Addiction

Is addiction a disease or is it caused by a lack of willpower?

DEAR DOCTOR K: My brother has struggled with addiction for years. I've told my husband that addiction is a disease, but he claims my brother is weak and lacks willpower. Is he right?

DEAR READER: There is a lot of stigma and shame associated with addiction. But the truth is, people with substance-use disorders aren't simply weak or immoral. It surely is true that people who try out illegal addictive drugs for recreational purposes are breaking the law. In my opinion, they also are doing something profoundly stupid. But they're often teens, who tend to do a lot of stupid, impulsive things. Moreover, many people who become addicted to legal drugs were started on those drugs by their doctors.

Should I be concerned about my drinking?

DEAR DOCTOR K: During my daughter's wedding, and all the events surrounding it, I started drinking more than usual. But that was six months ago, and I haven't cut back to where I was before. When do I get concerned that I might have a drinking problem?

DEAR READER: It's not easy to answer your question. What constitutes "healthy" versus "harmful" drinking can vary quite a bit from person to person. So where is the line between social drinking and problem drinking? Does drinking every day or drinking a certain amount indicate a problem?

Is it possible to ease the symptoms of alcohol withdrawal?

DEAR DOCTOR K: My husband has a problem with alcohol. He has finally decided to quit and has set a date for his final drink. How will his body react once he stops? Is there anything we can do to help ease his withdrawal symptoms?

DEAR READER: Alcohol withdrawal refers to the changes the body goes through when a person who has been drinking heavily for a long time suddenly stops.

What’s behind the recent epidemic of opioid addiction?

DEAR DOCTOR K: The news media say that we suddenly have an epidemic of addiction to prescription opioid painkillers. These pills have been around for a long time. What's changed?

DEAR READER: Developing treatments that reduce or eliminate pain has been one of the great accomplishments of medical science. Until the past couple of centuries, our ancestors had no way to relieve the pain from a major injury, or from a disease like cancer.

Could low-nicotine cigarettes help me quit smoking altogether?

DEAR DOCTOR K: I've decided to quit smoking. Do you think low-nicotine cigarettes could be a good stepping-stone to kicking the habit completely?

DEAR READER: I'm always glad when readers ask about how to quit smoking. It causes so many health problems and so much misery. And while it's not easy, people can quit smoking. Yet millions of adults and teenagers continue to smoke. The main reason is nicotine.

Why can’t women drink as much as men?

DEAR DOCTOR K: Can you explain why "moderate" drinking is defined differently for men and women? Is it because men tend to be heavier? Or is there more to it?

DEAR READER: Women are advised to drink less alcohol than men because they are much more vulnerable to alcohol's harmful effects.

How can I prevent addiction to my prescription painkillers?

DEAR DOCTOR K: My doctor has prescribed prescription painkillers -- opioids -- for my severe back pain. They relieve my pain, but how can I reduce my risk of becoming hooked?

DEAR READER: Simply being aware of the risk of addiction is a good first step in ensuring that you do not become addicted to prescription painkillers. I'll explain a little bit about painkillers. Then I'll describe some steps you can take to prevent addiction.

How can I help my brother overcome his alcohol addiction?

DEAR DOCTOR K: My brother is addicted to alcohol. How can I help him overcome his addiction?

DEAR READER: It is so hard to watch a loved one suffer. And addiction surely causes suffering. In some ways, the suffering from addiction is worse than from other illnesses. One reason is that family members and friends often worry that they might have contributed to the addiction.

Why are some people more vulnerable to addiction than others?

DEAR DOCTOR K: Is it true that some people are more vulnerable to addiction than others? Why?

DEAR READER: We tend to think about the ravages of addiction mainly when it takes a celebrity from us. Recently the actor Philip Seymour Hoffman died, at 46, of an apparent overdose of heroin. In 2012, it was the singer Whitney Houston, at 49. Both were once-in-a-generation talents -- and both gone, just like that.

I’ve been drinking more recently — How can I rein in my drinking before it becomes a problem?

DEAR DOCTOR K: I'm a 36-year-old woman. Lately I've been drinking more than I used to. How can I rein in my drinking before it becomes a problem?

DEAR READER: Even for people who initially have a healthy relationship with alcohol, things can change over time. So how can you prevent casual drinking from crossing into problem drinking? First, some basics. A standard drink equals 12 ounces of beer, 5 ounces of wine or 1.5 ounces of hard liquor.