The Opioid Epidemic: How to Spot the Difference Between an Addiction and Physical Dependency

The Opioid Epidemic: How to Spot the Difference Between an Addiction and Physical Dependency

By Crystal Tsui

In a paper written by Turner et. Al (2017), Opioid Use Disorder: Challenges During Acute Hospitalization, discussed the difference between drug addiction and physical dependency. Addiction is described as a disease. It occurs when a drug produces chemical changes in the brain that enforces the medication to be more desirable. When a person is addicted to a certain drug, they start to build a higher tolerance meaning that they would not feel the effects of the drug with the same dosage. This would make them want to increase the dosage each time just to experience the same effect, which can be dangerous and lead to an overdose. The 4 C’s are the beginning signs of addiction. They are:

  • Craving
  • (loss of) Control
  • Compulsion
  • (using despite) Consequences

A few physical signs of substance abuse includes:

  • Track marks
  • Abscesses
  • Pinpoint pupils
  • Blood in their vomit
  • Chronic cough

There are 3 types of opioid consumers we should be aware of; these include patients with chronic pain, patients who are on medication-assisted treatment and stable, and those who are self-medicating. If you or anyone you know has an opioid addiction, they should be met with warmth and compassion. A caring individual, like you, can help an addict seek the help they need, such as medication–assisted treatment or detoxification.

Individuals who are physically dependent on opioids are a different story. They are usually patients with chronic pain and have become dependent on opioids to relieve pain. However, they don’t feel the desire to take the medication for any purpose other than to relieve their pain. They wouldn’t feel the need to have their dosages increased constantly because the dosage of opioids does not change the effects of relieving pain.

This article is to help define the difference between an addiction and being physically dependent on opioids. This is not an exhaustive list.

If you or someone you know has a drug addiction, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit .


Opioid Use Disorder: Challenges During Acute Hospitalization, Turner et al. (2017).

The Opioid Epidemic and Drug-Seeking Behavior

The Opioid Epidemic and Drug-Seeking Behavior

By Crystal Tsui

AMA Journal of Ethics states there has been a 300% increase in opiates in the US. What does this mean for the people? Well, drug availability increases when the demands for opiates increase. Long story short, patients with complaints of pain are getting addicted to opiates and are relying on opiates as pain medication when it’s not entirely necessary. Doctors and nurses in the Emergency department are in the frontlines of this epidemic. They see patients with all sorts of complaints, but over 500,000 ED visits are patients with drug-seeking behavior, specifically for opiates. Different types of opiates include:

  • Heroin
  • Oxycodone
  • Percocet
  • Morphine
  • Tramadol

How did the epidemic begin? Doctors and nurses would prescribe their patients opiates just to improve the flow of the ED. However, recently the epidemic has gotten worse. Patients have learned different catch phrases and to over exaggerate their pain to get these opiates. Such as “headaches”, “back pains”, “neck pain”, and even “dental pain”, or rate their pain higher on the scale of 10.

So, how do doctors and nurses know when to give opiates for patients complaining of pain? The answer to the tough question is quite simple, they don’t. Opiates are always a last resort and there are other pain medications out there that treat everyday pain. The most common are:

  • ibuprofen (motrin)
  • acetaminophen (Tylenol)
  • aspirin (advil)
  • steroids

If you or someone you know is addicted to opiates do not be afraid to reach out for help with pain management or drug addiction.

If you or someone you know a drug addiction, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit .


Addictions in College

By: Julia Keys

     Ever hear the old saying “work hard, play hard”? Unfortunately, this saying is taken to the extreme across many college campuses in America.  Unhealthy behaviors like binge drinking and drug use are normalized due to the party culture that pervades college life.  According  to the National Institute on Alcohol Abuse and Alcoholism, 50% of college students binge drink (drinking three or more drinks in one sitting) and about two thirds of those with a valid prescription for an ADHD medication such as Adderall or Ritalin, share their pills with their friends.  Other drugs that are common on college campuses include benzodiazepines such as Xanax or Klonopin, which are prescription medications and helpful when used properly, but are often abused, and illegal drugs like marijuana and cocaine.

What causes college students to participate in these behaviors?

  • Greek Life
  • Independence/living on one’s own for the first time
  • Peer pressure
  • Pressure to do well in school

Signs of Addiction

  • Abnormally red, glassy, or dilated pupils
  • Red, irritated nostrils
  • Needle or track marks
  • Weight loss
  • Secretive behavior
  • Sudden increase in irritability, depression or anxiety

If you or a loved one are suffering from an addiction, recovering from an addiction, or suspect  you are developing an addiction, please contact your college’s counseling center or Arista Counseling & Psychotherapy, located in New York and New Jersey to speak to a licensed professional psychologists, psychiatrists, psychiatric nurse practitioners or psychotherapists. To contact the office in Paramus NJ, call (201) 368-3700. To contact the office in Manhattan, call (212) 722-1920. For more information, please visit .


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Alcohol Abuse: College Students

Alcohol Abuse: College Students

By Toniann Seals

For many, college is the first time in one’s young adult life that they are away from their families and on their own. Without direct supervision they begin to experiment, especially with alcohol. Unfortunately, some find themselves victims of alcohol abuse and have a hard time fighting the addiction.

