“Addiction is a chronic disease, and without treatment and intervention, the individual can die from their addiction.” — Kevin Wandler, MD
There has long been a negative stigma associated with drug abuse and addiction. While medical advances have changed the way we talk about the disease of addiction, millions of Americans try drugs like alcohol, marijuana, cocaine, prescription opioids, or heroin for the first time each year.
Unfortunately, 89.7% of people who struggle with substances do not receive treatment for their substance use problem, complicating their ability to stop.
Accepting help for a drug addiction often begins with understanding what it is, how it impacts people, what signs and symptoms to look for and who to call for help. By understanding the impact substances have on the body, you can make better decisions for yourself and help loved ones who may be struggling with drug addiction.
Table of Contents
Drug Abuse vs. Drug Addiction
Often used interchangeably, the terms “drug abuse” and “drug addiction” have unique implications and meanings.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) once referred to substance abuse and substance dependence as diagnostic terms. In the updated fifth edition (DSM-5), however, these terms are replaced by the singular “substance use disorder.” This is further categorized into mild, moderate and severe to refer to the physical and mental impairments caused by substance use.
What Is Drug Abuse?
Drug abuse typically refers to misusing substances — not necessarily being addicted to them. However, drug abuse often leads to physical dependence or addiction, which is associated with overwhelming drug cravings, withdrawal symptoms and more.
Drug abuse can apply to a wide variety of substances, from prescription medication to illicit street drugs. The term is often used to discuss the improper use of substances, especially substances that can be used for medical purposes. Drug abuse is not limited to those with a history of addiction, as many people develop a substance use disorder after taking prescription medications like prescription painkillers. Regular drug abuse can lead to serious patterns of behavior that result in addiction.
What Is Drug Addiction?
A drug addiction is a medical condition. It is a chronic, relapsing brain disease involving compulsive drug-seeking and use. This behavior occurs despite harmful consequences, like job loss or legal problems.
Addiction can result from a variety of factors and catalysts, including genetic predisposition, circumstances, environment, trauma and mental health disorders. Addiction is not an indication of a person’s morality. In fact, many addictions spring from legitimate prescription drug use or casual use of legal substances like alcohol.
What Is Physical Drug Dependence?
Drug dependence is different from drug addiction. When you become dependent on a drug, your body becomes used to the substance’s presence and begins to expect it. For this reason, suddenly stopping the drug can cause withdrawal symptoms. It often takes weeks of heavy use to become physically dependent on a drug.
Drug dependence can occur with many different drugs, including prescription medications that are taken as prescribed. Just because a person is physically dependent on a drug does not equate to misuse, abuse or addiction. Physical dependence acts as a barrier to sobriety, but it can be overcome.
Physical Drug Addiction
Being physically dependent on a drug can contribute to addiction. Dealing with withdrawal symptoms can make it harder to quit taking the substance, even when you want to quit. A physical drug addiction can occur in any substance on which you can become physically dependent.
Psychological Drug Addiction
Addictions also have a psychological component. This part of addiction is reflected in the addicted person’s behavior. When a person becomes psychologically addicted to a drug, the substance becomes a key component of their everyday thoughts, feelings and activities. These thoughts may give them a strong urge to use the drug.
Polysubstance Abuse & Addiction
Many people struggle with more than one substance at a time. About 15% of people who abuse alcohol and nearly 57% of people addicted to opioids struggle with additional substances at the same time. The risk of polysubstance abuse increases if a person is male, young, African-American or has certain mental health conditions.
In these cases, a person may meet DSM-5 criteria for multiple kinds of substance abuse at the same time.
According to a recent alcohol use survey by The Recovery Village, polysubstance abuse appears to be common among those trying to detox. For example, among the 1,559 respondents who underwent alcohol detox, 21.3% were detoxing from multiple substances. Unfortunately, polysubstance use can complicate the detox process and necessitate more medical care.
Criteria for Diagnosing a Drug Addiction
Drug addiction is often used as a synonym for a substance use disorder. Because it is characterized as a disorder, drug addiction is considered a medical problem.
A substance use disorder combines symptoms that fall into four separate categories:
- Impaired control
- Social impairment
- Risky use
- Pharmacological criteria
Addiction professionals use these criteria to diagnose and treat substance use disorders based on a person’s behavior over a 12-month period. Substance use disorders are also broken down into specific drug types, such as opioid use disorders, alcohol use disorders and more.
