Identifying and treating pre-addiction

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TO treat pre-addiction, you first have to identify it. This means screening and intervention during routine checkups in the primary-care setting, among other places. That sounds obvious enough, but we’re not there yet in terms of what those screens look like.

The goal of intervention is clear, though: As Volkow puts it in her Journal of the American Medical Association Psychiatry commentary, we want “to alert people to problematic patterns of drug or alcohol use that do not (yet) meet the threshold of addiction.”

Further, we need to “define and detect substance use that is clinically significant and amenable for early intervention. Existing diagnostic and statistical manual criteria for mild to moderate substance use disorder are a starting point, as are existing screening tools used in primary care that ask about frequency of substance use.

But research is needed to better characterise the kinds of substance use and the kinds of individual risk factors that would raise concern for future addiction and other health problems.” (Italics added because it’s such a key point. That research is needed as soon as possible.)

As for self-treating pre-addiction, the beauty is that this can be done at all, unlike when people have full-blown addiction. Following are the sorts of adjustments that someone diagnosed with pre-addiction would be able to make if they are worried about their problem drinking or drug
use:

  • Do not drink or use drugs alone
  • Eat food and take in water when you drink.
  • Know that in the “upsized” world of bar and restaurant portions, the alcohol content of beer, wine, or mixed drinks can be higher than the average, so be careful and conscious of that.
  • Assess all areas of your life — your job, relationships, finances, the amount you exercise, and so on — to see if drugs or alcohol are having a negative affect on any.
  • Make a conscious effort to replace unhealthy habits like drinking or drug taking with healthy habits. These include daily exercise (maybe at the end of the workday, when you would normally have a drink), fun hobbies, or regular self-care such as meditation, reading, yoga, or a weekly massage.

We still have a long way to go in our understanding of addiction and addiction treatment. This country’s recent, tragic increase in drug overdoses shows we are not there yet. But we are making progress on several
fronts.

This new thinking about pre-addiction is a significant example of that. It could lead to a new way of diagnosing, treating, and paying for addiction and addiction care.

— psychologytoday