Identifying Alcohol Abuse:

  • Missing important assignments, classes or meetings because of alcohol
  • Vomiting each time you drink alcohol
  • Not able to control the amount you drink
  • Drinking before or during class/work
  • Constant feeling of regret after a night out of drinking
  • Inability to control your behaviors while under the influence
  • Binge Drinking

Some may claim that they are just trying to have “fun” in college, however being a college student does not make a person immune to the detrimental side effects of alcohol abuse.

According to the NIAAA, “Approximately 2 out of every 5 college students of all ages (more than 40 percent) reported binge drinking at least once in the 2 weeks prior.” Drinking too much alcohol in a short period of time can lead to health problems, injury and even death. Fitting in is not worth what could potentially happen to you. If you are drinking because of stress, a traumatic experience or bad breakup, professional help could be very beneficial.

If you or someone you know is dealing with alcohol abuse speak with one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists. Contact us at our Paramus, NJ or Manhattan, NY offices at (201) 368-3700 or (212) 722-1920 respectively to set up an appointment. For more information, visit



Alcohol Use Disorder

By Samantha Glosser

Alcohol use disorder, more commonly known as alcoholism, is a pattern of alcohol use that results in impairment and distress in your daily life. Short term effects of alcohol use disorder include memory loss, hangovers, and blackouts. However, the long term effects are much more serious and include the following: stomach ailments, heart problems, brain damage, memory loss, liver cirrhosis, and cancer. Alcohol use disorder is also linked to increased chances of dying from automobile accidents, homicide and suicide, as well as increased rates of unemployment, domestic violence, and legal problems.

Cravings for alcohol, drinking in spite of it causing personal problems, an inability to stop drinking, and building up a tolerance to alcohol are common symptoms of alcohol use disorder. Alcohol use disorder can be diagnosed if two or more of the following are present in a twelve-month period (the severity of addiction is based on how many symptoms are present):

  • Drinking more or for a longer period than intended.
  • Feeling the need or trying to cut back on drinking.
  • Spending a lot of time drinking and recovering from the short-term effects of drinking.
  • Craving the use of alcohol.
  • Failing to perform responsibilities due to drinking.
  • Continuing to use alcohol even though it is creating relationship problems.
  • Ceasing participation in important activities to drink more.
  • Drinking before or during potentially dangerous activities (such as driving).
  • Continuing drinking despite its relation to physical and mental health conditions.
  • Developing a tolerance for alcohol.
  • Experiencing withdraw symptoms when reducing or stopping alcohol intake.

There are numerous treatment options available to individuals struggling with alcohol use disorder, such as detoxification, Alcoholics Anonymous (AA), inpatient/outpatient treatment programs, and medication. There are also different methods to recovery, such as abstinence (completely quitting) or just cutting down on alcohol intake. Finding the right treatment options depends on the individual, which is why it is recommended to seek guidance from a trained professional.

If you or someone you know appears to be suffering from alcohol use disorder, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit

Source: Alcohol Use Disorder. (n.d.). Retrieved from

Shopping Addiction (Yes, it’s Real)


Sonya Cheema

We are becoming more materialistic than ever now that we’re able to see the daily activities of rich people on social media every day – Kim Kardashian using a skincare regimen that costs more than your rent, Jeffree Star custom painting his Rolls Royce pink, various Instagram-famous models advertising their “favorite” detox tea, etc. It’s no wonder why we always feel the need to buy whatever’s new and trending. Getting caught up in the trends may be fun, but it could also lead to an overload of items you don’t need, debt you can’t repay, and guilt. Shopping addiction is real and should be brought to everyone’s attention, especially now.

Shopping addiction, or shopoholism, is just like any other addiction. The more you buy, the better you feel. Individuals suffering from this will get a “high” when they shop, meaning their endorphins and dopamine are activated, which reinforces their shopping problem. Some signs that a person may be addicted to shopping are:

  • Shopping to ease anxiety, depression, or other negative feelings/emotions
  • Engaging arguments with others about spending
  • Feeling lost without credit cards and/or having withdrawal symptoms without them
  • Purchasing items through credit instead of cash
  • Getting a high after spending money
  • Feeling guilty, ashamed, or embarrassed after spending
  • Lying about how much money was spent
  • Thinking obsessively about money
  • Trying to juggle different accounts and bills to accommodate for more spending

If you recognize a shopping addiction within yourself or someone else, it may be best to seek therapy for yourself or the person, have an intervention for the person, or look up the nearest Debtors Anonymous meeting for additional support.

Some suggestions for what to do in the meantime are to get rid of checkbooks and credit cards, shop with someone else, and find other meaningful ways to spend your time. While these suggestions are crucial to recovery, seeking professional help and receiving therapy may be more beneficial.

If you or a person you know is struggling with shopping addiction, it may be beneficial to contact a mental health professional and receive therapy. The psychologists, psychiatrists, and therapists at Arista Counseling and Psychiatric Services can help. Contact the Bergen County, NJ or Manhattan offices at (201) 368-3700 or (212) 722-1920. Visit for more information.


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