Is Ibogaine a Safe and Effective Treatment for Substance Addiction?

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Is Ibogaine a Safe and Effective Treatment for Substance Addiction?

What is ibogaine treatment?

Ibogaine is a psychedelic substance found in iboga, a Western African shrub. Historically it has been used in healing ceremonies and initiation rituals in the Bwiti religion in West Africa.

Today, some people claim it can be used as a treatment for opiate addiction. It hasn’t been approved by the Food and Drug Administration (FDA) for any addictive disorder and it is classified as a schedule I drug in the United States. Schedule I drugs are substances with a high potential for abuse.

Keep reading to learn more about the use of ibogaine treatment for addiction.


Ibogaine acts as a mild stimulant in small doses. In large doses, it can put a person into a severe psychedelic state. Some people have found that large doses reduce opiate withdrawal symptoms and help with substance-related cravings.

People with substance use addictions have found that large doses of it can reduce withdrawal from opiates and help rid them of their substance-related cravings. In many cases, however, the effects are short-lived. The safety of this treatment is also in question. Most studies have been in animals. In humans, there have been serious side effects, including unexplained deaths that may be linked to the treatment.

What does the research say?

In a long-term study in Mexico, investigators researched substance abuse changes in 30 people seeking ibogaine-based addiction treatment for opiate substance abuse. The researchers measured frequency and dosage of opiate use at the beginning of treatment and at monthly follow-ups for 12 months. They also conducted a survey that asked basic questions on topics such as:

  • medical status
  • employment status
  • family history
  • psychiatric status

According to the results:

  • one third of the participants relapsed within the first month
  • 60 percent relapsed within the first two months
  • 80 percent relapsed within the first six months
  • 20 percent made it more than six months without any aftercare
  • four out of the 30 participants did not relapse for more than a year following a single treatment

Researchers determined that ibogaine is not a cure for addiction. Instead, it merely interrupts addition. It is important to note the sample size was only 30 people and therefore may not apply to a greater population.
A 2014 studyTrusted Source in Brazil found ibogaine treatment to be effective in treating addiction when used alongside psychotherapy. The study was also small, with only 75 participants.

In a review of clinical trials and studies, researchers noted that, while studies have supported the claims that ibogaine can help treat addiction, there needs to be more and better controlled studies to determine the safety and efficacy of this treatment.

Not many long-term studies have been conducted on ibogaine and further research is needed for definitive proof on how it helps or hurts the body.

Learn more: Treating drug addiction with drugs »

What are the risks?

Using ibogaine comes with serious risks, including death. Additional complications include:

  • seizures
  • gastrointestinal issues
  • heart complications, such as arrhythmias
  • ataxia

Ibogaine treatment is risky and much is still not understood about appropriate dosage and safe administration. It should only be used under the direction of a medical professional, and even then, you should be aware of the risks.

Additional treatment options for addiction

If you are seeking help for an addiction, it is best to speak with your doctor before starting any treatment plan, including experimental ones. Most treatments follow this process:

  • Detoxification to rid the body of the drug. This can be done at home with the assistance of a medical professional or at a treatment center. You can find these centers throughout the country and they come fully staffed with compassionate, caring professionals trained in getting someone through the challenging detox transition.
  • Behavioral counseling. Psychologists trained in drug addiction work with individuals and help ease them into their new, drug-free lives. You can feel safe and secure and know that what you say is kept in a confidential environmental. You should look for someone you feel comfortable with.
  • Prescription for medications to help with any detox pain.
  • Evaluation for any mental health issues, such as depression and anxiety that often follow a detox.
  • A schedule for long-term follow-ups. Overcoming addiction is tough, so it’s important to always seek help and support from medical professionals who can work with you on remaining drug free.


Overcoming addiction is a long process and you don’t need to manage it on your own. There are many treatment options available. If one treatment doesn’t work, your doctor can help come up with a new plan. With treatment, it’s possible to get on a road to a happy and healthy life.

Last medically reviewed on November 21, 2016

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How to Recognize and Treat Tramadol Addiction


Tramadol is a synthetic opioid used to treat chronic pain. It is believed to bind to mu opioid receptors in the brain. It may possibly inhibit the reuptake of norepinephrine and serotonin, mimicking the effects of the body’s natural pain-relief system.

