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.

Can medications help me quit smoking?

DEAR DOCTOR K: I've tried to quit smoking on my own, but it never lasts. Could medications help? How do they work?

DEAR READER: Medicines can help, and they have improved "quit rates." Although smoking is a particularly hard habit to break, you can do it. The proof: There are more ex-smokers in the United States today than there are smokers.

How can I cure a hangover?

DEAR DOCTOR K: Why do I get a hangover when I drink? What's the best way to get rid of it?

DEAR READER: Last night was great -- friends, food, fun and wine. Lots of wine. But this morning your head is pounding and your mouth is dry. The lights are too bright and every noise sounds like a jackhammer. Breakfast? You can't bear the thought of it. There's a lot we don't know about hangovers -- but we do know about the effects of alcohol on the body. And what we know may explain some of your hangover symptoms.

Do I have a drinking problem?

DEAR DOCTOR K: I started drinking more during the holidays. It seemed natural, as there were so many parties and happy hours. But the holidays are long over, and I haven't cut back. Could I have a problem?

DEAR READER: You ask a difficult 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?

Do I have a drug addiction?

DEAR DOCTOR K: I think I may have a drug problem. But how can I tell if I'm truly addicted?

DEAR READER: The world is not divided neatly into those who are "addicts" and those who are not. More and more, doctors are viewing substance use as a spectrum.

Imagine that spectrum as a straight, horizontal line. At the left end are people who have do not use potentially addicting substances. Just in from the left end is a group that uses a potentially addicting substance regularly but only in small amounts -- and never feels pressure to use that substance.

Can medication help with opioid addiction?

DEAR DOCTOR K: I started taking oxycodone for chronic back pain, but now I'm addicted to it. I've heard there may be medications that can help me quit.

DEAR READER: Oxycodone, like morphine, codeine and hydrocodone, is an opioid drug. Opioids are among the most powerful painkillers available. They can also produce a feeling of well-being and euphoria. Opioids affect the brain by attaching themselves to structures on brain cells called receptors. The opioid is like a key and the receptor is like a lock. When the key fits into the lock, the brain cell is affected.

Is my gambling problem related to anxiety?

DEAR DOCTOR K: I used to gamble once a year, on a trip to Vegas. But lately my lifelong battle with anxiety has gotten worse — and so has my gambling. Are they related? What can I do?

DEAR READER: Gambling and anxiety do often go hand in hand. People who gamble report feeling less anxious while gambling because the excitement masks anxious feelings. This relief can become addictive, and the impulse to gamble can become overwhelming. So for many gamblers, reducing anxiety by some other means is necessary in order to control the urge to gamble as a way of dealing with anxiety. There are several techniques that can help.

How can I control my drinking before it becomes a problem?

DEAR DOCTOR K: I am a 42-year-old man who drinks alcohol pretty much every day. Although I don't feel "out of control" from the amount I drink, I know it's more than the recommended amount. How can I nip this in the bud before it goes too far?

DEAR READER: If you have just one drink a day, there's evidence that this actually may be healthy. More than two drinks a day for men under 65, more than one a day for men over 65, or more than one a day for a woman of any age can raise the risk of alcohol-related diseases.