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What Is The Process Of Diagnosing Addiction?

What is the process for diagnosing addiction? Addiction Alternatives

What Is the Process for Diagnosing Addiction?DSM-5 Diagnostic and Statistical Manual of Mental Disorders Book Cover

Addiction is a chronic condition that can be difficult to diagnose and treat properly. Addiction is not a disease that can be treated solely on the diagnosis from a doctor. While the signs may be glaring, diagnosing the disease requires the person struggling with addiction to acknowledge the problem and having the desire to address the disease. 

Initially, the diagnosis of addiction caused controversy in previous editions of the Diagnosis and Statistical Manual for Mental Disorders (DSM). However, the newest edition has combined substance abuse as well as dependence in a new category, substance abusedisorder.

The DSM-V was the first to include gambling addiction in the definition, as the behaviors associated triggers similar reward circuits as with other substance abuse disorders.

The Diagnostic Process

The first step in diagnosis requires acknowledgment from either the person with addiction themselves, a friend, or family member.

This is typically the most difficult step. Often times this step involves a personal or group intervention if an individual with substance use disorder is unable to see the extent of the problem.

Those with a suspected substance use disorder can begin their recovery process by visiting their primary care provider who can refer them to an addiction facility or rehabilitation specialist.

The suspected addict will go through a series of questions with their PCP about frequency of use, impairment of daily living, and whether the use of a substance is increasing. The primary care provider will also ask questions about how the pattern of use is impacting important social, occupational, education or other functional areas of the person’s life.

Questions regarding withdrawal symptoms that will have possibly occurred during times when the person has attempted to decrease or stop will narrow in on the severity of the disease progression.

The doctor will the complete a physical exam and run blood work to assess the overall health of the individual. This will help to determine
the type of facility that is appropriate for the individual.


Prescription Pills Addiction Diagnosis

Criteria

The DSM-V separated substance abuse disorder into nine individual categories.

  • Alcohol-related disorders
  • Caffeine-related disorders
  • Cannabis-related disorders
  • Hallucinogen-related disorders
  • Inhalant-related disorders
  • Opioid-related disorders
  • Sedative-, hypnotic-, or anxiolytic-related disorders
  • Stimulant-related disorders
  • Tobacco-related disorders
  • Other, or unknown, substance-related disorders
  • Non-substance-related disorders

DSM-V lists varying criteria for the above categories and many dependencies are accompanied with different withdrawal symptoms that occur when an individual does not have the ability to obtain the substance.

To receive a diagnosis of substance use disorder, an individual must demonstrate two of the following criteria within a 12-month period:

  • Regularly consuming larger amounts of a substance than initially intended or for a longer amount of time than anticipated
  • Often attempting to moderate the intake of a substance without actually reducing consumption or at least wishing to moderate the intake
  • Spending long periods trying to obtain or recover from use of the substance
  • Expressing a strong desire or craving the substance
  • Failing to fulfill professional, educational, and family obligations
  • Regularly using a substance in spite of social, emotional or personal issues it may be causing
  • Giving up pastimes, passions or social activities as a result of substance use
  • Consuming the substance in places or situations that could cause physical injury
  • Continuing to consume a substance despite being aware of physical or psychological harm it is likely to have caused
  • Increased tolerance, meaning that the person must consumer more of the substance to achieve intoxication
  • Withdrawal symptoms, or a physical response to not consuming the substance that is different for varying substances but may include sweating, shaking and nausea.

The number of qualifying criteria a person demonstrates helps define the severity of the dependence. If a personal regularly demonstrates two of three of these criteria, the DSM advises that that have a mild substance use disorder.

A person with four to five of these criteria would have a moderate substance use disorder. Six or more continuous prevalence in criteria would denote a severe addiction.

As new evidence emerges regarding addictive disorders, researchers attempt to determine whether or not they can develop reliable diagnostic criteria.

Some addictive disorders appear in the International Classification of Disease, Tenth Edition such as sex addiction, which the ICD-10 classes under the category of “other sexual dysfunction not due to a substance or know physiological condition”.