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Tramadol is available in long-acting or extended-release tablets and capsules. When swallowed, its effects appear gradually and peak within four to six hours. It’s weaker than other prescription and illicit opioids, such as heroin, codeine, or methadone. However, it can still lead to dependence.

Read on to find out more.

What are the side effects of use?

Tramadol’s effects are similar to those of other opioids.


  • sense of well-being
  • relaxation
  • euphoria


  • pain relief
  • constipation
  • slower rate of breathing
  • dizziness
  • fatigue
  • headaches
  • itching
  • nausea
  • vomiting
  • sweating
  • erectile dysfunction


  • confusion

Is dependence the same thing as addiction?

Dependence and addiction aren’t the same.

Dependence refers to a physical state in which your body is dependent on the drug. With drug dependence, you need more and more of the substance to achieve the same effect (tolerance). You experience mental and physical effects (withdrawal) if you stop taking the drug.

When you have an addiction, you can’t stop using a drug, regardless of any negative consequences. Addiction can occur with or without physical dependence on the drug.

However, physical dependence is a common featureTrusted Source of addiction.


Addiction has many causes. Some are related to your environment and life experiences, such as having friends who use drugs. Others are genetic. When you take a drug, certain genetic factors can increase your risk of developing an addiction.

Regular drug use changes your brain chemistry, affecting how you experience pleasure. This can make it difficult to simply stop using the drug once you’ve started.

What does addiction look like?

Addiction has some common signs, regardless of the substance being used.

Some general warning signs include:

  • substance use on a regular basis
  • an overpowering urge for the substance
  • taking more of the substance to achieve the same effect (tolerance)
  • having a constant supply of the substance on hand
  • spending money you need for bills or other necessities on the substance
  • failing to meet school or professional obligations due to substance use
  • using the substance in spite of the risks and problems it poses
  • engaging in risk behaviors, such as violence, to obtain the substance
  • taking out-of-character risks while under the substance’s influence
  • spending excessive amounts of time obtaining the substance, using it, and recovering from its effects
  • trying and failing to stop using the substance
  • experiencing withdrawal symptoms once substance use has stopped

How to recognize addiction in others

Your friend or loved one might try to hide substance abuse from you. You might wonder if it’s drugs or something else, such as a challenging job or a stressful life change.

The following can be signs of addiction:

  • personality changes, including mood swings or anxiety
  • behavioral changes, including secrecy, paranoia, or aggressive behavior
  • changes in appearance, including unexplained weight loss or weight gain, poor hygiene, and pinprick pupils
  • ongoing health issues, including exhaustion, poor nutrition, or insomnia
  • social withdrawal, resulting in strained relationships with friends and family or new relationships with other substance users
  • poor performance at work or school, often due to disinterest or absence
  • money or legal issues, including suspicious or frequent requests for money

What to do if you think a loved one has an addiction

The first step is to recognize any misconceptions you might have about addiction. Remember that taking drugs changes the structure and chemistry of the brain over time, making it increasingly difficult to simply stop using the drug.

Next, learn more about risks and side effects, including the signs of intoxication and overdose. Research treatment possibilities to suggest to your loved one.

You should think carefully about how best to share your concerns. If you’re considering an intervention, remember that a positive outcome isn’t a given.

Although an intervention might prompt your loved one to seek help for an addiction, it can also have negative repercussions. This includes feelings of shame, anger, or social withdrawal. In some cases, having a low-pressure conversation is a better option.

Remember that you might not get the response you hoped for. Your loved one might deny taking drugs altogether or refuse to seek treatment. If that happens, consider looking into additional resources or joining a support group for family members of people with substance abuse problems.

Where to start if you or your loved one wants help

For some, asking for help can be an important first step. When you — or your loved one — are ready to get treatment, consider reaching out to a supportive friend or family member. They can offer encouragement and help hold you accountable as you begin the road to recovery.

You can also start by making a doctor’s appointment. Your doctor can assess your overall health by performing a physical exam. They can also discuss your options for treatment and, if needed, initiate detoxification procedures and once detox is over, make a referral for additional help.

How to find a treatment center

Speak to a doctor or other health professional for a recommendation. You can also search for a treatment center close to where you live using the Behavioral Health Treatment Services Locator, a free online tool provided by the Substance Abuse and Mental Health Services Administration (SAMHSA).

What to expect from detox

Symptoms of tramadol withdrawal are similar to symptoms of opioid withdrawal, though they may be generallyTrusted Source milder (note that everyone’s experiences are different).

