the brain is still developing, using drugs at this age has more potential to disrupt brain function in areas critical to motivation, memory, learning, judgment, and behavior control.

Can research-based programs prevent drug addiction in youth?

Yes. The term research-based or evidence-based means that these programs have been designed based on current scientific evidence, thoroughly tested, and shown to produce positive results. Scientists have developed a broad range of programs that positively alter the balance between risk and protective factors for drug use in families, schools, and communities. Studies have shown that research-based programs, such as described in NIDA's Principles of Substance Abuse Prevention for Early Childhood: A Research-Based Guide and Preventing Drug Use among Children and Adolescents: A Research-Based Guide for Parents, Educators, and Community Leaders, can significantly reduce early use of tobacco, alcohol, and other drugs. Also, while many social and cultural factors affect drug use trends, when young people perceive drug use as harmful, they often reduce their level of use.

How do research-based prevention programs work?

National drug use surveys indicate some children are using drugs by age 12 or 13. Prevention is the best strategy.

These prevention programs work to boost protective factors and eliminate or reduce risk factors for drug use. The programs are designed for various ages and can be used in individual or group settings, such as the school and home. There are three types of programs:

Universal programs address risk and protective factors common to all children in a given setting, such as a school or community.

Selective programs are for groups of children and teens who have specific factors that put them at increased risk of drug use.

Indicated programs are designed for youth who have already started using drugs.

Young Brains Under Study

Using cutting-edge imaging technology, scientists from the NIDA's Adolescent Brain Cognitive Development (ABCD) Study will look at how childhood experiences, including use of any drugs, interact with each other and with a child's changing biology to affect brain development and social, behavioral, academic, health, and other outcomes. As the only study of its kind, the ABCD study will yield critical insights into the foundational aspects of adolescence that shape a person's future.

These brain images show the reward-related circuity in the cortical and subcortical regions of the brain that tend to be more active when a child is successful at achieving a reward. While all of the images show the regions of the brain that are active to reward, the regions in yellow and red are the most active.

Economics of Prevention

Evidence-based interventions for substance use can save society money in medical costs and help individuals remain productive members of society. Such programs can return anywhere from very little to $65 per every dollar invested in prevention.

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Preventing Drug Misuse and Addiction: The Best Strategy | National Institute on Drug Abuse

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Why is adolescence a critical time for preventing drug addiction? As noted previously, early use of drugs increases a person's chances of becoming addicted. Remember, drugs change the brain-and this can lead to addiction and other serious problems. So, preventing early use of drugs or alcohol may go a long way in reducing these risks.

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Must Read Books To Help Fight Addiction.

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Must Read Books To Help Fight Addiction.

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Drinking: A Love Story by Caroline Knapp

Girl Walks Out of a Bar: A Memoir by Lisa Smith
My Fair Junkie by Amy Dresner
How to Murder Your Life by Cat Marnell

High on Arrival by Mackenzie Phillips
A Million Little Pieces by James Frey