what is the self medication hypothesis

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What is the self-medication hypothesis?

The Self-Medication Hypothesis. The self-medication hypothesis began appearing in medical journals in the 1970s, as clinicians noticed that heroin addicts were using the drug to cope with problems such as stress and loneliness.

What is self-medication and why do people use drugs?

Self-medication takes on a different meaning in the world of substance use disorders. The self-medication hypothesis or model means that there’s an underlying cause that leads someone to use drugs. In this context, substances are a way to cope with emotions, stressors, and mental health disorders.

What is the self medication theory of addiction?

More in Addiction. The self-medication theory of addiction is based on the idea that people use substances, such as alcohol and drugs, or the effects of other addictive behaviors, such as eating or gambling, to compensate for underlying problems that have not been properly treated.

What is the self-medication model?

Self-Medication Model Self-medication denotes that individuals use specific substances to attenuate adverse states caused either by their psychiatric disorder or by its treatment. The underlying assumption is that substances are used in a selective manner based on their distinct pharmacological effects.

What is the self-medication theory?

The self-medication theory of addiction is based on the idea that people use substances, such as alcohol and drugs, or the effects of other addictive behaviors, such as eating or gambling, not to seek euphoria, but to relieve dysphoria or change an uncomfortable emotional state.

Who proposed the self-medication hypothesis?

1. Khantzian EJ. The self-medication hypothesis of addictive disorders.

What is an example of self-medication?

Common examples of self-medication are: Drinking or using drugs to escape depression. Using drugs to calm bipolar disorder. Using drugs or drinking to ease anxiety (often social anxiety)

What is meant by self-medication?

Definition of self-medication : the act or process of medicating oneself especially without the advice of a physician : self-treatment For chronic coughs, self-medication with cough remedies is usually inappropriate, and most doctors discourage their use. —

What are the reasons for self-medication?

In the current study, the most common reasons for self-medication were the non-seriousness of the illness, easy access to a pharmacy store, the ability to save necessary medications at home, the inconvenience of using health insurance, and the availability of health or drug information on the internet.

What are the benefits of self-medication?

Good self-medication can also provide benefits such as: Saving scarce medical resources from being wasted on minor conditions. Lowering the costs of community funded health care programs. Reducing absenteeism from work due to minor symptoms.

What are the problems of self-medication?

Potential risks of self-medication practices include: incorrect self-diagnosis, delays in seeking medical advice when needed, infrequent but severe adverse reactions, dangerous drug interactions, incorrect manner of administration, incorrect dosage, incorrect choice of therapy, masking of a severe disease and risk of ...

What are the five consequences of self-medication?

The risks of self-medication include:Incorrect self-diagnosis.Delays in seeking appropriate medical advice and proper treatment.Potential adverse reactions.Worsening of the condition the individual is trying to self-treat.Dangerous drug interaction.Masking of severe diseases.Risk of dependence and abuse.

What happens when people self-medicate?

Self-medicating can impact how well you sleep, deplete your energy levels, and lower your immune system, making you more susceptible to illnesses. Your mood and emotional well-being will also suffer as you get trapped in a downward spiral of worsening mood and increased substance use.

What is the primary purpose of self-medication administration?

Self administration aims to improve patient understanding, assess compliance, improve confidence, minimise medication problems when patients are discharged and allow the patient to maintain their independence.

How can you tell if someone is self medicating?

Signs of Self MedicatingStaying away from family, friends, social events, and other activities.A sudden change in hobbies or who one spends time with.Secrecy about how one spends time.Neglecting physical care, such as showering or eating.Having difficulties in work, school, or other areas.Sudden anger.More items...•

What does it mean to self medicate for mental illness?

Self-medicating is a term that many people use to describe their use of substances as a way of coping with difficult emotional or mental states.

Can you self medicate anxiety?

Although an individual may initially achieve the desired effect—numbing, escaping, or feeling relieved—these reprieves are temporary. Self-medicating is a dangerous gamble that typically ends up worsening anxiety, rather than treating the condition.

Why is self medication important in addiction?

Many people who have been through the process of becoming abstinent feel that any drug use, including medications, allows people to avoid dealing with psychological issues and reinforces denial. In tandem with this, the self-medication theory reinforces the disease model of addiction.

