Addiction is among the most serious public health issues facing the United States today. Over 20 million Americans are estimated to have a substance abuse disorder of some sort, with drug addiction challenges costing our healthcare system around $740 billion annually. Without proper treatment, drug abuse and addiction can change lives forever, harming friendships and family relationships, hampering career and educational growth, and even ending lives: over 72,000 overdose deaths occurred in 2017 alone. Addiction doesn’t stop at illicit drugs, either; any substance, from shopping to gambling to sex, can create both physical and mental compulsions based on the reward centers in the brain, driving behavior in unhealthy and obsessive ways.
Even with the differences in forms of addiction and the behaviors caused by addiction, the end result is largely the same. While users can often remain reasonably functional for a time, like alcoholics who still manage to hold down a job and care for a family, things eventually start to slide. At this point, many users are resistant to get help, assuming that when it’s time, they’ll be able to stop. When the plates start to fall – job loss, breakups, or legal issues, for example – an effort to quit may begin in earnest, but by this point, the bonds are too strong and without help, it’s extremely challenging to return to a normal way of life.
This is what you need to know to identify addiction in its early stages before rock bottom draws near, highlighting red flags to look for in your friends, family members, and even yourself.
One thing that makes it hard to spot the signs of addiction in yourself and others is the common image of an addict. We don’t usually picture an addict as an individual taking prescription drugs, obsessively gambling, spending wildly, being promiscuous or having other addictive behaviors. Instead, there’s a perception that most addicts take illegal drugs and live in poverty or on the streets. Some people believe all addicts come from dysfunctional families or experience serious life traumas.
Stereotypes and Misconceptions About Addiction
There’s also a misconception that a person can’t be addicted if they’re holding down a job and taking care of a family. Here are some of the common false beliefs about addiction that keep people from identifying it in themselves or a loved one:
- It’s a choice that can be changed at any time.<
- The only types of addiction are dependence on drugs and alcohol.
- It’s hard to tell if a person is addicted.
- Successful people aren’t addicts.
- You can’t get addicted to prescription drugs.
- Alcohol dependence isn’t as bad as drug addiction.
- Addiction treatment doesn’t work.
The Truth About Addiction
Addiction is a continuum, and if it’s not stopped, it can take over anyone’s life. In the middle stages of addiction, a person may be able to present a false image to others. To outsiders, it may look like they’re successful in their profession and meeting family commitments. That’s because people who are addicted are often skilled at defense mechanisms that hide their condition. They may attribute physical signs of addiction to other causes or minimize their consumption of drugs and alcohol.
One of the most harmful beliefs for anyone who’s considering treatment for addiction is that addicts can’t change. With professional help and rehabilitation, anyone can beat an addiction. Medical care and addiction counseling help break the cycle of dependence. There are successful outcomes both at the first early signs of addiction and when drugs, alcohol or other physical and emotional crutches have taken over.
Seeing the Signs of Addiction
Addiction often starts slow. Maybe a friend will try a common drug at a party, or take a drink in a dorm room away from home for the first time. Maybe addiction will start with a great night out at the poker table, or with the use of a legitimate prescription drug to treat a medical condition. Whatever the reason, use starts somewhere, and it’s generally not chronic from the beginning. As such, it can be extremely difficult to accurately interpret the signs before it’s too late.
In the earliest days of addiction, when it is viewed as an indulgence without addiction, it is used as a pleasure that is fun and entertaining – or, for those who develop addictions to medications legally prescribed, it may offer a euphoric escape from chronic pain. Use may be frequent or semi-frequent, but generally isn’t dominating. However, in time, this will change. This may depend on the individual, some are able to continue using in secret for months or years, but as dependence grows, so does abuse. Use will accelerate from occasionally to always, with a substance dominating all or most of the time an individual spends doing anything. Before long, the substance in question will surpass virtually everything else in life.
In evaluating signs and symptoms of addiction, it’s important to understand how lifestyles and attitudes change in time. It’s easy to make excuses for those who are close to you, mistakenly assuming that new behavior patterns were always in place or failing to see the signs out of denial or simple naivete. For this reason, be objective about the signs you’re seeing in those around you, even if it’s tempting to rationalize them away.
- How has behavior changed? Has a previously studious individual given up on school, or a once-dedicated employee quit work?
- Were there any triggers that may contribute to a growing substance problem, like divorce or the death of a loved one?
- Is an addictive drug taking over in a way it never used to?
- Has a once-open relationship changed to one of secrets and hiding things, like plans and whereabouts?
- Has substance use become a crutch or a form of stress relief never previously needed?
While it’s only natural to idealize loved ones, in evaluating addiction, being as realistic as possible is always an advantage.
The Evolution from ‘Want’ to ‘Need’
For many users, the most critical turning point comes at the intersection between want and need. Many Americans live life balancing the things they want to do – sleep all day, or skip work to spend time with family and friends, for example – with the things they know they need to do – go to work and cook dinner – and most adults are at the very least competent in achieving an appropriate split. However, for those with a burgeoning addiction, ‘wants’ begin to cross the lines into needs. While many people like drinking, an alcoholic needs to drink, and his motivations will begin to change greatly with this in mind.
Those who need an addictive substance or activity will be far less flexible and compliant than those who simply like to relax or indulge from time to time. From a disinterest in previous hobbies to reluctance to change plans, as addiction sinks in, outside activities and obligations become far less important.
Extreme Behavioral Shifts
Those who are addicted or on the brink of abuse or reliance will often show behavioral signs. These include:
- Secretive behavior, like hiding plans, failing to give explanations for whereabouts and covering up potentially suspicious activities
- Inability or extreme reluctance to change plans
- Lying about plans; for example, pretending to spend more time at the office rather than admitting to an increasing presence at the bar
- Financial troubles; most addictions can be quite expensive, and the average individual will not be able to spend hundreds or thousands of dollars a month on a vice without raising suspicion
- Stealing, either money or substances
- Interest in isolation; those hiding addictive behaviors will not want others around
- Disregard of others, including friends and family
A single sign can be indicative of any number of personal or behavioral problems, but as the evidence begins to mount, denying addiction becomes far less likely.
How to Spot Withdrawal
For those stuck in a downward spiral, it’s not uncommon to attempt to quit without intervention, whether due to want, need, or a combination of both. This may be done out of shame due to conflicts in life, like challenges at work or at home, or to attempt to take control the situation without letting anyone else know how bad an addiction is getting. Unfortunately, this is generally easier said than done.
Trying to quit, whether going cold turkey or using detox guides available on the Internet, can be both challenging and dangerous, and it’s not uncommon to see rapid relapse rates in patients attempting recovery without professional support. For this reason, these individuals may show withdrawal signs, whether short-term or long-term. While withdrawal will differ from one substance or activity to another, it is often characterized by symptoms that include:
- Anxiety and paranoia
- Irritability, anger, and mood swings
- Nausea, vomiting, and intestinal discomfort
- Muscle weakness or cramping
- Insomnia
- Apathy or depression
- Intense, obsessive cravings
For many substances, these withdrawal symptoms are derived from the physical components of addiction; when the brain chemistry adjusts due to prolonged use, removing the presence of a substance can be deeply uncomfortable. The unpleasant nature of withdrawal is a direct contributor to relapse.