How Addiction Becomes Such a Big Crisis: Opiate Fatalities Part 1

“What’s wrong with me? I thought it would never happen to me. I come from a good family and I have goals. I wouldn’t know if I, my loved one, or friend was becoming addicted to drugs.”

These are the questions that recovering people, families, and local communities ask themselves when they experience the tragedies of drug addiction, particularly when it becomes a major cause of death. Addiction does not just happen. It can occur when individuals, families, and the communities do not expect it, have a lack of understanding of addiction, do not recognize the signs, and/or do not know how it can be effectively prevented and treated. This certainly pertains to the current opiate crisis. Although there is no one exact cause for it and no one can be blamed for it, we all have a responsibility to do something about it for our own personal well-being, for our families’ well-being, and for our communities.

Problems and Consequences of Addiction

No one plans or wants to become a drug addict, alcoholic, or compulsive gambler. Before addiction, these individuals were healthy, had positive relationships, and were accomplishing their personal and professional goals. However, at some point the problems and consequences associated with addiction accumulated and became unbearable.  By that time, it was too chronic and difficult to stop despite their desire to end their use. There are significant and chronic problems that occur when a person becomes addicted to drugs and then when addiction increases in the local and national population. People who use drugs can have negative moods (anxiety, depression, and anger) and cognitive impairment (lack of concentration, judgement, coordination, and memory) as well as behavioral problems (impulsivity, aggression, and isolation). These affect job performance and relationships resulting in job loss, financial stress, divorce, arrests, incarcerations, health problems, physical injury, and death. Addiction and its chronicity is defined by its significant consequences of drug dependency. Communities suffer due to an increase in crime, domestic problems, abused or neglected children, hunger, and homelessness. Nationally, there is an increase in crime, costs of medical insurance, economic problems, and mortality rates. Currently, there is an opiate crisis as addicts have been overdosing on opiates and dying across the country because of chronic drug dependency. Thus, it is important to learn everything we can about addiction, and to continue to develop community prevention and effective counseling interventions.

Is Addiction Caused by Biological Factors?

Addiction is a biopsychosocioeconomic disease. There is a genetic predisposition in which addiction can be passed from one family member to another, and from one generation to another. When you start drinking or using drugs, you are more likely to acquire an addiction if you have a grandfather who is an alcoholic and aunt dependent on crack cocaine than someone with little to no family history of substance dependency. Cross addiction is when you become addicted to one addictive substance or addictive behavior and you can become easily addicted to another.  Also, gamblers, compulsive shoppers, and sex addicts are more likely to become a drug addict or an alcoholic, and vice versa.

Why Do People Continue Addictive Behaviors and Use Drugs?

Some individuals, families, and communities do not recognize addiction because it is progressive and gets worse over time. It simply cannot stop without professional intervention. Biologically, there is a tolerance in which someone’s use increases in frequency, and amount and duration of time. With regular use, the body becomes dependent on the substance and the body can go through painful physical and emotional withdrawal (nausea, vomiting, diarrhea, cramping, headaches, anxiety, depression, hallucinations, delusions, seizures, and/or sometimes death) upon cessation of using drugs. Inpatient detox or medication assisted outpatient treatment (ambulatory detox, methadone, or suboxone treatment) is recommended and medications are prescribed to curtail the withdrawal, prevent fatal symptoms, and/or relapse. However, some people do not know they are physically dependent until they try to stop. Unfortunately, by that time, they unknowingly have also become psychologically dependent on the substance(s) and addictive behaviors.

Many who are drug dependent persons don’t try to stop their use due to fear and emotional dependence. They have learned to cope with their mental and physical pain by self- medicating. They have learned to deal with life stressors (unachieved goals, health problems, pain, financial stress, conflicted relationships, past trauma, and low self-esteem) through addictive behaviors. They maladaptively adjust to their negative emotions of anxiety, depression, anger, and fear associated with their stressors through drug or alcohol use and/or other addictive behaviors.  Some people do not become addicted to a controlled substance until they are first prescribed it for an emotional condition or physical pain. Because of tolerance, they abuse their medication by taking an increased amount to get the same effect (relief) they once had with the lesser prescribed dose. Some people prescribed a benzodiazepines medication like Xanax, Ativan, or Klonopin for anxiety have become addicted to it.  Some people who suffer pain from physical conditions or physical injuries become addicted to their prescribed opiate pill medication (Vicodin, Percocets, and Oxycontin) and later inject heroin as a substitute when their prescription has stopped. Like drug use, other addictive behaviors, such as excessive gambling and compulsive shopping, change the brain chemistry and creates a “high” which helps them forget their pain.

I would like to hear other experiences regarding addiction and mental health as well as any suggestions that would help others in their recovery. However, be aware that this is a public forum. I thank those who have shared their own experiences and insight with me over the last 30 years. You have made me a better person and psychotherapist by giving me knowledge which helps me provide guidance, compassion, and hope to others who seek my counsel.

Angela Beckerman, LPC, LADC

Psychotherapist and Addiction Specialist