How can depression be treated?

Depression, for example, can often be successfully treated with antidepressants and lifestyle modifications such as exercise, potentially freeing the individual from seeking emotional comfort from their mood symptoms in their addiction. 2 3.

What is the self-medication hypothesis?

The self-medication hypothesis began appearing in medical journals in the 1980s as clinicians noticed that people who were addicted to heroin were using the drug to cope with different types of underlying distress such as rage and loneliness. 1. The self-medication theory suggests that use develops as a way ...

Is self medication theory popular?

Responses. The self-medication theory is increasingly popular among people with addictions and professionals who treat them. However, there are some who take a hard line on addictions and believe the self-medication theory is an excuse for irresponsible behavior. Many in the medical profession find it useful to transition people from substances ...

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Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Do celebrities have drug addictions?

Addiction and its treatment are no longer swept under the carpet, and these issues have even become the subject of reality shows, such as "Intervention." Many celebrities and even politicians have admitted to past drug use.

Who is Steven Gans?

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. The self-medication theory of addiction is based on the idea that people use substances, such as alcohol and drugs, or the effects of other addictive behaviors, such as eating or gambling, not to seek euphoria, ...

What is the self-medication hypothesis?

One of the main propositions of the self-medication hypothesis is that a person’s choice of substances (e.g., alcohol, cocaine, heroin) is intimately tied to the particular distressing emotional state that they are trying to manage. For example, individuals who experience anxiety and fear may use alcohol, a central nervous system depressant, because of its calming and sedative effects. Stimulants, such as cocaine or amphetamines may be appealing to those who are avoidant, depressed, or have low self-esteem because of these drugs’ energizing properties (acute effects of stimulants include improvement in mood, increase in energy, self-esteem, self-confidence, and reduction of feelings of emptiness and depression).

Why do people turn to drugs?

People often turn to drug and alcohol use in order to reduce or manage negative or overwhelming emotional states. The “ self-medication hypothesis” is a term coined in the 1980’s by Dr. Khantzian, Clinical Professor of Psychiatry at Harvard Medical Center. By the 1990’s the term was used to describe a general model of addiction that posits that people use substances as a self-regulation strategy, due to difficulties in four different areas: self-esteem, emotions, interpersonal relationships, and self-care.

Does alcohol cause withdrawal symptoms?

Other studies that call into question the self-medication hypothesis show that alcohol and drug use may actually cause or worsen psychological symptoms (Tomlinson and colleagues, 2006) – a process called the rebound effect . After reducing or stopping substance use after extended periods of heavy use, withdrawal symptoms may mimic psychological symptoms such as anxiety and depression, due to neurochemical imbalances in the brain leading to a hyper-excitable central nervous system response. This may then perpetuate a cycle whereby the person uses additional substances to manage the physiological effects of the withdrawal process. Therapeutic interventions in this realm would focus on strategies to reduce or eliminate substance use first, with an eye on the safe and therapeutic management of withdrawal symptoms throughout the process of resolving psychological issues.

What is ESM in addiction?

ESM offers a general framework that can potentially be applied to an understanding of several types of addictive behaviors. Available data from animal models suggest that a variety of distressing situations can trigger corrective consummatory actions, including physical pain (e.g., sciatic nerve ligation), pain-induced fear (inescapable shock), and psychological pain (e.g., reward loss). Such research has also identified voluntary anxiolytic intake as substances preferred and consumed during periods of distress. Theoretically, there are reasons to predict that ESM will be triggered by other sources of emotional distress induced by negative changes (e.g., physical restraint, escape behavior, open spaces) and supported by the consumption of a variety of substances (e.g., opioids, over-the-counter analgesics, serotonergic anxiolytics). ESM may also be supported by nondrug substances, making the framework potentially relevant to obesity, video game addiction, and other activities that can develop properties similar to those of more traditional addictions. Furthermore, the ability to regulate emotional states suggests that the consumption of substances with anxiogenic effects may be selectively inhibited during periods of stress. Finally, the bridge between consumption limited to periods of distress and excessive consumption will require additional research. One possibility is anticipatory ESM, that is, consumption triggered in anticipation of an anxiogenic situation. If sustained, such behavior could become habitual, occurring even in the absence of a negative emotion, or acquire a new goal—reducing withdrawal symptoms generated by the very substance originally used for self-medication. Thus, a behavior that started as a way of reducing negative emotions induced by specific external events (e.g., reward loss) may become co-opted to reduce new negative emotions induced by other events, including drug deprivation.