Risk Factors for Drug Addiction
Although anyone can become addicted to a substance, some people have a higher likelihood of doing so. Some people may be able to take a substance recreationally while avoiding addiction, while other people are more at risk of struggling to quit. These risk factors for addiction include:
- Community risk factors like living in an area with high crime and a high rate of drug use
- Minority status risk factors including discrimination and problems with assimilation
- Family environment risk factors like an unstable family environment or parental abuse
- Constitutional risk factors such as having a birth defect or a physical disability
- Behavioral risk factors like problems with stress, violence and resisting authority
Although risk factors do not guarantee that a person will develop an addiction, they may make an addiction more likely. It is important to be even more careful with substance use if an addiction risk factor applies to you or a loved one.
Signs and Symptoms of Drug Addiction
Addiction is an all-consuming disease that uses much of an individual’s time, energy and resources. There are many physical, mental and emotional signs of addiction. Identifying these can be the first step toward identifying an addiction.
Mental Effects of Drug Addiction
Drugs affect the way a person thinks, feels and behaves. Some of these mental effects of addiction include:
- Mood changes
- Losing interest in things that once gave pleasure
- Changes in energy levels
However, substance use disorders are often accompanied by co-occurring mental health disorders like anxiety or depression. Some people may use drugs as a form of self-medication for these issues, while other people may develop a mental health disorder after taking substances.
When a person is struggling with both a mental illness and a substance use disorder, it can be difficult to identify and treat the issues of each. Many treatment facilities focus solely on the symptoms of substance use without treating the mental health issues that may contribute to addiction. Centers that specialize in dual diagnosis treatment, like The Recovery Village, can help identify the roots of a substance use disorder and equip patients with the tools they need for lifelong recovery.
Physical Effects of Drug Addiction
Each drug can cause its own distinct physical effects. For example, methamphetamine is linked to dental problems, while anabolic steroid abuse is linked to high cholesterol levels.
Some drugs can be linked to physical effects from how they are administered. Drugs that are injected may leave track marks at the places in the body where they were injected. Drugs that are snorted or sniffed may lead to nasal irritation and nosebleeds.
Sometimes, a person’s behavioral changes from addiction can cause physical effects. For example, a person struggling with addiction may have hygiene issues if they avoid bathing or changing clothes due to being high.
Social Effects of Drug Addiction
Drug addiction impacts not only the person struggling with the substance but also the people around them. Friends, coworkers and loved ones often must come to grips with changes they see in a person struggling from substance use. Common social effects from addiction include:
- Not spending as much time with friends and loved ones
- Spending more time with new friends
- Having interpersonal problems with family and friends
- Spending more time alone than usual
Addiction and Drug Withdrawal
Different drugs affect the body and brain in unique ways. Similarly, addiction can lead to a variety of withdrawal symptoms, depending on the drug. A physical dependence on a drug causes serious withdrawal symptoms if a person suddenly stops using the substance or severely reduces the dose.
The withdrawal process can be uncomfortable. For example, some of the classic signs of opioid withdrawal include tremors, cold sweats, involuntary movements (jerking, twitching or shaking), nausea and vomiting, muscle cramps and bone pain. Because withdrawal from some substances can be dangerous or interfere with recovery, proper medical detox can be an important step in overcoming addiction.
Drug Addiction Treatment
Like any other life-threatening disease, drug addiction requires intensive treatment by credentialed specialists. While some people may be able to find recovery alone, true healing is a lifelong process that typically requires continued support.
Drug addiction treatment options range from medical detox and inpatient care to 12-step programming, pharmacotherapy, outpatient services and teletherapy. Throughout a continuum of care, patients are offered resources, skills, and support to ensure that they’re making progress toward recovery goals.
- Drug Detox: Detox, short for detoxification, is the first phase in many substance abuse treatment programs. During detox, patients are monitored by… Learn More
- Addiction Medications: Medication-assisted treatment can help reduce withdrawal symptoms, make cravings more manageable, and reduce urges after leaving a treatment center. Learn More
- Inpatient Treatment: Inpatient or residential treatment provides intensive therapy, 24-hour monitoring and a full spectrum of rehab services for patients who need… Learn More
- Outpatient Treatment: Outpatient therapy is ideal for those who have completed a residential treatment program. Consistent meetings with a therapist on a… Learn More
- Teletherapy: With teletherapy, people with substance use disorders can receive therapy services over the internet or phone. Learn the options, benefits… Learn More
- Aftercare & Sober Living: Sober living homes offer a safe place for those in recovery to live and begin to rebuild their life alongside…Learn More
Preventing Drug Addiction
It can be hard to predict if a person will become addicted to a substance they are taking, so the best way to prevent drug addiction is to avoid misusing substances in the first place. Ideally, illicit substances and street drugs should be avoided entirely. Meanwhile, prescribed drugs should be taken exactly as your doctor instructs, and not taken more often or at higher doses than you are told.
