Social Work and Addictions

According to the National Survey on Drug Use and Health (NSDUH), 46.3 million Americans aged 12 and older had substance use disorders (SUDs) in 2021.¹ People who develop these conditions become mentally and physically dependent on alcohol, heroin, or other drugs.¹ These substances can have serious and even fatal consequences for users. The Centers for Disease Control and Prevention (CDC) reports that almost 92,000 people died from a drug overdose in the United States in 2020.²

Social workers play a central role in the battle against addiction. Substance abuse counseling helps people with SUDs develop healthy coping strategies and achieve addiction recovery. Additionally, social workers can provide treatment for behavioral addictions, such as gambling and shopping addictions. As a social worker, it can be immensely rewarding to make a difference in your clients' lives. Read on to learn more about addiction and the techniques social workers can use to aid people with behavioral addictions and SUDs.

SUDs can take many forms, and some people may develop more than one kind of addiction. Common types of these disorders include:

Data from the NSDUH shows that 29.5 million people had an alcohol use disorder (AUD) in 2021.¹ This medical condition impairs people’s ability to moderate or stop their consumption of alcohol. People with AUD may binge drink sporadically or regularly drink heavily.³

Symptoms of AUD include:³

• Intense cravings for alcohol
• Prioritizing drinking over hobbies
• Needing to drink larger quantities of alcohol to get the same effect as when the user first started drinking
• Having difficulties fulfilling academic and family obligations because of alcohol
• Getting into unsafe situations while under the influence of alcohol

Alcohol can cause many side effects. For instance, people who misuse this substance may have impaired cognitive function. According to certified addiction specialist Dr. Timothy B. Conley, heavy drinkers can develop permanent brain damage, but many users recover after abstaining from alcohol for several months or a year.⁴

Opioid drugs, such as fentanyl and morphine, affect the nervous system and decrease feelings of pain. They also evoke positive feelings like euphoria and pleasure, which can make them addictive.⁵ According to the CDC, 2.7 million people had an opioid use disorder (OUD) in 2020.⁶

Signs of this chronic disease include:⁵

• Emotional distress caused by opioid use
• Failure to take care of family, school, and work responsibilities
• Potentially fatal overdose

Cannabis, or marijuana, contains psychoactive compounds that affect emotion and memory. Research shows that cannabis can alter circuits in the brain when used heavily or for extended periods of time. As a result, individuals who misuse the drug can develop cannabis use disorder (CUD).⁷

CUD is characterized by:⁷

• An uncontrollable desire to use cannabis
• Inability to control cannabis consumption
• Failure to maintain social relationships due to cannabis use
• Taking cannabis in dangerous situations

Some people can become addicted to nonchemical activities that affect the brain’s reward system. The brain’s reward system responds to certain stimuli by releasing dopamine, which in turn makes you feel happiness and pleasure. Common behavioral addictions, including gambling, exercise, shoplifting, and video games, trigger the brain’s reward system, forming an association between the activity and the pleasure of the dopamine release. Like SUDs, behavioral addictions can have adverse health and social consequences.⁸

Addictions typically develop through three stages:

During this phase, the substance alters structures in the brain, including the basolateral amygdala and the prefrontal cortex. These changes impair the user’s decision-making, self-inhibition, and working memory. They also cause intense cravings for the substance.⁹

When someone consumes intoxicating amounts of a substance, their brain releases dopamine. This chemical provides positive reinforcement, increasing the likelihood that the user will repeat the behavior.⁹

After the user stops taking the substance, they experience adverse symptoms, such as emotional numbness, irritability, and stress. These side effects motivate them to take the drug, starting the cycle over again.⁹

Social workers use many treatment approaches during behavioral and substance abuse counseling, such as:

Addictions and mental health disorders often go hand-in-hand. Approximately 33% of people with SUDs also have a mental health condition, such as anxiety or depression.¹ When two or more conditions coincide, patients have a dual diagnosis.¹⁰

It’s not always clear whether patients develop SUDs or mental disorders first. In some cases, people with mental disorders may attempt to self-medicate their symptoms with drugs. In other situations, patients may develop mental disorders after misusing substances that cause structural changes in the brain.¹⁰

Social workers can use dual diagnosis treatment to manage both conditions. This approach may involve:¹⁰

• Cognitive behavioral therapy to change harmful thought patterns
• In-patient rehabilitation treatment
• Medication to treat either disorder
• Support groups

People with addictions to gambling and other behaviors may benefit from several kinds of treatment, such as:¹¹

• Guided self-help: Self-guided activities like informational phone calls and workbooks may help people overcome behavioral addictions
• Motivational enhancement: These interventions help patients develop the motivation to alter harmful behaviors
• Personalized feedback: This technique helps people compare their behavior to the actions of most people

Social workers can teach preventative strategies to help patients with SUDs avoid a relapse. Popular methods include:¹²

• Attending peer support groups like Alcoholics Anonymous
• Prioritizing self-care
• Identifying events that may trigger a relapse, like a vacation

Additionally, social workers can refer patients to psychiatrists who can prescribe medications that decrease physical symptoms of withdrawal. For instance, bupropion can prevent relapses in people addicted to nicotine, while naltrexone reduces cravings for alcohol.¹¹

An online Master of Social Work from Yeshiva University can help you enhance your counseling expertise and improve the lives of people battling severe conditions. Whether you’re passionate about addiction recovery or other types of social work, you can develop new skills and knowledge through our flexible curriculum. You’ll gain hands-on experience through practicum and get individual guidance from expert faculty advisors and peer mentors.

Ready to get started? Contact one of our admissions outreach advisors today to learn more.