The most common side effects include:

  • agitation
  • anxiety
  • craving
  • diarrhea
  • insomnia
  • stomach cramps
  • muscle aches
  • nausea
  • vomiting
  • restlessness
  • shivering
  • sweating

Approximately 10 percent of people will experience more severe symptoms, such as:

  • numbness and tingling
  • confusion
  • extreme anxiety
  • hallucinations
  • panic attacks
  • paranoia

Detoxification (detox) is a process aimed at helping you stop taking tramadol as safely and as quickly as possible. This can include medication to ease withdrawal symptoms, such as non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and anti-anxiety drugs.

Before detox begins, your doctor will perform a physical evaluation. This may also include blood tests to determine if there are any additional physical issues that must be addressed. Stabilization is achieved when the drug is out of your system.

Detox can take several days or several weeks. Your individual timeline will depend on your body’s level of dependency. Your doctor will help you prepare for treatment once the drug is completely out of your system.

What to expect from treatment

Treatment generally begins once detox ends. The overall goal is to help you lead a healthy life without taking tramadol or other drugs. Treatment can also help address any other underlying health conditions, such as anxiety or depression.

There are relatively few studies assessing treatments specifically for tramadol dependence. Treatment options are generally the same for any opioid addiction.


Therapy is led by a psychiatrist, psychologist, or counselor. You can do it alone, with your spouse or family, or in a group.

There are a number of different types of therapy. Cognitive behavioral therapy (CBT) can help you identify and change negative attitudes and behaviors, namely those that lead to drug use. You’ll also learn how to cope with cravings, avoid triggering situations, and reduce your risk of relapse.

Contingency management (CM) therapies for opioid addiction incorporate rewards, such as cash prizes or vouchers in exchange for drug-free urine samples. The value of the reward typically increases the longer you’re drug free.

Therapy can be intensive during the first weeks of treatment. As time wears on, you may be able to attend therapy less frequently.


Medication is available to treat tramadol dependence. Maintenance medications, such as methadone, may be considered to ease withdrawal symptoms without producing a “high.”

Other maintenance medications, including buprenorphine-naloxone and naltrexone, prevent tramadol from activating opioid receptors, so it doesn’t produce a “high.”

If tramadol dependence is mild, medication may not be necessary.

How to reduce your risk of relapse

In some cases, relapse is part of the recovery process. Learning how to reduce your risk for relapse — as well as what to do if relapse occurs — can help improve your chances of long-term recovery.

The following lifestyle changes can help you reduce your risk of relapse over time:

Depending on your situation, reducing your risk of relapse may also include treatment for other health conditions, for example: seeing your therapist on a weekly or monthly basis, or practicing mindfulness techniques, such as meditation.

What’s the outlook?

Treatment outcomes are comparableTrusted Source to that of other chronic illnesses. However, recovering from any addiction is a process that can take time.

Treating yourself, or your loved one, with kindness and patience is key. Don’t be afraid to reach out for help. Your doctor can also help you find support resources in your area.

Last medically reviewed on June 27, 2018

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Opiate Withdrawal: What It Is and How to Cope with It


Opiate addiction is a growing problem in the United States and around the world. In the United States, there were more than four timesTrusted Source as many unintended overdose deaths from prescription pain relievers in 2014 as there were in 1999.

If you have an opiate addiction, you know that withdrawal can be a tough obstacle in overcoming your addiction. Withdrawal is certainly not a walk in the park, but it is something you can get through. And you’re taking the first step by reading this article. Learning about the withdrawal process and ways to get through it is key to a successful, permanent break-up with opiates.

Opiate dependence and addiction

Opiate addiction can involve illegal drugs such as heroin. It can also involve prescription medications used to treat pain, such as:

  • codeine
  • methadone
  • morphine
  • oxycodone

Long-term use of any opiate — illegal or prescription — can lead to tolerance. This means you need to take more of the drug to get the same effects. And as you continue to use the drug, your body can become dependent on it. This means you’ll have withdrawal symptoms if you stop taking the drug. There’s also psychological dependence, also known as addiction. With addiction, you have cravings for opiates and can’t control your use, even when it causes harm to you or others. All of these factors can mean you take more of the drug than recommended, which can lead to overdose. Addiction can also mean that you take illegal steps to get more of the drug.

