Jamaica Gleaner
Published: Wednesday | July 22, 2009
Home : Profiles in Medicine
A D D I C T I O N !

Over the last few weeks the world has been taking a good look at drug addiction as, whatever Michael Jackson's cause of death, some are convinced that he started on the slippery slope to never, never land several years ago.

Although many medical professionals still do not agree on the exact nature of addiction, definitions speak of an obsession, compulsion or excessive psychological dependence on a substance or on a process (for example, gambling). Addiction has been described as a disease. One scholar suggests that addictive behaviour is aimed at achieving a specific pleasure or avoiding a specific discomfort. Let's take a look at drug addiction.

We don't know what exactly causes addiction. In drug addiction, the drug produces a reward by releasing increased amounts of some chemicals like dopamine in the reward circuit of the brain. Apart from the addictive nature of some drugs, there are some nature/nurture explanations. In many cases drug dependence is the outward sign of an underlying problem, for example, depression, anxiety, personal problems or peer pressure.

The drugs which many are addicted to include illegal substances, prescription and over-the-counter drugs. Addictive substances include stimulants such as caffeine, cocaine, nicotine and methamphetamine are addictive; sedatives such as alcohol and those used by doctors to treat anxiety disorders, muscle spasms and insomnia, such as alprazolam, triazolam and phenobarbital. Other addictive substances include opiates, powerful prescription painkillers, like morphine, codeine, heroin, oxycodone and pethidine. They depress certain brain function and calm emotional response to pain. They produce a 'buzz', a feeling of well-being (euphoria) and sleepiness.

Drug addiction is treatable

Treatments vary widely according to the types of drugs involved, amount of drugs used, duration of addiction and the user's psychosocial needs. Of course, the ultimate aim of treatment is abstinence from the drug. This is often difficult.

Anti-addictive drugs: There is no cure for drug dependence. The medical treatment with drugs usually gives users the opportunity to manage their lives and reduce their dependence.

1. Methadone which is used to treat opioid-dependence is actually an opioid, and is itself addictive, but is given temporarily as a substitute for heroin, morphine, oxycodone and other opiates considered more dangerous.

2. Naltrexone blocks the action of opioids and is given to opioid-dependent persons to help stop the physical cravings and to prevent relapse.

3. Buprenophine and lofexine have been found to be useful too.

Detoxification involves getting the user to wean from the drug, using less each day. There is some chance of recovery from substance dependence if detoxification is followed by several weeks in a rehabilitation facility.

Residential drug treatment (drug rehab programme) includes individual and group counselling, providing information about the addiction, and cognitive behavioural therapy by a mental health professional.

In a later article, we will look more closely at specific drugs which are abused such as prescription sedatives, alcohol, nicotine in cigarettes and THC in ganja (marijuana).

Dahlia McDaniel is a pharmacist and final-year doctoral candidate in public health at the University of London; email: yourhealth@gleanerjm.com.

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