Whereas the DSM-V does not acknowledge sex addiction as a diagnosis.

A study from 2016, suggests that smartphone addiction is a developing condition and fits within the criteria of addiction.

Take Away

The DSM-V uses a category called “substance use disorder” to group addictive disorders.

Diagnosing the substance use disorder is a vital first step from either the person with the condition or someone close to the individual. Acknowledging and accepting the fact that a health problem exists must also be accompanied with wanting help, otherwise treatment is unlikely to be a success.

A doctor will ask about the patterns of use to determine the fit within the criteria in the DSM-V. Primary Care Providers will also assess the impact of physical damage already prevalent as a result of the substance use disorder.Addiction Diagnosis

To match the criteria, an individual must present two or more signs of addiction over the previous 12 months, including consuming more and more quantities, continued use despite severe consequences, and a reducing interest in activities and socializing.

A person who fits a large number of criteria is diagnosed with a severe substance use disorder.

The doctor will then refer the individual for specialized care.

Importance of Treating Opioid Disorder During Pregnancy

Risks of Opioid Misuse During Pregnancy

Untreated opioid use disorder during pregnancy can have life-threatening effects for the unborn baby. Frequent changes in opioid levels for the mother can expose the baby to multiple periods of withdrawal, which can be harmful for placenta function.

Other direct physical risks include but are not limited to the following:

  • Neonatal abstinence syndrome
  • Stunted growth
  • Preterm labor
  • Fetal convulsions
  • Fetal death

Other indirect fetal risks include:

  • Increased risk for maternal infection (I.e.: HIV, HBV, HCV)
  • Malnutrition and poor prenatal care
  • Dangers drug-seeking behavior (I.e.: violence, incarceration) 

What is Neonatal Abstinence Syndrome?

Neonatal abstinence syndrome or NAS occurs when an infant becomes dependent on opioids or other drugs used by the mother during pregnancy. The infant can experience symptoms of withdrawal that can include tremors, diarrhea, fever, irritability, seizures, difficulty feeding, and death.

NAS has increased nearly fivefold nationally between 2000 to 2012, which is in correlation with rising rates of opioid use disorder overall.

Medically Driven Solutions

Evidence-Based Treatment

Buprenorphine and methadone have been proven as safe and effective methods of treatment for opioid use disorder for pregnancy. While NAS may still occur for babies born by mothers receiving these medications, it has shown less severe than in the complete absence of treatment. Research does not support reducing medication dose to prevent NAS, as it may lead to increased illicit drug use by the mother. Which will result in greater risk to the fetus.

Methadone vs. Buprenorphine

While recent studies have shown an associated higher treatment retention rate with methadone, buprenorphine has shown better results for the fetus. Those findings are listed below:

  • 10 percent lower incidence of NAS
  • Decreased neonatal treatment time by 8.46 days
  • Less morphine needed for NAS treatment by 3.6mg

Patients should work closely with their doctor to determine the best form of treatment for them.

Breastfeeding During Treatment

While breastfeeding statistics are typically low with mothers suffering from opioid use disorder, studies have shown that breastfeeding can decrease the length of hospital stay as well as lowering the need for morphine treatment for infants. Unless there are specific medical concerns such as maternal HIV infections, mothers are encouraged to breastfeed and swaddle newborns to ease infant NAS symptoms and improve bonding.

Methadone and Buprenorphine Can Effectively Treat Opioid Use Disorder During Pregnancy

Since the 1970s methadone has been used to treat pregnant women with opioid use disorder and has been recognized as the standard for care by 1998. However, studies have shown that buprenorphine is a feasible alternative treatment. The American College of Obstetricians and Gynecologists and the American Society of Addiction Medicine support both methadone and buprenorphine treatment as the best treatment options for pregnant mothers with opioid use disorder.

