well as address the physiologic and psychologic
aspects of the substances to which the person has
addictions. In the short term, SUBSTANCE ABUSE
TREATMENTmay require intensive psychologic sup-
port and therapy through an outpatient or inpa-
tient substance abuse treatment program.
Treatment may involve medical care for symp-
toms of WITHDRAWAL SYNDROMEresulting from drug
dependence, such as NICOTINE REPLACEMENTpatches
for tobacco dependence, METHADONEorBUPRENOR-
PHINEfor opiate dependence, and disulfiram for
alcohol dependence. Medication therapy may also
focus on treating underlying or accompanying
psychologic disorders such as DEPRESSION(ANTIDE-
PRESSANT MEDICATIONS) and anxiety (ANTIANXIETY
MEDICATIONS). Treatment programs typically also
include intensive psychotherapy, BEHAVIOR MODIFI-
CATION THERAPY, COGNITIVE THERAPY, group therapy,
and peer support. These approaches attempt to
help people understand their motivations for seek-
ing the effects of the substance of abuse, the
behaviors they indulge in to achieve the sub-
stance, and the ways in which they can replace
those behaviors with others that support nondrug-
seeking behaviors.
Relapses are common among people who have
addictions. Once established, an addiction remains
a powerful compulsion even with treatment and
methods to mitigate its strength. Absolute avoid-
ance of the substance or behavior (abstinence) is
crucial; most addiction experts agree that people
who have addictions cannot experience “just a lit-
tle” of the addiction’s source without succumbing
again to the addiction. Though researchers do not
fully understand the complexity of addiction’s
mechanisms, they do know that even small expo-
sure to the source can reactivate the addiction.
Long-term REMISSION requires persistence and
determination in combination with a strong sup-
port network of family, friends, and health-care
providers.
Risk Factors and Preventive Measures
Multiple factors contribute to addiction. Among
the key risks are
- underlying psychologic conditions such as
depression, ATTENTION DEFICIT HYPERACTIVITY DIS-
ORDER(ADHD), andPOST-TRAUMATIC STRESS DISOR-
DER(PTSD)- intense feelings of anxiety, loneliness, and loss
- PEER PRESSURE
- family history of ALCOHOLISMor substance abuse
Though genetic factors likely exist that con-
tribute to an individual’s vulnerability to addic-
tion, researchers believe such factors are multiple
and affect numerous processes within the body. As
well, some drugs have higher potential for addic-
tion, notably those that produce an intense
response to taking them. Such drugs include
methamphetamine, heroin, and cocaine.
It often seems, to those outside looking in at
addiction, that the simple solution to preventing
addiction is making the choice not to use drugs or
alcohol. This is an effective solution in many cir-
cumstances; the person who is able to avoid the
substance does not develop addiction to sub-
stances if not taking them. However, the health
condition of addiction is complex; one of its most
destructive features is its ability to impair a per-
son’s capability to make such choices. The conse-
quences of addiction are often severe yet do not
deter the pursuit of the addiction’s source. The
most effective prevention efforts are those that
combine education about substance abuse and its
negative health effects with measures to help peo-
ple choose not to use substances of abuse the first
time.
See also GENERALIZED ANXIETY DISORDER (GAD);
ILLICIT DRUG ABUSE; NALTREXONE;OBSESSIVE–COMPUL-
SIVE DISORDER(OCD); PRESCRIPTION DRUG ABUSE; SMOK-
ING CESSATION; SCHEDULED DRUG; SUBSTANCE ABUSE
PREVENTION; TOLERANCE.aerosols and glues See ORGANIC SOLVENTS.alcohol In the context of health and substance
abuse a fermented or distilled beverage containing
ethanol (also called ethyl alcohol) that, when
ingested, has numerous effects on the body, rang-
ing from mild relaxation to INTOXICATION. Alcohol
consumption is legal though regulated in the
United States by federal and state laws and pro-
hibited by minors (those under age 21). Each state
establishes the laws and regulations that govern its
alcohol sales. However, access to alcohol is such
that underage alcohol consumption is a significantalcohol 315