Understanding the Nature of Addiction
“Addiction isn’t the use, or even the occasional abuse of a substance. It’s an obsessive desire—when something you take, drink or smoke becomes the master of your mind and the tyrant of your life.”
Bill Moyers - Moyers on Addiction: Close to Home
Most Texans have been affected by substance abuse in some manner. Drug and alcohol abuse and addiction is truly experienced close to home. For many, it is a frustrating, confusing and heartbreaking experience to encounter a loved one, co-worker, friend or neighbor who is actively dependent on drugs or alcohol. It seems they would be able to stop if they really wanted to. But, the hallmark of addictive disorders is the inability to limit the use of alcohol or drugs despite negative consequences or the desire to stop. Addicted individuals are compelled by a powerful, compulsive craving and they are not able to “stop” without help.
Addiction is a chronic, progressive fatal disease and not just “a lot of drug use”. The addictive disease process actually begins with drug or alcohol use– when a person makes a conscious choice to use a mood altering substance. People begin using drugs for a variety of reasons, but basically people take drugs because the drug makes them feel better immediately. This happens because drugs change brain function.
Recent scientific research provides overwhelming evidence that not only do drugs interfere with normal brain functioning but they also have long-term effects on brain metabolism and activity. All abusable drugs such as cocaine, alcohol, marijuana, and nicotine involve the release of dopamine, a neurochemical found within the brain that is involved in the experience of pleasure. The more a person uses drugs to induce feelings of pleasure, the more a person tends to repeat the drug-using behavior and the more the brain learns to depend on drugs to evoke pleasure. Eventually, the drugs decrease the brain’s ability to experience pleasure without the drug and the person becomes addicted. The drug has literally changed his or her brain functioning.
Addiction typically follows a sequence of identifiable stages based on escalating use. Each stage entails some risk of progression to the next. As the frequency and amount of substance use increases, so do the related physical, social and psychological problems.
Results from National Institute on Drug Abuse (NIDA) funded prevention research have shown that comprehensive prevention programs that involve the family, schools, communities and the media are effective in preventing the onset of use and in reducing escalating substance abuse. Numerous studies including NIDA research have also demonstrated that addiction is clearly treatable and has outcomes comparable to other established treatments for chronic diseases such as diabetes, asthma and hypertension (Physician Leadership on National Drug Policy). With treatment, patients can learn to control their condition and live normal productive lives.
At a time when research is providing scientific evidence to better understand the nature of addiction and the value and efficacy of prevention and treatment services, moral stigma about drugs and alcohol remains. All too often addiction is perceived and handled as a moral or legal problem, rather than a preventable, treatable health issue. A better understanding about addictive disorders and the effectiveness of prevention and treatment services illustrates why adopting a comprehensive public health approach to drug and alcohol problems in Texas is a positive policy response.
Providing improved access to substance abuse prevention and treatment is a practical, strategic and cost saving measure for Texas.
A growing body of scientific research continues to demonstrate that the societal and financial burdens associated with drug and alcohol abuse and addiction can be effectively reduced with prevention and treatment services. We continue to pay a high price for the effects of substance abuse as it takes a heavy toll on our economy, health and safety. Providing improved access to substance abuse services is a practical, strategic and cost saving measure for Texas.
Every dollar spent on treatment saves taxpayers $7.00, [1994 CALDATA].
For every dollar spent on drug use prevention, communities can save $4 to $5 in costs for treatment and counseling, [NIDA].
A Blue Cross Blue Shield study found that treatment resulted in a collateral drop in health care costs of family members by more than 50%, [Treatment for Addiction: Join Together].
An extensive cost effectiveness study in Ohio on the impact of treatment on job performance found absenteeism was reduced by 61%, incomplete work was reduced by 37% and errors dropped by 36%, [CSAT- Producing Results].
Cornell University Researchers found that the odds of engaging in substance use was 40% lower among students who participated in a school based substance abuse program in grades 7-9 than their counterparts who did not, [CSAP Prevention Works].
Treatment is 15 times more effective in reducing crime than incarceration. For every one crime that incarceration would eliminate, treatment would eliminate at least 15, [RAND Corp. 1997].
Individuals in federally funded treatment decreased their welfare use by 10% and increased their employment 18.7% one year after treatment, [NTIES].
A perinatal treatment program in Baltimore saved $18K - $26.5K per treated mother-infant pair compared with the cost of treating one drug-exposed infant, [Legal Action Center: Making Welfare Reform Work; 1997].
A vital part of the solution for drug and alcohol problems must include prevention and treatment services on many fronts. The problems and costs associated with substance abuse are experienced within the workplace, healthcare, public assistance, education, law enforcement and criminal justice systems. Adopting a public health approach that incorporates prevention and treatment services within these systems will positively impact the State.
REDUCE HEALTH CARE COSTS: Expand access to prevention and treatment services through private health insurance and public healthcare systems.
DECREASE WELFARE DEPENDENCY: Recognize and address drug and alcohol problems as a barrier to self sufficiency and include prevention and treatment services in Texas welfare reform programs.
STRENGTHEN TEXAS YOUTH, FAMILIES AND COMMUNITIES: facilitate coordination, collaboration and expansion of substance abuse prevention services to help children grow up healthy, principled and productive.
CURTAIL CRIME, RECIDIVISM AND CRIMINAL JUSTICE COSTS: move toward full implementation of the treatment levels specified in the Texas Criminal Justice Treatment Initiative.
INCREASE WORKPLACE PRODUCTIVITY: Provide employers with incentives to establish drug and alcohol free work environments.
ENHANCE HEALTH CARE DELIVERY: Educate healthcare professionals to recognize drug and alcohol abuse and dependency symptoms which will facilitate the provision of cost effective early intervention and treatment.