Pre-Addiction: New Approaches to Drug and Alcoholic Treatment

Thanks to a substantial amount of research on the topic of addiction and treatment methods, a great deal of progress has been made in the past 20 years. For those in the field of psychiatry, the improvements in how patients with addictions are treated has been very satisfying.

The way health care professionals’ understanding of drug dependency has increased is all thanks to a better knowledge about brain chemistry. As a result, it is easier to identify which treatment methods would be most effective for a particular patient, including medications that are far more effective than in the past. Furthermore, there is more awareness about mental conditions that often accompany addiction — such as PTSD, ADHD, depression, and eating disorders.

Another development that will certainly make a difference going forward is the understanding of “pre-addiction,” which involves diagnosing and treating the addiction at the earliest stage possible.

What is Pre-Addiction?

Several prominent experts at the US National Institute on Drug Abuse recently proposed the term “pre-addiction” to describe people who are mildly or moderately addicted to a particular drug. This is comparable to the concept of “prediabetes” in which the patient doesn’t have full-blown diabetes, but is in danger of developing it if intervention does not take place. Identifying and tackling the problem early means lower medical costs and higher quality of life.

As the concept of pre-addiction gains acceptance in the healthcare community, it will be helpful in recognizing and targeting resources to combat the problem as soon as possible. Likewise, those who are identified as having pre-addiction will be prompted to understand it and get the help they need. Ultimately, by catching it at a stage where the patient doesn’t yet require more intensive interventions such as inpatient treatment or detox, it becomes easiest to treat.

Why is it essential to identify patients at the pre-addiction stage? Once it becomes a full-blown addiction, their brain chemistry and structure changes drastically. It isn’t to say it is irreversible, but two major issues make it more difficult: it takes substantially longer to recover — often many months — but since their brain chemistry has been altered, they are less inclined to stick to the recovery plan. But if it is treated before it reaches the point in which their brain has changed, sobriety becomes infinitely easier to maintain.

In summary, here are the reasons why helping patients at the pre-addiction stage increases the odds of recovery:

• Stopping the progression of addiction is far easier.
• The patient is able to make the right choices without the need of intensive guidance.
• The available therapies and treatments are much more affordable and accessible.

Identifying and Treating Pre-Addiction

The first step involves identifying pre-addiction. This means screening and taking proactive measures during routine health checks with the primary-care providers. Although this might seem self-explanatory, there isn’t yet a universal standard for how to go about this health screening. However, in terms of intervention, there are clearly established techniques for letting the patient know they have a problem, but one that does not yet constitute a full-fledged addiction.

Additionally, healthcare professionals need to determine the parameters for being addicted in a clinically significant way and detect them in a way that allows for early intervention. There is a current criteria that defines “mild to moderate” drug and alcohol use, and screening tools are available to help doctors and mental healthcare workers make some determination, but a more individualized approach that takes into account the type of drug being used along with the individual patient’s risk factors needs to be further researched.

The fact that somebody with a pre-addiction can treat themselves with minimal assistance is important, because once they reach the point where they have a full-on addiction, this is no longer possible. Here are some steps a pre-addict can take if they’re concerned that it might get worse:

• Don’t drink unless you’re in the company of friends and family.
• Make sure your alcohol is accompanied by food and water.
• Recognize that when you go out to bars and restaurants, the alcohol content of the cocktails and craft beers is likely to be higher than what you might have at home, so be aware of this and practice moderation.
• Think about the various aspects of your life — your marriage, family, finances, job, etc., — and ask yourself if drugs or alcohol are interfering with any of these.
• Develop a plan that replaces unhealthy habits like drinking alcohol or taking drugs with something beneficial such as exercise, yoga, reading, new hobbies and interests, or weekly spa treatments.

Although there has been a lot of progress in terms of understanding how addiction works, there is much more that needs to be discovered. Considering the country’s ongoing opioid crisis, it is urgent that we find solutions in order to prevent more tragic deaths. However, the fact that researchers are thinking more about pre-addiction is a positive step that will make a difference in the future.