Benefits of Treatment During Pregnancy

Methadone or buprenorphine treatment improves infant outcomes by the following:

  • Stabilizing fetal levels of opioid, therefore, reducing repeated prenatal withdrawal
  • Providing mothers with infectious diseases (I.e.: HIV, HBV, HCV) access to treatment, therefore, reducing the likelihood of transmission of disease to the unborn baby
  • Providing more stabilized opportunities to better prenatal care improving the long-term health outcomes for both mother and baby

When compared to mothers who were left untreated, women who are treated with methadone or buprenorphine generally have infants with:

  • Lower risk of NAS
  • Less severe NAS
  • Shorter treatment time
  • Higher gestational age, weight, and head circumference at birth

Solutions Driven Science

Increasing Treatment Prescribing

NIDA-funded studies are evaluating the key barriers and facilitators to prescribing methadone and buprenorphine for pregnant mothers suffering from opioid use disorder. Current projects include:

  • Validating reliable screen tools to identify pregnant women in need of treatment
  • Analyzing infant outcomes to inform medication selection for mother suffering from opioid use disorder
  • Evaluating behavioral interventions for misuse of opioids during pregnancy 

Improving Treatment Strategies

Treatment with either methadone or buprenorphine does have some risk for infants developing NAS. Dividing dosing with methadone such as taking smaller doses more often – reduces fetal exposure to potential withdrawal periods between doses. Mothers treated with divided doses often deliver babies with a lower NAS severity. Currently, the study is also examining buprenorphine during pregnancy and how to improve the dosing regimens.

Improving Engagement in Treatment

  • The stigma and bias often shown from healthcare providers can result in under-reporting of drug use and insufficient medication dosing which often leads to the delay or infectiveness of treatment
  • Eighteen states classify maternal drug use as child abuse and three states consider it as reason for involuntary hospitalization, therefore, decreasing the likelihood of women seeking treating.
  • Studies have shown to the contrary that women who are allowed to stay with their children during treatment are more likely to successfully undergo treatment for the duration of the pregnancy and to maintain abstinence afterward.

Supporting Access to Treatment

Health insurance providers that cover treatment for substance use disorder are required to provide coverage equivalent to what is provided for other health conditions. Dr. Buscema, has made it the mission of Addiction Alternatives to help pregnant women suffering from opioid use disorder to not only provide treatment but to also find access to gynecologists and obstetricians in the area inclined to help these mothers during and after pregnancy.

Where Can I Get More Information?

If you or someone you care about is pregnant and has opioid use disorder:

Call Addiction Alternatives at (772) 618-0505

Visit our site at www.addictionalternatives.org

Statistical information provided by:

https://www.drugabuse.gov/publications/treating-opioid-use-disorder-during-pregnancy/treating-opioid-use-disorder-during-pregnancy

https://www.stanfordchildrens.org/en/topic/default?id=neonatal-abstinence-syndrome-90-P02387

https://archives.drugabuse.gov/news-events/nida-notes/2012/07/buprenorphine-during-pregnancy-reduces-neonate-distress

https://www.hindawi.com/journals/jp/2014/906723/

https://www.jognn.org/article/S0884-2175(16)30208-8/pdf

Opioids: The Crisis Next Door

The Crisis Next Door: Stories of the opioid epidemic

THE CRISIS NEXT DOOR

The US government has created a website to inspire hope for people suffering from opioid addiction.  On the website, Crisis Next Doorthere is a list of different people and their stories.  Some are famous, such as Darryl Strawberry, and others are just your everyday, average American. To hear some of their stories about overcoming addiction click the button below:

In 2018, more than 2 million Americans will suffer from addiction to prescription or illicit opioids. Opioids killer more people last year than either car accidents or gun violence. The crisis of addiction can affect any Amercian, from all-state football captains to stay-at-home mothers.  As a result, Americans across the country are feeling the weight of the crisis next door.

Oxycodone Addiction: Symptoms and Treatment

Oxycodone Addiction: Symptoms and Treatment

Oxycodone Addiction: Symptoms & Treatment

Oxycodone addiction is an epidemic. It’s powerful opiate and often used by doctors to treat mild to moderate as well as post-operative pain, the MentalHelp.Net says.

Immediate effects
Growing dependence on opiates can lead to the following conditions.