What are some examples of symptom alleviation?

Examples of symptom alleviation include the use of nicotine by people with schizophrenia to normalize deficits in sensory processing (attention) or the use of stimulant drugs (amphetamines and cocaine) by depressed patients to counter anergic symptoms (lack of energy and amotivation).

What are some examples of substance use mitigating the side-effects of psychotropic medications?

An example of substance use mitigating the side-effects of psychotropic medications is nicotine relieving the extrapyramidal motor and dysphoric side-effects induced by antipsychotic medication; it is proposed that it releases dopamine to ameliorate the dopamine D2 receptor blockade induced by the medication.

Why do people with schizophrenia use drugs?

Reasons for use are similar to the general population, e.g. “to get high,” to decrease depression, to relax, to increase pleasure, and to increase energy. The psychiatric symptom most associated with addiction among patients with schizophrenia is depression.

What is the ESM hypothesis?

The ESM hypothesis states that the drug consumed depends on its ability to relieve a preexistent psychiatric disorder or reduce negative emotions.

What factors are associated with substance use in psychiatric patients?

Second, the factors most consistently associated with substance use in psychiatric patients, such as availability, cost, compliance with the peer group, facilitation of social interaction, intoxication, and relaxation, are the same as that observed in the general community . Similarly, patients seldom report self-medication as a reason ...

What are the factors that influence self-medication?

Use of self-medication is influenced by several factors such as personal, organizational, and environmental factors ( de Boer, Versteegen, & van Wijhe, 2007; Sawalha, 2008; Worku & Mariam, 2003 ). Media, Internet, and extensive advertisement by the pharmaceutical manufacturers also play an important role toward practicing self-medication ( Bond & Hannaford, 2003; Klemenc-Ketis, Hladnik, & Kersnik, 2011 ). Inadequacies in the healthcare delivery systems especially in low income countries such as inaccessibility, unregulated distribution of medicines, inequitable distribution, lack of healthcare professionals, high costs, and patients’ attitudes toward healthcare providers are some of the key drivers of self-medication ( Esimone, Nworu, & Udeogaranya, 2007; Yousef, Al-Bakri, Bustanji, & Wazaify, 2008 ).

Why is addiction a disease?

Neuroscientists have similarly concluded addiction is a “primary disease,” which underscores brain pathways that explain the physiological bases for addiction and relapse. As one neuroscientist said, “Addictive drugs hijack the brain.”

What is SMH theory?

SMH is a theory that gets at the human psychological underpinnings of addictive disorders. It does not compete with approaches that emphasize biological or social factors. More likely, the perspectives complement each other. If judiciously integrated, they can enrich our approach to unravelling and solving the elusive equation of addiction. Such an understanding and perspective is in the best humanistic traditions of science, medicine, and psychiatry.

Why is the SMH important?

The SMH provides a valuable investigative and clinical paradigm to address this challenging issue.

What is self medication?

1 It focused on how and why individuals are drawn to and become dependent on heroin and cocaine. An updated version was published in the Harvard Review of Psychiatry in 1997 with application to conditions that had not been previously considered. 2 The hypothesis of self-medication derives from clinical evaluation and treatment of thousands of patients (practice-based evidence) spanning 5 decades. It is a theory that has been and continues to be endorsed. It is widely and regularly cited and endorsed by clinicians and investigative scholars, as evidenced in research websites such as Research Gate, Academia.edu, and Google Scholar. In an article in the American Journal of Psychiatry, Mark S. Gold, MD, 3 concluded that it was one of the most “intuitively appealing theories” about addiction.

What is distressful feelings?

For some, distressful feelings are intense, volatile, and threatening. In others, feelings remain inaccessible and confusing, rendering the sufferer vulnerable to a nameless interminable dysphoria.

What are the feelings of a person?

Feelings (eg, sadness, fear, anxiety, anger) are powerful governing emotions in many aspects of our lives. They determine how we regulate ourselves; they are the basis by which we develop a sense of self-esteem and who we are; they are the foundation for a sense of well-being; they are the currency for human connection and attachment; and they are a primary ingredient for guiding our behavior, especially our capacity for self-care, which guides us in the contexts of risk and danger but is often underdeveloped in persons prone to addiction.

