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No singular path to drug addiction

GRAND FORKS -- Addiction can start with a fall, a car accident or a chance offer at a party. What begins as a way to relieve pain or forget about life's challenges becomes a need--one that can be fulfilled only with the drugs that drive it. Exper...

GRAND FORKS - Addiction can start with a fall, a car accident or a chance offer at a party. What begins as a way to relieve pain or forget about life's challenges becomes a need-one that can be fulfilled only with the drugs that drive it.

Experts say there is no one pathway to drug addiction. But Michael Kaspari, the agency director at First Step Recovery in Fargo, will tell you 80 percent of opioid addicts started with painkiller abuse. Kaspari points out that people with a family history of drug abuse also have a 400 percent increased risk of abuse or dependency.

"There are several pathways to addiction," he said. "There's not one thing that leads to it."

Addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite its harmful consequences, according to the National Institute on Drug Abuse.

In simple terms, Kaspari said drug addiction often occurs when a person uses too much too often for too long.

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The cycle of addiction rules and ruins many lives, with the stigma surrounding it placing blame on the shoulders of the abusers and their perceived aversion to seek treatment. But more and more, experts are looking at addiction as a brain disorder, said Deb Davis, director of the alcohol and drug services unit at the Northeast Human Service Center in Grand Forks.

As a person continues to use drugs, the brain adjusts to the excess dopamine by making less of it or reducing the ability of cells in the reward circuit to respond to it. This reduces the high a person feels compared with the high they felt when first taking the drug-an effect known as tolerance, according to the National Institute on Drug Abuse.

It becomes a vicious circle when a person then takes more of the drug to chase that same dopamine high.

Many factors influence the likelihood an individual will develop a substance use disorder, including family history of addiction, age of first use, lack of commitment to school, availability of alcohol or other drugs, and community laws and norms favorable to drug use, according to information from the North Dakota Department of Human Services.

Many times, people turn to drugs because they are trying to self-medicate other problems in their lives, such as anxiety or depression, Kaspari said. Those drugs often will help manage the symptoms for a short time while a person is under the influence, but in the end, the drugs make the depression or anxiety worse.

For instance, marijuana may calm a person while high, Kaspari said, but it can make problems of anxiety and depression a person was dealing with far worse.

"It will help them calm down at first, but not much will make those problems they're dealing with worse than chronic weed use," he said.

A person may then develop a dependency for the drug while they self-medicate.

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A person's tolerance goes up rapidly with painkillers, even in a short period of time of two weeks or so, Kaspari said. Once a person runs out of painkillers, they're left to go buy them on the street, which can be incredibly expensive, or go doctor-shopping.

Kaspari said one person recently came to First Step Recovery after seeing more than 35 doctors up and down the valley who were all prescribing him painkillers.

Others may turn to heavy drugs such as heroin because, in some cases, it's less expensive and easier to get.

Eventually, a person may use drugs so often that they don't use drugs to get high anymore-they're just using to stay out of withdrawals, Kaspari said.

"There becomes a cycle of substance abuse where you can't not use drugs," he said.

When it comes to opioid addiction, Davis said, it's the withdrawal from the drug that people don't like, which causes aches, pains, shakes and psychological dependency. Many are scared of what it's like to not be under the influence.

The physical withdrawal, however, is short-lived compared with the amount of time the brain needs to heal from a drug dependency.

"Once the physical is gone, it's a lot of the psychological, the emotional, the mental piece that goes with addiction," Davis said. "And then where the brain is impacted by that, those are kind of keys to relapse. So, we need an ongoing recovery that recognizes the craving that can come up again, and that's a difficult piece-keeping people clean and getting them in a lifestyle that promotes not using while their brain is healing."

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Davis said preventing people from using drugs in the first place is the key to stopping drug addiction.

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