• Drug Abuse and Drug Addiction

    (Drug Dependence)

    Definition

    Drug abuse is continued misuse of drugs even when faced with drug-related job, legal, health, or family difficulties.
    Drug dependence is long-term, compulsive drug use. The person may attempt to stop using drugs, but repeatedly return to drug use despite physical, emotional, or social harm. Drug dependence also means that the body has begun to require the drug in higher doses to have the same effect and to avoid withdrawal symptoms.
    Drugs that commonly abused include:
    • Cocaine
    • Heroin
    • Morphine
    • LSD
    • Marijuana
    • Sedatives
    • Methamphetamine (crystal meth, speed)
    • PCP
    • Ecstasy
    • GHB
    • Ketamine
    • Steroids
    • Inhalants
    • Prescription medicine that is used improperly (eg, narcotic pain relievers, amphetamines, sleeping pills, anti-anxiety medicine)

    Causes

    The exact cause of drug abuse and dependence is unknown.
    There are many theories, though. For example, some people may inherit certain genes that make them more likely to abuse drugs. Another theory is that people learn how to use drugs by copying the behavior of others. Also, changes that happen in the brain due to long-term drug use may reinforce a person's desire to keep using drugs.
    Chemical Release in Brain
    neurotransmitter
    Drugs stimulate unnecessary chemical release in the brain. Long-term drug use may change brain function.
    Copyright © Nucleus Medical Media, Inc.

    Risk Factors

    Factors that may increase the risk of drug abuse and dependence include:
    • Sex: male
    • Age: youth
    • Family members with substance abuse problems
    • Early antisocial behavior (eg, breaking the law, repeated lying)
    • Social and peer pressure (spending time with people who abuse drugs)
    • Stress
    • Easy access to drugs
    • Mental health conditions (eg, anxiety , depression , panic disorder )

    Symptoms

    It is common for a person to deny that he has a drug problem.
    Symptoms of drug abuse include:
    • Repeated work, school, or home problems due to drug use
    • Continued use of drugs even though it means risking physical safety
    • Recurring trouble with the law related to drug use (eg, driving while under the influence of drugs)
    • Continuing to use drugs despite drug-related problems in personal relationships
    Drug abuse can occur without being physically dependant on a drug.
    Symptoms of drug dependence include at least three of the following:
    • Craving for the drug
    • Inability to stop or limit drug use
    • Tolerance (taking greater amounts to feel the same effect)
    • Withdrawal symptoms that occur when the drug is stopped
    • Significant amounts of time trying to acquire drugs and recover from the effects
    • Drug use continues even when it causes or worsens physical or mental health problems

    Diagnosis

    The doctor will ask about:
      Your drug use:
      • How often do you use drugs?
      • Which drugs do you use?
      • How much do you use? Do you have to increase the amount of drugs that you use to get the same effect?
    • Emotional problems that may have occurred while using drugs
    • Problems with work, school, homelife, or the law
    Your doctor may order blood or urine tests to check for the presence of drugs.

    Treatment

    While there is no cure for drug abuse or dependence, there are three main treatment goals:
    • To help you stop using drugs
    • To decrease the toxic effects of the drugs being used and to aid in symptoms of drug withdrawal (detoxification)
    • To prevent relapse
    Successful treatment depends on you being able to recognize that you have a problem and having the desire to change. Recovery takes a long time. It is a difficult process. In some cases, you may need to go through treatment several times.
    Therapies include:

    Medications

    Drugs may help relieve withdrawal symptoms. In some cases, your doctor may prescribe medicine to help reduce the risk of relapse.
    Examples of drugs that may be used for treatment include:
    • Methadone—blocks cravings as well as pleasurable effects of opiates
    • Naltrexone—blocks the effect of opiates (eg, heroin, morphine, codeine, oxycodone)
    • Buprenorphine—reduces opiate withdrawal symptoms and helps prevent relapse
    • Buprenorphine with naloxone (Suboxone)—prevents relapse

    Therapy

    Therapy can help raise your awareness of issues and lifestyle choices that lead you to abuse drugs. Through therapy, you can improve your coping skills and problem-solving skills. You can also learn how to replace drug-using activities with healthier choices. It is also important that your family is involved in your treatment.

    Support Groups

    There are many organizations and support groups dedicated to helping people become drug-free. Two examples are the 12-step programs Narcotics Anonymous and Cocaine Anonymous. Members meet regularly to talk about their drug-related problems and their recovery. They provide a network of support.

    Prevention

    Drug education programs may be helpful. Suggested strategies to lower the risk of drug abuse or dependence include:
    • Learn about risks related to drug use.
    • Do not spend time with people who are abusing drugs.
    • Learn ways to handle peer pressure.
    • Have a good relationship with your children to help reduce their risk of using drugs.
    • Seek therapy for anxiety , depression , and other mental health problems.

    RESOURCES

    Cocaine Anonymous http://www.ca.org/

    Narcotics Anonymous http://www.na.org/

    National Institute on Drug Abuse http://www.nida.nih.gov/

    CANADIAN RESOURCES

    Centre for Addiction and Mental Health http://www.camh.net/about%5Fcamh/

    Narcotics Anonymous http://www.torontona.org/

    References

    DrugFacts: treatment approaches for drug addiction. National Institute on Drug Abuse website. Available at: http://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction . Updated September 2009. Accessed August 27, 2012.

    Drugs, brains, and behavior: the science of addiction. National Institute on Drug Abuse website. Available at: http://www.drugabuse.gov/publications/science-addiction/drug-abuse-addiction . Updated August 2010. Accessed August 27, 2012.

    Substance use disorders. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated August 23, 2012. Accessed August 27, 2012.

    2/4/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Schinke SP, Fang L, Cole KC. Computer-delivered, parent-involvement intervention to prevent substance use among adolescent girls. Prev Med. 2009;49;429-35.

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