The only way to stop opiate addiction is to stop taking the drug. This means going through the withdrawal process. To get through withdrawal successfully, it helps to know what to expect, such as symptoms and side effects.

overdosetaking more of a drug than prescribed
toleranceneeding more of a drug to maintain the same effects
physical dependenceoccurs from continued use, leads to withdrawal symptoms when you stop taking the drug
psychological dependence (addiction)being unable to control your cravings and use, even when it’s harmful to yourself or others
withdrawal (detox)psychological and physical effects following the reduced or stopped use of a drug

Withdrawal symptoms and timeline

You’ll develop withdrawal symptoms as opiates leave your system. You may go through different withdrawal stages during the process, which is also called detox. The amount of time it takes you to get through detox depends on factors such as:

  • how severe your addiction is
  • your overall health
  • how often you used the opiate
  • the type of opiate you used

Early stages

During the early stages of withdrawal, symptoms begin around six to 30 hours after you stop taking the drug. The timing depends on the type of opiate you’re addicted to.

During these early stages of withdrawal, you may experience:

  • anxiety or irritability
  • muscle pain
  • body aches
  • tiredness
  • trouble sleeping
  • sweating

Later stages

About 72 hours after you stop taking the drug, symptoms are typically their worst. During this time, your early symptoms can become more severe. You may also have new symptoms such as:

  • chills
  • stomachache
  • nausea
  • vomiting
  • diarrhea

Overall timeframe

The first week of withdrawal is typically the worst, but be prepared for some symptoms to last longer. Symptoms typically last up to one month, but can linger for several months. Symptoms that can last longer than one week include tiredness, depression, anxiety, and trouble sleeping.

Withdrawal treatment

Medications are available that can help you get through withdrawal. For instance, some treatments can shorten the withdrawal process and make symptoms less severe. These include:

  • clonidine hydrochloride, to treat common symptoms
  • naloxone, to reverse and treat heroin overdose
  • naltrexone, to prevent relapse
  • buprenorphine, used with naloxone during withdrawal to reduce symptoms or alone after detox to prevent relapse

In severe cases of methadone addiction, a doctor may actually prescribe methadone during withdrawal. The doctor gradually decreases your dosage over time to help reduce dependence. If you have questions about any of these treatments, your doctor can tell you more.

Learn more: Methadone withdrawal with methadone therapy »

Potential risks and benefits of withdrawal

Although it can be painful to get through withdrawal, the overall benefits outweigh any risks. Still, there are a few risks involved with the withdrawal process. These include:

  • severe diarrhea or excessive vomiting, which can lead to dehydration and loss of electrolytes
  • aspiration (breathing in vomit)
  • lung infections from aspiration
  • seizures

To find out more about these risks, talk to your doctor. Always keep in mind that the risks of withdrawal are much less dangerous than the risks of continuing your opiate addiction.

Keys to coping

When you’re ready to kick your opiate habit, know that support is key to coping with opiate withdrawal. The more support you have, the more likely you’ll succeed in overcoming your addiction.

Professional care

Rather than going through withdrawal alone, consider going to a detox facility. There, you’ll be monitored closely by a team of healthcare providers who will help keep you safe and help relieve your withdrawal symptoms.

If you’d rather go through the withdrawal process at home, be sure to stay in close contact with your doctor. Tell them when you’re doing it, and before you start, discuss medications they could prescribe that might help you get through it. As you go through the process, be sure to report ongoing side effects to your doctor.

Emotional support

Be sure to tell your family and friends that you’re going through withdrawal. You’ll be facing a tough time, and having their support can make a big difference. If you’ll be at home, make sure at least one person checks on you every day.

Support groups and individual counseling are also options for emotional support. Narcotics Anonymous is one resource that could help you get off and stay off of opiates.


Being prepared can make all the difference for your success in getting through withdrawal. If you’ll be at home, stock up on items you may need. These can include:

Fluids: If you have vomiting or diarrhea during withdrawal, you may be at risk of dehydration. So, it’s important to drink plenty of fluids. Consider purchasing drinks that contain electrolytes, such as Pedialyte.

Over-the-counter (OTC) medications: OTC drugs may help you battle side effects from withdrawal. These products may include:

  • dimenhydrinate (Dramamine) or meclizine (Bonine) for nausea
  • Imodium (loperamide) for diarrhea
  • ibuprofen (Motrin) or naproxen (Aleve) for muscle aches, chills, and fever

Activities: Be sure to have activities available to help keep you occupied. Books, movies, and music are all things that can help get your mind off of your withdrawal symptoms.