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What Does “Self-Medicating” Mean?

Self-medicating is a behavior in which someone uses drugs, herbs, or other home remedies to self-administer treatment. They do so to reduce physical or psychological ailments without consulting a doctor first.

What are the most common opioids?

Commonly used opioids include codeine, morphine, heroin, oxycodone, and hydrocodone.

What is the effect of nicotine on the brain?

The self-medicating effects of nicotine use include an increase in focus and alertness and a feeling of increased relaxation. Nicotine changes the brain’s chemicals and causes a wide range of side effects on the body’s organs and symptoms.

What percentage of people with PTSD use substances?

Individuals with post-traumatic stress disorder (PTSD) are more likely to use substances to self-medicate. Approximately 20% of individuals with PTSD used substances to relieve their symptoms, including depression and anxiety.

Why should individuals with a substance use disorder (SUD) receive treatment for co-occurring disorders?

Individuals with a substance use disorder (SUD) should also receive treatment for co-occurring disorders because they negatively impact substance use issues.

What are the most common diseases that self-medication causes?

The most frequent diseases for self-medication were fatigue, weakness, anxiety disorders, and fever.

Why is alcohol used to self-medicate?

Alcohol — a common substance used to self-medicate because of the availability and general acceptance of alcohol use. Alcohol can temporarily relieve depression and anxiety. However, it can lead to dependence and can worsen depression and anxiety when used regularly.

Stress and Trauma

When trouble is imminent, the first instinct is to head for cover, what we often refer to as “fight or flight.” Individuals who rely on a substance to cope with stress are seeking protection from what they feel is imminent.

Anxiety and Depression

Research suggests that substance use and depression or anxiety commonly occur together. One study found that almost 25 percent of individuals with depression used drugs to relieve or manage symptoms. Some substances may provide temporary relief from anxiety and depression, particularly central nervous system depressants like alcohol.

Chronic Pain

Self-medication isn’t always in response to mental health disorders. In addition to emotional pain, substance use can relieve physical pain.

What are the risks of using opioids?

Risks: Worsened depression symptoms, death, legal consequences. Opiates, such as codeine and morphine, are drugs derived from the poppy plant. Any drug that mimics the effects of an opiate is called an opioid. Opioids include heroin, oxycodone, and methadone.

What is depression in psychology?

Depression is classified as a mood disorder. It’s associated with feelings of sadness, loss, and anger. When someone is depressed, these symptoms can impact their everyday life. Treating depression is important. It usually involves counseling, medication, or both.

How many people used opioids in 2013?

The World Drug Report estimated that in 2013, 40.9 to 58 million people worldwide used opiates and opioids.

What are the risks of self-medicating with psychostimulants?

Self-medicating with psychostimulants. Forms: Cocaine, amphetamines. Risks: Heart failure, death, legal consequences. People with mental health conditions may abuse psychostimulants such as cocaine and amphetamines. This is most likely due to the feelings of euphoria these drugs can cause.

What are the risks of eating emotional food?

Risks: Decreased self-esteem, worsened depression symptoms. If you’re an emotional eater, you might self-medicate with food. “Emotional eating” is using food as a way to suppress or soothe negative emotions. This practice is also called “bingeing” or “comfort eating.”.

What is the most commonly used substance for depression?

Risks: Worsened symptoms of depression, legal consequences. Compared to illicit substances (such as opioids, cocaine, and amphetamines), marijuana, or cannabis is, by far, the most widely used substance among those with depression.

When was the idea of self-medication first introduced?

The idea that substance abuse can be a form of self-medication is formally known as the self-medication hypothesis and was introduced in 1985. The hypothesis claims that people use substances as a response to mental illness. It states that alcohol and drug abuse is often a coping mechanism for people with a variety of mental health conditions, ...

Summary

Origin

• The self-medication hypothesis began appearing in medical journals in the 1970s, as clinicians noticed that heroin addicts were using the drug to cope with problems such as stress and loneliness. This lead to the idea that drug use develops as a way of coping with stress in the absence of adequate solutions and meaningful social relationships.

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