September 20, 2019
Clinical Contributors to this Story
Steven Drzewoszewski, LCSW, LCADC, CCS, MINT contributes to topics such as Behavioral Health.
By Brianna McCabe
Imagine always feeling empty and isolated.
For as long as you can remember, you were never gifted with feelings of normalness, love, comfortability, satisfaction or fulfillment—both from others and from yourself. And, even if someone did try to uplift you and fill you with these feelings, for some reason you didn’t feel it was something that you were worthy of accepting.
Now imagine, just for a moment, that you have an experience—whether that be from the looseness you feel after pounding back a few drinks, an out-of-body high from a drug, the euphoria of winning big at a casino or the rush that overcomes you after an impulse purchase—and suddenly, you feel alive. In your mind, you have finally found something to fill that void that has pained you for so long.
You lean on it.
Then you depend on it.
Over and over and over again.
“Addiction, unfortunately, is a complex problem and disease that affects a person’s biological, psychological, social, emotional and spiritual life in all aspects,” says Steven Drzewoszewski, LCSW, LCADC, CCS, MINT, director of Substance Abuse Services for Carrier Clinic.
What are the factors that cause addiction?
As explained by Drzewoszewski, several factors can lead to addiction including a search for ways to relieve stress and injuries (such as being prescribed medications for pain relief which then turns into a dependence on opioids). “There’s also that whole nature versus nurture debate,” he adds, “which has been resolved in a lot of ways—it’s both.”
Is there a gene for addiction that gets passed down?
“It is a genetic disease,” Drzewoszewski confirms. In fact, the American Addiction Centers Resource (AACR) states that first-degree relatives of someone with a history of addiction are between 4 to 8 times more likely to develop problems with addiction themselves when compared to those who do not have a family member with an addiction.
“If you come from a family that has addiction in it, you should certainly be very careful as there is a likelihood you may develop an addiction yourself,” Drzewoszewski advises. “But it’s not just genetic—growing up in that environment can play an equal role.”
What happens if you grow up with parents suffering from addiction?
In households of parents suffering from addiction, Drzewoszewski expresses that there’s more than likely going to be turmoil, anxiety, stress, depression and possibly some trauma associated with that upbringing.
“Just imagine if there’s constant drinking or using, fighting and chaos—then you’re going to think that’s normal,” he says. This can create a cycle within the family of those abusing substances.
“Also kids, they are like antennas for emotions and energy—they pick up on this,” Drzewoszewski adds. “This can lead to faulty attachment issues, loneliness and depression. Kids will yearn for comfort—but sometimes they find this in the wrong things.”
Is there hope if I have a family history of addiction?
“Four to 8 times is a pretty big number,” cautions Drzewoszewski. “But there’s prevention and treatment options available.”
Children in the family can be offered a safe space, therapy, educational resources and early intervention programs to understand the disease and try to prevent a life of active addiction.
One of the big problems, Drzewoszewski warns, is that some families try to hide the addict or even dismiss the disease. “Addiction teaches the family three rules: don’t talk, don’t trust and don’t feel—as we must protect the family secret,” he says. “By doing this, though, families don’t learn how to properly cope.”
Additionally, Drzewoszewski explains that addicted family systems often become overly focused on trying to fix the addicted person at great cost to their own health and wellbeing. “They become so enmeshed in the problem that they no longer realize that they also deserve to have a life,” he comments. “Everyone starts to become affected by the disease and ‘sick,’ so to speak.”
With proper help and support, though, he says that there is hope and a future of recovery.
What are the signs of substance addiction?
According to Drzewoszewski, addiction is a progressive disease in which someone will become obsessed with his or her addiction and lose the ability to control cravings. Addiction is marked by signs and symptoms, which vary “quite substantially” by substance:
- Opioids. This class of drugs includes substances such as heroin, fentanyl and prescribed pain relievers (like oxycodone). Physically, a person might be lethargic, nodding off or have pinpoint pupils. Behaviorally, Drzewoszewski says that a person will experience a lack of interest of hobbies, have abrupt changes in friends, feel withdrawn, lose weight or have serious shifts in personality.
- Stimulants. When using a stimulant, such as cocaine, amphetamine or methamphetamine, a person may experience rapid heart rate, hyper-verbiage (rapid talking), loss of appetite, sweating, deceptive behavior, risky or impulsive actions or dilated pupils. Off the substance, though, Drzewoszewski notes that individuals may be severely depressed or anxious.