Support for the long haul

Withdrawal is just one step in the opiate recovery process. You’ll likely want to set up a plan for long-term success after opiate withdrawal. This can also include support groups, as well as mental health treatment. Other steps may help make your withdrawal experience easier. To find out more, read about remedies to ease opiate withdrawal symptoms.

Talk with your doctor

Opiate withdrawal is uncomfortable, and you should be supervised by your doctor to help make sure you’re safe. But as difficult as it can be, withdrawal itself is generally not life-threatening, and it’s so worth the effort. Getting through the struggles of withdrawal allows you to move forward without the terrible risks and limitations of an opiate addiction.

To get started, talk to your doctor. They can help put you on the path to an opiate-free life. We won’t tell you that going through withdrawal is easy, but the pros definitely outweigh the cons. As mentioned above, you will have side effects during withdrawal. But these will likely last about one week, with some perhaps lasting a bit longer. Still, the benefits of taking your life back from opiate addiction far outweigh those negatives. During your withdrawal, focus on these positives that you can enjoy for the rest of your life after you break free from opioid use.

Last medically reviewed on November 14, 2016

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Heroin Addiction: What You Should Know


Heroin is an opioid that originates from morphine, a substance derived from opium poppy plants. It can be injected, sniffed, snorted, or smoked.

Heroin addiction, also called opioid use disorder, is a disorder that involves changes in the brain and behavior as a result of heroin use.

What causes heroin addiction?

Heroin is highly addictive. It’s an opioid, which binds to receptors in the brain to release the chemical dopamine. As with most drug side effects, this release is only temporary — which leaves some people wanting more of the “good” feeling.

If a person takes an opioid repeatedly over time, the brain doesn’t naturally produce dopamine as it once did. This results in the person taking higher or more frequent doses of the opioid in order to achieve the same level of good feeling.

Sometimes opioid use disorder begins with legal drugs like painkillers that are prescribed after a surgery or some other injury. These pain-relieving drugs act in similar ways to heroin.

If a person becomes addicted to these prescribed medications and can’t obtain them anymore, they may pursue illegal drugs like heroin to achieve the same pleasurable feeling.

While not everyone who takes legal painkillers or recreational substances becomes addicted, some people won’t be able to stop taking them.

Who’s at risk for a heroin addiction?

Addiction can happen to anyone, and anyone who takes opioids can be at risk for developing an opioid use disorder.

While it’s impossible to say who’s at risk for an opioid use disorder, there are factors that can raise the risk of developing a drug addiction.

According to the Mayo Clinic, some of these risk factors can include:

  • family or personal history of addiction to other substances
  • heavy tobacco use
  • history of severe depression or anxiety
  • unemployment
  • exposure to high-risk individuals or environments
  • history of risk-taking behavior

It’s important to remember, though, that even if you or someone you care about has one or even many of these risk factors, that doesn’t mean they’ll develop a substance use disorder. Addiction is multifaceted. It can include genetic, psychological, and environmental factors.

What are the symptoms of heroin addiction?

Early on, there may be no symptoms of opioid use disorder, especially if the person is going to great lengths to hide their use. As the use increases, it can get harder to hide. Signs and symptoms of heroin use can include:

  • agitation or drowsiness
  • slurred speech
  • constricted (smaller) pupils
  • depression
  • memory problems
  • needle marks (if injecting the drug)
  • runny nose or nose sores (if snorting the drug)
  • constipation
  • reduced sense of pain

Other signs of heroin use can include:

  • changes in appearance or decline in personal hygiene
  • changes in behavior, like sudden secrecy or aggression
  • money issues, such as missing money or needing more and more money without any logical reason
  • problems at school or work
  • risky or dangerous behavior

One of the hallmarks of addiction is a person not being able to stop using a substance, despite any negative consequences or multiple attempts to stop and not being able to.

If you yourself are using, you might realize that you need to ingest more and more heroin to achieve the same pleasurable feeling you used to get with less of the drug.

How is heroin addiction diagnosed?

Diagnosing any kind of substance use disorder, including opioid use disorder, is done by a thorough examination and assessment by a psychiatrist or psychologist. In some states, a licensed drug and alcohol counselor may make the diagnosis.

