Mira Choi Tyson, L.Ac.

Those suffering with a substance abuse addiction are often unable to cease their behavior without some form of medical intervention. Studies have found that repeat use of certain drugs can figuratively rewire the brain, resulting in alterations to neural pathways associated with dopamine. This means that repeat drug users may become reliant on consuming the substance in order to function. For example, those with alcohol addiction ("alcoholism") become physically dependent on alcohol and may experience extreme withdrawal symptoms when avoiding alcohol entirely; in rare cases, medically unsupervised withdrawal can lead to death.

Behavioral addictions are similar to substance abuse addictions; however, people with behavioral addictions are addicted to a behavior or emotion associated with certain behaviors, as opposed to drugs. In addition to gambling, common behavioral addictions include food, video games, social media, shopping, and pornography addictions. When performing the activity, people experience euphoria (a rush of dopamine) that slowly lessens over time, meaning they build a tolerance and dependency on a behavior. For example, people who are addicted to shopping may need to purchase more items or spend more money to feel the same rush that once fueled their addiction.

Addictions can be assessed through a variety of means such as diagnostic screening, abuse assessment, or psychiatric evaluation. Treatment can help patients recover from their addictions and manage mental and physical health conditions related to their addiction. People with addictions may be treated in rehabilitative treatment facilities, hospitals, and other clinical settings.

Addiction treatment for substance abuse may include:

• Detoxification (withdrawal from an addictive substance)
• Pharmacotherapy (prescription medications), such as buprenorphine-naloxone (Suboxone), disulfiram, and naltrexone to ease withdrawal symptoms
• Overdose treatment, such as the administration of naloxone (also known as Narcan)

Addiction treatments for both substance abuse and behavioral addictions may include:

• Addiction therapy and psychiatric care, such as cognitive behavioral therapy (CBT)
• Prescription medicine for co-occurring psychiatric disorders
• Twelve-step programs and support groups, such as Alcoholics Anonymous (AA) or Food Addicts Anonymous (FA)

Addiction treatment has expanded to include care for patient substance abuse in non-clinical settings. A number of community programs now provide at-risk substance users a safe place or means to use drugs and mobile doctor's services for drug-associated illnesses and injuries. Behavioral addictions are also gaining increased attention as researchers and mental health professionals seek to better understand and treat them. For example, some researchers are assessing the connections between video game addiction and childhood risk factors. More and more, mental health experts are recognizing the importance of meeting people with addictions where they are at, using more advanced treatments. Addiction treatment is intended to care for people with addictions with compassion and respect.

Joint problems include bursitis and arthritis. Bursitis is the inflammation of a fluid-filled sac cushion on the outside of a joint, causing symptoms including pain and swelling. Arthritis is the inflammation and damage of a joint due to wear and tear or disease. There are several treatments for arthritis, but if the damage progresses far enough, joint replacement may be necessary. In joint replacement, a metal or plastic implant is surgically placed within the joint to make movement easier.

Bone problems include scoliosis, fractures, and osteoporosis. Scoliosis is a curvature of the spine, making the normally straight spine look like a 'C' or 'S.' It is treated with braces or surgery. Osteoporosis is a disease that causes bones to weaken and break easily. It's most common in women, especially older women. Fully half of all women over 65 have osteoporosis. Fractures are any break in the bone. They can be a simple crack or a severe and complicated shatter. Osteoporosis causes fractures in people who have it, but other causes are trauma (such as a fall) or overuse.

Tendon and ligament problems most often result from injury or overuse. Two good examples are ligament tears and tendonitis. The most common ligament tear is the ACL tear in the knee. This ligament supports and stabilizes the knee and is most often torn during sports activities. Tendonitis happens when a tendon, which connects muscles and bones together, becomes irritated and inflamed. This happens most often in older patients who push their bodies too far, leading to pain and swelling. Treatment for both tendon and ligament problems usually includes rest, ice, and supporting the area to let it heal.

Pain and numbness problems can be caused by overuse, disease, an injury, or a compressed nerve. Lower back pain and carpal tunnel syndrome are two of the most common conditions patients encounter. Lower back pain may be caused by sore muscles that have been overworked, or an injury to the disks separating the vertebrae in the spine. Lower back pain usually goes away on its own within a few days, but it may require medical treatment depending on the cause. Carpal tunnel syndrome occurs when the nerve at the base of the palm becomes trapped or pinched. Symptoms include tingling, pain, numbness, or weakness in the hand. Treatment involves rest and sometimes steroid injections.

Because the musculoskeletal system involves so much of the body, problems here can be incredibly varied in their type and severity. Some musculoskeletal problems will go away on their own or only require rest, while others may require medication, physical therapy, or even surgery.

TMJ can cause a wide variety of symptoms related to the movement of the jaw. They can include earaches, headaches, an inability to open the mouth very far, painful clicking or popping noises when chewing or talking, and stiffness or pain in the jaw, face, or neck. Sometimes TMJ symptoms seem to go in cycles, getting better or going away for a while only to come back again. Symptoms can be mild and not very bothersome, or so persistent and painful as to be almost debilitating.

There can be many potential causes of TMJ. An injury or trauma to the jaw, arthritis, or grinding the teeth can all contribute to TMJ. The temporomandibular joint contains a small disc of cartilage that allows it to move smoothly, and this disc can become dislocated or torn. Sometimes the cause is unknown. There are no standard tests for TMJ, and it can be difficult to diagnose and treat.

Mild cases of TMJ may benefit from self-care such as eating soft foods, practicing stress management techniques, and applying ice packs to the jaw. NSAIDS, such as ibuprofen, can be purchased without a prescription and work to reduce pain and inflammation. Some dentists and occupational therapists can suggest stretching techniques for the jaw which may help relieve stiffness. More serious cases may require a form of splinting called a stabilization splint or bite plate, which helps reduce pressure on the joint. Extreme cases may benefit from arthroscopic surgery on the joint.