- Depressants. Often referred to as “downers,” these drugs reduce brain stimulation and can be marked by secretive behavior, mood swings, decreased social activity, periods of depression and withdrawal symptoms when not using the substance. Tranquilizers, sedatives, anesthetics and alcohol fit into this category of drug.
- Alcohol. “The major sign is a change in someone’s drinking patterns,” Drzewoszewski says. Additionally, an individual may face consequences, such as getting a DUI, feel agitated, miss appointments or scheduled events and will not be able to stop drinking. “Eventually, down the line there will be medical problems related with the addiction such as liver conditions or pancreatitis,” he adds.
- Inhalants. Entered into the lungs either directly (snorting) or indirectly (through paraphernalia such as rags), individuals addicted to inhalants may show signs of slurred speech, disorientation, exhaustion, drowsiness, nausea, rashes around the nose or mouth and loss of motor skills.
- Dissociatives. Perception-altering hallucinogenic drugs, such as phencyclidine (PCP) and ketamine, fall into this category. Those abusing dissociatives may show signs of immobility, numbness, slurred speech, blank stares, rapid eye movements, hallucinations and depression.
“There’s a lot of overlap in symptoms, though,” says Drzewoszewski, “because most of the time there is more than one addiction.”
Additionally, there are process addictions—such as with sex, food, gambling and shopping—which can have their own set of signs as well, he adds.
How does addiction grow?
“Everything is attributed somehow to a chemical change that has been created as a result of substance abuse,” explains Drzewoszewski. “And this change—this addiction—it grows over time at a different progression rate for each individual and substance.”
For instance, Drzewoszewski says that an alcohol addiction can typically take years before someone seeks help and is diagnosable, whereas someone with a stimulant addiction “may end up in a very bad position, very fast.”
There are different levels of progression:
- Early. “This is where you pretty much start to develop the addiction and may face one or two minor consequences, such as a person getting his or her first DUI, experiencing a first blackout or having difficulty making it to work. “They may also start having some problems at home due to drug use or drinking,” shares Drzewoszewski.
- Mid. According to Drzewoszewski, this stage is marked by a continued substance use despite adverse consequences—which then bleeds into other areas of the individual’s life. It’s in the beginning of this stage, he notes, that many experts like to ‘catch’ those experiencing an addiction. “If you try to help someone too early, most of the time his or her life hasn’t really gotten to a point where the addiction feels out of control yet,” he explains. “But in this stage, sometimes people are a bit more willing to hear what they need to hear to get the treatment to get back on track.”However, Drzewoszewski stresses that a person can recover at earlier or even later stages. “A person needs to get to a place where the desire to stop outweighs the desire to continue using,” he explains. “No matter what stage a person is in we should always try to reach them and support recovery, but we must also be prepared for them to reject our efforts if he or she is just not ready.”
- Late. “This is when the body starts to fall apart on you despite medical conditions due to substance abuse,” he shares. An addicted person does not continue using because they want to in this stage, but instead against their will. “Many have been through treatment multiple times and feel completely and totally defeated,” he continues. “Often they just don’t know what to else to do or feel it is too late—but it is never too late.”
“Our job, as experts, is to resolve the ambivalence of the addicted individual and tap into their internal motivation. We are the helper that provides the tools and support for a person to make a positive change,” says Drzewoszewski. “In the Narcotics Anonymous (NA) and Alcoholics Anonymous (AA) meetings, there’s a saying that goes, ‘You change when the pain becomes great enough.’ The issue there, though, is that everyone has a different threshold for pain.”
What should I do if myself or a loved one is suffering from addiction?
Drzewoszewski recommends seeking professional help if you or a loved one suspect substance abuse. “There’s more ways now than ever to get help, and not all treatment is created equal so do your research,” he says. “There’s hope and people do recover—I’ve seen it many, many times. Don’t give up.”
Carrier Clinic is a leader in specialized behavior health, mental illness and addiction treatment. Visit CarrierClinic.org or call 1-800-933-3579 for more information or to schedule an appointment.
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.
American Addiction Centers: Alcohol and Drug Abuse Statistics
Centers for Disease Control and Prevention (CDC): Alcohol and Drug Use
National Institutes of Health (NIH): Biology of Addiction
USA Today: Substance Abuse Addiction