Typically, a variety of tests are used. These include lab tests like blood or urine tests and a clinical interview.

If you suspect that you or someone you care about has a heroin addiction, talk with a professional. This can include a mental health professional like a licensed drug or alcohol counselor or a social worker, physician, or psychiatrist.

How is heroin addiction treated?

There’s no one “cure-all” for any drug addiction, including heroin. Rather, there are effective treatments available to help the person into and through recovery. The specific kinds of treatment used usually depend on:

  • the individual
  • the substance being used
  • any coexisting medical conditions

There are various kinds of treatments for opioid use disorder. Using multiple forms of treatmentTrusted Source is often more effective than just using one.

The two main forms of opioid use disorder treatment are pharmacological (medication) and behavioral.

Pharmacological treatment

Stopping an opioid like heroin when you’re physically addicted to it can cause an array of physical symptoms during withdrawal. Some of these symptoms can be serious. These include:

  • nausea
  • vomiting
  • pain
  • diarrhea

Going through detox from heroin can be painful and uncomfortable, on top of intense cravings for the drug. People sometimes use heroin to stop the pain from withdrawal and detox itself.

Because of this, medication can ease cravings and physical withdrawal symptoms, reducing the likelihood of using heroin during detox.

Detoxing from the drug is the first step in most treatments. If detox is physically impossible to endure, further treatment will be less effective. To enhance the safety of detox, it’s best the person is medically supervised. Your doctor may want to hospitalize you for detox.

Behavioral treatment

Behavioral treatment can be done in either outpatient or inpatient treatment settings. It can include:

Behavioral therapy can help a person:

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  • identify triggers of drug use
  • build coping skills when faced with cravings
  • develop ways to deal with relapse
  • identify and cope with any issues that might be causing emotional discomfort

What’s the outlook for heroin addiction?

Opioid use disorder is a serious condition, but it’s treatable. Addiction doesn’t have to be permanent, or even long term. There’s help out there, and it’s possible to recover.

If you think you or a loved one has developed an addiction to heroin, talk with your doctor or another healthcare provider. They can help you with an assessment and provide further resources for help and recovery.

Last medically reviewed on July 24, 2018

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Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Jul 25, 2018

Written By

Jaime R. Herndon, MS, MPH, MFA

Edited By

Frank Crooks

Jul 24, 2018

Medically Reviewed By

Timothy J. Legg, PhD, PsyD

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Types of Addiction and How They’re Treated

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Addiction is a complex disease, but nearly a century of scientific study has helped researchers come to a deeper understanding about how it works.

This research has culminated in an important change in how we talk about addiction: Addiction is now classified as a disease that affects the brain, not a personal failing or choice.

Most people think of substance use when they hear about addiction, but that’s not the only type of addiction.

ResearchTrusted Source suggests that addictions to substances work similarly to patterns of compulsive behavior, like gambling or shopping.

Today, most experts recognize two types of addiction:

  • Chemical addiction. This refers to addiction that involves the use of substances.
  • Behavioral addiction. This refers to addiction that involves compulsive behaviors. These are persistent, repeated behaviors that you carry out even if they don’t offer any real benefit.

How addiction generally works

Before getting into the different types of addiction, it’s helpful to understand a few general elements of addiction.

The reward system

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Addiction interferes with normal brain function, particularly in the reward system.

When you do something you find enjoyable, whether that’s hanging out with your best friend, drinking a bottle of wine, or using cocaine, this reward system releases the neurotransmitter dopamine along with other chemicals.

Contrary to popular belief, dopamine doesn’t appear to actually cause feelings of pleasure or euphoria. Instead, it seems to reinforce your brain’s association between certain things and feelings of pleasure, driving you to seek those things out again in the future.

Cravings and tolerance

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The desire to experience this euphoria again can trigger cravings for the substance or behavior, especially when you encounter the same cues (like a party where people are drinking, for example). These cravings often serve as the first sign of addiction.

As you continue using a substance or engaging in a behavior, your brain continues to produce larger amounts of dopamine. Eventually, it recognizes that there’s plenty of dopamine in your brain already and starts producing less in response to normal triggers.

There’s one problem, though: Your brain’s reward system still needs the same amount of dopamine to function as it should.

Before long, you need to use more of the substance to make up for what your brain isn’t releasing. This effect is called tolerance.

