Substance use disorder: Addiction is a disease, not a moral failure – Expert

An addiction to medicines may go unnoticed by close family, colleagues, and friends, although these sometimes legal drugs can do more harm than good if they become a source of dependence.

When medicines are overused, anyone, young or old, can slip unwittingly into drug abuse. “Addiction to medication, such as codeine, which is found in over-the-counter painkillers and cough syrup, sleeping pills or prescription tranquillisers can be as harmful as addiction to illegal drugs.

“However, many people affected do not recognise they are developing a problem until they are in the grip of a substance use disorder,” says clinical psychologist, Janine Deiner, who practises at Akeso Alberton.

“While the individual may begin using substances such as these either to self-medicate for physical pain or on the advice of a healthcare professional, it is all too common to develop a tolerance to the medication, which means they need to take more and more to get the same effect.

In time, they may find they cannot function normally without taking the medication,” she says.

“In addition, people suffering from stress, anxiety or symptoms of depression may try to self-medicate, trying to numb emotional pain. In the short term, this may help to mask the symptoms of a mental health condition but, ultimately, it fuels addiction and makes the condition worse.”

According to Deiner, people often delay seeking treatment because they have difficulty recognising that their habit has become a potentially devastating addiction, especially since medicines may be perceived as more socially acceptable than illegal drugs.

She suggests seeking help if you notice any of the following:

-Feeling anxious or stressed about not being able to access the medicine, which is not otherwise medically needed;

-Craving the medicine, or don’t enjoy being without it;

-Visiting multiple doctors to get prescriptions and different pharmacies to fill the prescriptions, or to buy enough over the-counter medicine to get you through in your daily functioning;

-A preoccupation with the medicine, particularly if it consumes a considerable amount of your time and energy or requires time to recover from its effects;

-Justifying why you need the addictive substance. For example, “It’s been a stressful day, I need some pills to unwind.”;

-You may have tried to cut down or control the use of the medicine before but are unable to stop completely; v If you can’t access the medicine, you can’t get through the day or sleep at night; and

-It has started to negatively affect your work performance, social or family relationships, but you can’t stop taking it.

“People who have a dependency or addictive disorder may begin to display changes in their behaviour, neglect their responsibilities and may be unable to function in their daily lives,” says Deiner.

Those closest to the person may notice that the individual:

-May often be tired or drowsy;

-Sleeps more than usual;

-Withdraws socially;

-May seem irritable or twitchy;

-Suffers stomach problems;

-Takes frequent trips to the pharmacy; and

-Has an excessive amount of medicine or empty medicine packages. Sandy Lewis, Netcare’s mental wellness and compassion coach, adds that no one should feel ashamed about seeking help for any kind of substance use disorder.

“Addiction is a disease, not a moral failure. If you are having difficulty getting through a few days or a week without taking medicine, approach your pharmacist and have an honest and confidential discussion about your dependence on the medicine,” she says.

“Pharmacists are highly accessible healthcare professionals with the knowledge and skills to advise and provide referrals to help you get the better of potentially problematic use of medicines, or any concerns or questions you may have about using medicines appropriately.”

Deiner adds that people may develop a tolerance to medicines with habitual use, meaning the person will require larger doses to achieve the same effect, putting the person at risk of potentially fatal overdose, or leading to addiction to other types of drugs.

“Addiction frequently manifests together with other psychiatric conditions such as depression, anxiety, or other mood disorders. “

The professional healthcare teams at dual diagnosis units at Netcare Akeso mental health facilities provide integrated treatment programmes, which take into account that such conditions are often interrelated,” she says.

“Irrespective of which came first, addiction and other mental health problems, both contribute to a destructive cycle, and we find that a holistic multidisciplinary treatment approach, which seeks to address both the addiction and the other mental health problems in tandem, tends to offer better patient outcomes.”

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