What is it about ?
Drug addiction (addiction) should not be confused with dependence.
We talk about drug dependence when stopping a drug that has become unnecessary causes withdrawal signs. This is the case, for example, when you want to stop antidepressant treatment because the depression is cured. Signs of withdrawal from the antidepressant drug appear. This requires gradually reducing the antidepressant treatment.
Addiction is the repetition of addictive behaviors, for example the consumption of drugs. It is due to irrepressible cravings, despite a desire and motivation to abstain. There is then a psychological and / or physical need with signs of lack as well. It is necessary to gradually increase the doses of the drugs consumed to feel the same effects. We are talking about tolerance and addiction. In drug addiction or drug addiction, the person does not consume or no longer consumes drugs with the aim of treating an ailment, even if he actually suffers from this ailment, but seeks the psychic or physical effects of the drugs. This usually results in inappropriate behavior. For example, she may try to get a prescription at any cost, regardless of the consequences.
Addictive drugs mimic the action of certain substances in our brains, but with increased potency. They allow us to feel good, to relax, to feel pleasure, etc. You can develop an addiction to different drugs:
- Opioid painkillers such as morphine, oxycodone, codeine, tramadol;
- Stimulants that improve concentration: centrally acting appetite suppressants, a drug for attention deficit hyperactivity disorder (ADHD) (methylphenidate);
- Painkillers: cough preparations that contain opioids, sleeping pills (benzodiazepines) such as alprazolam or lorazepam;
- Medicines which have a euphoric effect when combined with alcohol.
How to recognize it?
A person who suffers from drug addiction knows very well for which complaints the drugs he needs are prescribed. She can describe these complaints as they are described in medical textbooks.
She may report abusing drugs and wanting to quit, but she needs it time to get through this difficult time.
The person with the addiction will try to build sympathy by talking about moving stories, faking physical problems such as neck pain, migraines or kidney stones, and presenting evidence of their illness such as reports. medical. A number of people do have the disease they claim to have.
The characteristic symptoms of people who suffer from drug addiction are memory loss when using high doses and self-destructive, demanding and threatening behaviors.
A person who suffers from drug addiction rarely consults his own doctor, but regularly several other doctors (“medical shopping”). She can threaten the doctor directly, by violence or blackmail. She often chooses young doctors or doctors willing to write prescriptions in exchange for financial gain.
What can the doctor do?
If the doctor suspects a drug addiction, he will talk to the person. He will try to understand the situation and offer help. The doctor will explain that although the signs of withdrawal can be bothersome, they are rarely life threatening. However, high doses of sleeping pills (benzodiazepines) are associated with a risk of epileptic seizures. On the other hand, in the event of uncontrollable abuse, there is a high risk of death by overdose.
If the person demands a prescription, the doctor will not give in under the threat. He can immediately call the police and report the blackmail to the authorities.
The doctor will carefully examine the person, possibly offer them an appointment at a specialized center and help them during their rehabilitation. He may prescribe pain reliever medication or alternatives for sleep disturbances.
Some people who take sleeping pills (benzodiazepines) actually need the drug on a regular basis to relieve severe and chronic anxiety. The doctor will therefore regularly check whether there is a risk and signs of heavy drinking and, if necessary, will intervene immediately while offering support to the person.
A person who suffers from drug addiction and is in a disturbed psychological state may require treatment in hospital. Once in the hospital, the examinations can be carried out with the consent of the person, or under duress depending on their condition and the legislation in force.
The following questions provide an update on addiction:
- When were the drugs first prescribed and why?
- When did the situation escape you?
- When did you start to abuse drugs?
- What was the part of the daily dose prescribed by the doctor?
- How much was purchased illegally?
Medicines intended to control the withdrawal process and the symptoms associated with it are dispensed either under supervision in a specialized center or by the pharmacist in consultation with the doctor. The doctor will monitor the person’s progress fairly closely.
The aim is to stabilize drug abuse in order to break the vicious circle of the growing need for drugs and the resulting overdoses and to avoid withdrawal signs such as seizures or states of extreme confusion (delirium).
The rate at which the dose of medication is reduced is different from person to person. If the person is addicted to multiple substances, the chances of successful detoxification may be negated as the person falls back into heavy drinking. In this case, the treatment of alcoholism should be intensified, for example by the administration of drugs under supervision. If these measures fail, the person can be admitted to a specialized center.
The treatment of addiction to opioid-type painkillers (morphine derivatives) is in principle identical to the treatment of addiction to sleeping pills, with a gradual reduction in the dose.
If the withdrawal symptoms are too debilitating, they can be alleviated by administration of clonidine. If the urge for painkillers seems to intensify again after relief from the signs of withdrawal, naltrexone can be used to prevent a relapse.
If stopping opioid-type painkillers repeatedly fails, addiction can in some cases be interpreted as chronic opioid addiction, which warrants opioid replacement therapy. Methadone treatment can then be set up under medical supervision. National legislation and other local regulations provide more detailed information on the subject.
Want to know more?
- Sleeping pills or tranquilizers, update on your consumption – Stop or else?
- Sleeping pills and sedatives, think before consuming – FAMHP – Federal Agency for Medicines and Health Products
- Painkillers and self-medication – Federal Agency for Medicines and Health Products
- Opioids – CBIP – Belgian Center for Pharmacotherapeutic Information
- Benzodiazepines – CBIP – Belgian Center for Pharmacotherapeutic Information
- Methylphenidate – CBIP – Belgian Center for Pharmacotherapeutic Information
- Medicines for opioid dependence – CBIP – Belgian Center for Pharmacotherapeutic Information
- Clonidine – CBIP – Belgian Center for Pharmacotherapeutic Information
- Naltrexone – CBIP – Belgian Center for Pharmacotherapeutic Information
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