  • Dulled physical and emotional sensations
  • Euphoria
  • Mood swings
  • Hallucinations (possible at high doses)
  • Lack of motivation
  • Slow and sluggish movements
  • Poor judgment due to inability to focus and concentrate
  • Anxiety
  • Slowed respiration and heart rate
  • Appetite changes
  • Changes in sleeping patterns

Long-term effects

Prolonged use of the drug can lead to heart problems, lower immunity, pregnancy complications, permanent brain damage, personality changes, loss of memory and mental health symptoms that will only grow worse over time.

Treatment

Given the effects of the drug, it’s essential that you look for a treatment center that offers oxycodone addiction treatment in Florida as soon as possible. Don’t try to go cold turkey because this will do more harm than good to your health. If you’ve been using the drug for a long time, you’ll need to undergo a medically-assisted withdrawal process. That’s because the longer you use the drugs, the more severe your withdrawal symptoms will get. With a trained and competent medical team to look after your needs, you can go through the process safely and in greater comfort.

Find a facility

Look for a facility that’s been around for years. Consider the staff. Do they have the right credentials and qualifications to provide you with the help and assistance you need?

Ask about the program

Know more about the program. You’ll have an easier time choosing a facility for oxycodone addiction treatment in Florida when you know what their care program entails. Pick one that can provide you with treatment options well-suited to your personality and needs. (Source: https://www.werecover.com/blog/lyrica-withdrawal/)

Know as much as you can

If your doctor tells you that you’re suffering from a dual condition, that means you have a mental condition along with your drug addiction. You’ll need to look for a drug rehabilitation facility that’s well equipped to handle your case. Failure to treat both conditions will only lead to more problems in the future.

Pick a program

For cases involving prolonged drug use, residential treatment programs are a much better option. The isolation will help you cut ties with bad influences, keep you from being exposed to potential triggers, and provide you with the means to cope with those triggers in the future without resorting to drugs.

Want to know more? Ask us at Addiction Alternatives.

Suboxone Addiction and Treatment

Suboxone Addiction and Treatment

Suboxone Addiction and Treatment

The FDA approved Suboxone for the treatment of opiate addiction, the Daily Beast reports. That’s because Suboxone presents lower risks of abuse. If you think your loved one is in danger of abusing the drug and overdosing on it, though, here are a few symptoms to watch out for.

Symptoms of Suboxone overdose

Check his pupils. Does he have pinpoint pupils? Is he experiencing extreme drowsiness? Does he suffer from blurry vision and dizziness? If your loved one’s breathing show signs of slowing down, don’t wait it out. Get help right away. If the symptoms persist, it could lead to collapse, breathing problems, and death.

Explore treatment options

Patients who suffer from psychological problems or an inability to deal with problems and stressful situations may resort to the use of this substance. One way to stop the addiction is to look for treatment options that are right for your loved one. This will include outpatient therapy, residential treatment programs, a combination of the two and even group sessions and one-on-one sessions. Discuss these options to make sure he knows about them. That should help your loved one make an informed decision about where to seek out Suboxone treatment in Florida.

Understand why

Don’t judge your loved one for the choices he made. That’s not going to help him achieve a successful recovery. Instead, read about the addiction. Know what your loved one is dealing with. That’s going to improve your perspective on things and make you more likely to offer help and support without any bitterness or hurt.

Relapses are a part of it

Relapses are a normal part of the process. Don’t give up on your loved one because of a relapse or two. Continue to offer your support. That’s going to drive your loved one to work harder towards recovery.

Don’t make comparisons

Everyone’s journey to recovery is different. Someone may only take months or a year. Someone may take years. There’s no manual to getting there. That’s why it’s never a good idea to compare your loved one’s rate of progress with someone else’s. Instead, focus on your loved one’s recovery—on his small triumphs and successes. That’s going to contribute to his desire to get sober.

Look for help

If you need Suboxone treatment in Florida, don’t look any further than Addiction Alternatives. Check out the options we offer to help you find the treatment and facility that’s going to work for your loved one.