Disinterest in other activities

As addiction develops, it’s common to lose interest in hobbies and other things you once enjoyed.

This happens because your brain no longer produces much dopamine in response to natural triggers, like having sex or making art.

Even when you want to stop using a substance or engaging in a behavior, you might feel like you still need them in order to feel good about anything.

Loss of control

Addiction usually involves an inability to control substance use or specific behaviors. This can result in job loss, health issues, and relationship concerns, among other things.

In response, you might decide to quit the substance or behavior, only to find that you keep falling short, despite your best efforts.

What to know about chemical addiction

Chemical addiction can be tricky to talk about because there’s often confusion around what constitutes substance misusedependency, and addiction.

This is partly why the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recommends using the term “substance use disorder.” This classification includes more diagnostic criteria to help healthcare professionals differentiate between mild, moderate, and severe cases.

Many experts also prefer it because it avoid terms like “abuse,” which can further stigmatize addiction and prevent people from seeking help.

Common symptoms of substance use disorder include:

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  • cravings intense enough to affect your ability to think about other things
  • a need to use more of the substance to experience the same effects
  • unease or discomfort if you can’t easily access the substance
  • risky substance use, like driving or working while using it
  • trouble managing work, school, or household responsibilities because of substance use
  • friendship or relationship difficulties related to substance use
  • spending less time on activities you used to enjoy
  • an inability to stop using the substance
  • withdrawal symptoms when you try to quit

Some of the more common addictive substances include:

What to know about behavioral addiction

There’s some disagreement around the concept of behavioral addictions and whether they truly involve addiction. However, the DSM-5 now recognizes two behavioral addictions:

While most medical experts agree certain behavior patterns can become problematic over time, but there’s still some debate around:

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  • the point when behaviors become addictions
  • specific behaviors that can become addictive

For example, some may agree that shopping, sex, and exercise addictions exist but question the idea that people can become addicted to Facebook.

The APA chose not to include these behavior patterns in the DSM-5, citing the lack of scientific, peer-reviewed evidence necessary to develop standard criteria for diagnosis.

As a result, there’s no official diagnostic criteria.

However, general signs of a potential behavioral addiction include:

  • spending large amounts of time engaging in the behavior
  • urges to engage in the behavior even if it negatively affects daily life, responsibilities, or relationships
  • using the behavior to manage unwanted emotions
  • hiding the behavior or lying to other people about time spent on it
  • difficulty avoiding the behavior
  • irritability, restlessness, anxiety, depression, or other withdrawal symptoms when attempting to quit
  • feeling compelled to continue the behavior even when it causes distress

Common behavioral addictions people often seek therapy and other professional support to address include:

Treatments for substance use disorder

It’s often extremely difficult to quit or control substance use alone without support from a trained professional.

The first step of treatment for some forms of substance use disorder, including those that involve alcohol, benzodiazepines, and heroin, typically involves medically supervised detoxification. This won’t treat the condition, but it can help people get through the withdrawal process safely.

From there, one (or a combination of) the following is usually recommended.

Residential treatment

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Rehab, or residential treatment, involves staying at a treatment facility where trained treatment specialists provide medical attention and support. Some programs only last a few weeks, while others might last several months to a year.

Many rehab programs also incorporate elements of the following treatment approaches.


Psychotherapy and addiction counseling can help with recovery, especially if someone started using substances to deal with distressing emotions.

A therapist can help them explore some of the reasons behind their substance use and come up with new coping strategies for dealing with challenges.

Online therapy options

Read our review of the best online therapy options to find the right fit for you.

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In some cases, medication can help people working through addiction have greater success with recovery.

It can be particularly helpful for preventing relapses in people dealing with substance use disorder involving alcohol, nicotine, or opioids. These medications work in different ways, but they generally help reduce cravings for the substance and reduce symptoms of withdrawal.

Treatment providers typically recommend using medication in combination with other treatment approaches, like therapy, to address underlying factors.

Support groups

Twelve-step programs like Alcoholics Anonymous and Narcotics Anonymous help many people achieve recovery. These programs rely on self-help treatment methods and involve anonymous group support from other people working toward recovery.

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Comfort and guidance from others working toward recovery can make a lot of difference. However, these programs typically don’t provide enough support on their own. Plus, the 12-step model doesn’t work for everyone.

