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		SPECIAL HOSPITAL FOR ALCOHOL AND DRUG DEPENDENCE "Dr BORO LAZIC" Pere Popadica Street 33, Novi Sad
	The word addiction arouses a lot of different pictures and strong emotions. How do we react? Very often we are focused on the wrong aspects of the addiction, so our efforts to face with this dif-ficult problem are wrongly oriented. An addiction is very often described as a mistake or a fall in a moral sense. Wrong interpretation of drug addiction requires defining of an addiction as a disease, in order for ill persons to get the proper treatment, as the other people who have different chronic illnesses do. An assessment based on prejudices influences the society in treating and solving the problem socially and medically. Unfortunately, since the ordinary people and even doctors very of-ten see addiction only as - a provoked state, an addict doesn't get the same medical treatment as the ones with the chronic illnesses do. Thanks to the influence of a drug addiction to the social system the drug addiction became primarily a social problem. Drug addiction (abuse and drug dependence) has been seen as a strictly social problem, and persons who are taking drugs as morally weak with a tendency to crime. They believe that the drug addict or temporary user should be able to quit if he wants to change his behavior. Unfortunately, very often the families of the addicts and health workers who work with them have such wrong attitudes (mis-leads). Dependence has started with taking drugs when the person made the choice to use drugs, but the dependence does not mean only taking drugs often and a lot. Since taking drugs is on voluntary bases, control of behavior or willpower is important in development (in the beginning) of depend-ence. In one way the person is to blame for behavior that leads to addiction, but this voluntary ini-tiation of a disease process doesn't separate etiologically an addiction from other diseases. There are a lot of diseases where voluntary choice causes beginning and maintaining, espe-cially when voluntary behavior interacts with genetic and cultural factors. Genetic factors, personal choice and influence of environment factors are included in the eti-ology of addiction. The persons make choice when they start to use drugs. Some of them start in order to alleviate some medical conditions and then continue after the medical indications (demands) are gone. Sometimes, children with depression or other psychiatric diseases start to take drugs to cure themselves. Other people start to take drugs to feel the pleasure, to avoid the life pressure (stress) or to change an opin-ion on reality (picture of reality). Public opinion on drug addiction has an influence on this volun-tary initiation in the world of addiction. When does use of drugs become a disease? Nobody becomes an addict after the first use. Actually, an addiction is the top of one contin-uum: No use - periodical use (abuse) - dependence! Addiction leads to the long-term changes in anatomy and biochemistry of the brain. Changes in the brain don't lead just to the loss of control in taking substance, but the substance changes all life as-pects. The essence of the addiction is the urge to take the substance and the compulsive behavior. They are very difficult to control, more difficult than physical dependence. The entire life of the addict be-comes focused to acquiring and using the drugs. For one addict the power of motivation for giving up the drugs is significantly minor than the urge to take drugs. These persons are able to commit any crime, even to leave their own children, just to get drugs. An addict has a compulsive need (crave) to take drug disregarding harmful physical, social and emotional consequences. The addicts become isolated from the families, friends and they have difficulties at work and school. Some people think that the addiction is a phenomenon of permanent repeat of an urge for the ex-perience for which they are willingly paying a certain price. No matter if the drug provokes a physical crisis or doesn't, it is very difficult to end taking it due to changes in the brain caused. When the addict stops taking the drugs, he feels a strong urge or inten-sive desire to take it. The urge starts from the brain need to maintain the state of a new equilibrium (homeostasis) which now includes the presence of the drug. The person can feel the urge in all phases of addiction, even early in the experimental phase. The urge has the physiological basis in the brain. New scientific researches provide a lot of proofs that the drugs don't just interfere to normal brain functioning in producing a strong feeling of pleasure, but also they make long - term effects on their metabolism and activities. The changes made in certain parts of the brain alter peri-odical use of drugs into dependence, a chronic disease with relapses. Such person suffers from a strong urge and need to use drugs and can't quit on his/her own. The treatment for ending this compulsive behavior is necessary. The addiction is in many ways similar to other chronic diseases like diabetes or disease of coroner arteries. Genetically, environmental and behavioral factors have an influence on their development. Somebody might think that the addiction is something different since such state is self-provoked. Actually, only the first step is a voluntary choice, but once the dependence is developed, taking the substance is compulsive, not voluntary. Biological basis of addiction doesn't liberate the person from the responsibility for his/her in-dividual actions. Voluntary choice can contribute to development of many diseases, for instance the person who chooses to live unhealthy life (fat food, smoking, inactivity) increases the risk of genesis of the coronary disease. An addiction is a chronic disease which can be well treated similarly as other chronic diseases. Successful solving of the addiction problem requires more than "just say no". The addict suffers from compulsive urge and need to take the substance and can't quit on his/her own. The treatment for ending this compulsive behavior is necessary. Successful treatment of any chronic disease requires patient's consent to initiate the predicted treatment. Following the treatment plan is difficult for each person with a chronic disease. For instance, less than 50% of diabetic patients only monitor the routine treatment plan, and just 30% really follow the treatment. 50% of all diabetic patients who don't follow the treatment plan, then repeat the treatment during the first year after setting the diagnosis. The similar statistics is for the other chronic diseases. Around 40% of patients with hypertension require treatment in intensive care due to episode of extreme high tension in the first year of treatment and just 30% of adults with asthma take prescribed medicaments. Even if the treatment of addiction is statistically more successful than in the case of other chronic diseases, the addicts have very often the relapse of disease during the treatment and recovery and they start to use the substance again. Difficulty in following the treatment plan and overcoming of stress (efforts) in chronic diseases shows how difficult is to change human behavior. The treatment programs have different ways to help the patients to overcome the urge and avoid the relapses, if possible. The scientific research shows that addiction is curable with a certainty. Through the treatment that is adjusted to individual needs, the patient can learn to control his own state and live relatively normal life. Since the dependence has more dimensions and disturbances of many life aspects of an individual, the treatment of this disease is never simple. The treatment of the dependence must help an individ-ual to stop taking drugs and maintain the abstinence and at the same time to achieve productive functioning in the family, at work and in the society. Effective treatment programs of drug abuse and dependence consist of many components; each of them is directed to a certain aspect of the dis-ease and its consequences. Three decades of scholarly research and clinical practice contributed to development of many effec-tive ways of dependence treatment. New research information shows that dependence treatment is successful as the treatment of the other chronic diseases. In spite of scientific evidences that the de-pendence treatment is successful, many people still don't believe. Partly, it's because of unrealistic expectations. Many people think that dependence is the same as simple taking drugs and because of that they expect that dependence should be cured fast, or in the opposite, the treatment is not suc-cessful. In reality, since dependence is chronic disturbance, the final goal and success for long-term abstinence very often requires persistent and repeated treatment episodes. Who dares, wins!