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Whitney Houston's Death Raises Addiction Questions

Addiction Relapse Often Deadly: A WebMD FAQ
By
WebMD Health News
Reviewed by Laura J. Martin, MD

Feb. 13, 2012 -- Whitney Houston's death at age 48 is reportedly the result of drug and alcohol abuse.

Houston had entered addiction treatment at least three times. Each effort at recovery was followed by relapse.

Why do people with addictions so often relapse? What is addiction, and what does it mean to recover?

WebMD asked two experts in the field: Ihsan Salloum, MD, MPH, professor of psychiatry and chief of the division of alcohol and drug abuse at the University of Miami Miller School of Medicine; and Bruce Goldman, LCSW, director of substance abuse services at Zucker Hillside Hospital, Glen Oaks, N.Y.

What Is Addiction?

Experts think of addiction as a long-lasting, often relapsing brain disease, Salloum says.

"It is a chronic disease. It is an ongoing illness," Salloum tells WebMD. "People can recover, but they are always at risk of relapse."

Imaging studies document changes in the brains of people addicted to various substances. The brain's pleasure/reward circuit is affected.

"The drug hijacks those circuits," Salloum says.

How Is Addiction Treated?

Most of us are familiar with 12-step programs such as Alcoholics Anonymous. Such programs, which offer intensive community support, can be very effective.

But ultimately, the most effective addiction treatment varies from person to person, says substance abuse treatment expert Goldman.

"Treatment is a very personal choice," Goldman tells WebMD. "Nowadays there are many options: medications, individual psychotherapy, group therapy, family therapy, behavior modification therapy, contingency management, a whole menu of choices, including self-help groups and meetings, that are very helpful to many people."

What works best?

"Addiction treatment can take whatever form is best for an individual," Goldman says. "We understand it is not one size fits all. And the treatment community has worked hard to customize treatment to each person's particular needs."

Salloum says that medications, some targeted to specific addictive substances, can help reduce cravings and make other forms of treatment more effective.

But ultimately, Goldman says, the best predictor of treatment success is how long an addicted person stays in treatment.

"My message is, it is important to get help and stay in help as long as possible," he says. "The longer people stay in treatment, the better their chances."

Salloum notes that even inpatient treatment often is too short. Many insurers reimburse only for a 28-day course of inpatient treatment, but he says a 90-day inpatient treatment course offers better odds of recovery.

Why Is Addiction Relapse So Common?

Addictions are for life. But life isn't always a smooth course. Stress inevitably comes along.

"The whole stress system is linked to the reward system, which has been hijacked by the addiction," Salloum says. "When addicted people are faced with stress they cannot cope with, they are at high risk of relapse."

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