Other programs, such as SMART Recovery, may be a better option for people looking for a more scientific approach to group support.

Treatments for behavioral addictions

As with chemical addiction, many different factors can contribute to behavioral addictions. Treatment approaches can vary, but therapy is usually the first recommendation.


A type of therapy known as cognitive behavioral therapy (CBT) if often most helpful for behavioral addictions.

CBT focuses on paying attention to the thoughts and emotions that cause distress and learning how to reframe them in the moment. This, combined with more productive coping skills, can reduce the need for addictive behaviors.

Other types of therapy can also help address underlying issues that might play a role in behavioral addiction, like relationships concerns.

Other treatments

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Self-help groups and other types of peer support can help with behavioral addiction, especially when used in combination with therapy.

Some researchTrusted Source also suggests SSRI antidepressants may have some benefit for addressing addictive behaviors.

The bottom line

Experts may still have more to learn about how and why addiction happens, but one thing is clear: Addiction is treatable.

The Substance Abuse and Mental Health Services Administration (SAMHSA) website can help you find recovery resources for yourself or a loved one, including information about addiction, a treatment services locator, a free 24-hour informational helpline, and more.

Crystal Raypole

Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.

Last medically reviewed on February 28, 2020

How we reviewed this article:


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Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Feb 28, 2020

Written By

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Timothy J. Legg, PhD, PsyD

Copy Edited By

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Medically reviewed by Timothy J. Legg, PhD, PsyD — By Crystal Raypole on February 28, 2020

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Artificial Intelligence and Healthline

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Over the past year, we’ve seen a massive increase in the degree to which AI is being integrated into products and services we use on a daily basis. Artificial intelligence (AI) — large networks of data that can generate text, answer questions, edit images, transcribe audio, and more — is creating a step change in how people create, access, and use information to answer questions, solve problems, and make decisions. In this way, what’s happening now has parallels with the impact that Google had when it first released its search engine. People moved from accessing information on the internet as if they were browsing a phone book to the dominant information navigation experience of the last 20 years: ranked search results. AI has the potential to change how users discover information in a similarly meaningful way.

As one of the largest health and wellness information properties in the world, Healthline’s core mission is helping people own their health and well-being, largely by providing access to trustworthy and accurate information about health conditions, mental health, and overall wellness.

We see the potential for what’s happening in AI to make a positive impact on our ability to help consumers access this vital information. We want to communicate proactively where we see opportunity and what we are doing to evaluate this opportunity in a responsible way that seeks to realize the benefits, while also mitigating the risks that come with using a relatively new technology.

Where we see opportunity and how we see AI being integrated into healthcare

Artificial intelligence models are being used elsewhere in the healthcare industry — to assist doctors in their work burden, to improve the access experience, and to assist in diagnosis and treatment, to name a few.

We fundamentally see AI as another technological advance that can impact human lives. To that end, some of the initial use cases for leveraging AI that we are starting to explore include creating chat-based assistants to answer user questions to augment the existing Healthline experience. The first iteration of a chat-based assistant is an AI-powered health-journey assistant, specifically focusing on skin care. This assistant tool will utilize our content repository to generate responses to queries.

How we plan to experiment responsibly and work to mitigate the risks

We want to acknowledge the risks that come with using a still-new technology in a domain like healthcare where accurate, unbiased information is paramount. We believe that the way this technology allows people to access, understand, and use information has the potential to create significant value when it comes to helping people manage their health, and we want to responsibly evaluate the potential applications.

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To that end, we want to be transparent about the measures we are putting in place to best address some of the potential risks that come with using this technology. We have formed an AI Review Board composed of leaders across our medical, legal, equity, business, data, security, privacy, creative, editorial, and engineering teams. The purpose of this review board is to define the standards we are using to vet uses and applications of AI from a broad, multidimensional perspective.

We will work in lockstep with our clinical teams, editorial team, and medical reviewers to ensure close vetting for medical rigor and factual accuracy of any and all external-facing experiences or pieces of media in which AI is involved. We will be transparent to end users whenever they are viewing or interacting with an experience that is assisted or powered by AI. All content will be subject to the rigorous copy edit, editorial, and medical review standards users expect from all of our content.

We continue to work with leaders and monitor the evolving technology in the AI space to ensure that we improve the iterations of our model’s outputs. We also welcome feedback through our established reader feedback process as part of our overall surveillance to continuously improve the outputs.

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Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

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