The risk of addiction increases when a person is exposed to drugs at an early age. For this reason, preventing drug addiction starts early in life. Helping adolescents avoid substance use when they are young reduces their overall risk of addiction.
Drug Abuse Facts and Statistics
Overall, about 20 million Americans, or approximately 7.4% of Americans aged 12 or older, meet the criteria for a substance use disorder. Globally, the figure is lower: up to 3% of adults around the world suffer from a substance use disorder. At first glance, these numbers may seem small. However, these statistics do not reflect the number of people who have tried illicit drugs or who have abused illicit substances or prescription medications. In any given month, more than 11% of Americans try illicit drugs. Anyone who uses drugs recreationally or experimentally is at risk of developing a dependence and addiction.
Other FAQs About Drug Addiction
- What is the difference in addictions to specific substances?
“Drug addiction” is a general term that refers to the compulsive need to seek and use substances despite harmful consequences. However, drugs vary in their addictive properties, and social trends can influence the popularity of certain drugs. Some commonly abused substances include:
- Marijuana has become one of the most widely used drugs in the United States. In 2019, around 3.5 million Americans tried marijuana for the first time. The prevalence of marijuana abuse has greatly increased over the past few years and has remained high among high school students. Meanwhile, disapproval of cannabis among teens has declined. Marijuana was not always considered to be addictive, but recent data indicates that this drug can cause symptoms of dependence and addiction, including cravings, insomnia, anxiety, depression and agitation.
- Cocaine / Crack Cocaine is a central nervous system stimulant. Its euphoric, energizing effects are not only seductive but also highly addictive. In 2019, nearly 671,000 Americans tried cocaine for the first time. Crack cocaine, a more potent form of the drug, is estimated to be between 75% and 100% more powerful than the powdered form. Crack is highly addictive and causes changes in brain chemistry that quickly lead to compulsive abuse and dependence.
- Methamphetamine. Known as “meth,” methamphetamine is a central nervous system stimulant that is illicitly taken by about 2 million Americans annually. The importation of meth from Mexican drug trafficking cartels has become increasingly common, contributing to the rise in addiction.
- Opioids encompass a group of potent pain-relieving substances ranging from oxycodone to heroin. They are often collectively called narcotics. Approximately 3.7% of Americans misused opioids in 2019, with most of them misusing prescription opioids. As central nervous system depressants, opioids slow down the brain’s activity, leading to overdose if too much is taken. Overdose deaths from opioids have increased during the COVID-19 pandemic, posing a risk for opioid users.
- Hallucinogens are psychoactive drugs that affect the way someone experiences the world around them. Some common hallucinogenic drugs include ecstasy, LSD, PCP and mushrooms. The effects of hallucinogenic drugs can range from pleasant sensory distortions and feelings of empathy to terrifying hallucinations and violent impulses. Young people may be introduced to hallucinogenic drugs at clubs, raves, concerts or parties. Although hallucinogenic drugs are commonly believed to be non-addictive, ecstasy may permanently damage the body’s ability to produce the neurotransmitter serotonin.
- Other prescription drugs. Opioids are not the only prescription drug class that is prone to abuse. Other commonly abused prescription drugs include benzodiazepines (Valium, Klonopin, Ativan, Xanax), stimulants (Adderall, Ritalin, Concerta), and prescription sleeping pills (Ambien, Lunesta).
- What causes addiction?
There are many factors that contribute to drug addiction, including genetic makeup, family background, social influences, neurological factors and environmental issues. Having a close family member who is addicted to drugs or growing up in an environment where drug use is widely accepted can increase a person’s chances of developing dependence and drug addiction. A co-occurring mental health problem also makes someone vulnerable to addictive drug use.
Even now, many people assume that drug addiction is caused by a failure of willpower or by weak character. However, the medical community recognizes that addiction is a brain disease — not a character flaw. The repeated use of drugs like heroin, cocaine, meth or prescription opiates causes profound changes in the structure and function of the brain. These substances interfere with the way the brain processes and responds to neurotransmitters, chemicals that control emotion, energy levels, pain response, judgment, sleep patterns and metabolism.
The more someone uses these drugs, the more their brain and nerves come to rely on these substances to produce feelings of pleasure, excitement, relaxation or euphoria. Drug addiction occurs when repeated use of a drug changes the brain in such a way that the user can no longer function normally without it.
- How long does it take to become dependent on drugs?
There is no hard and fast rule on how long it takes for an individual to become dependent on drugs or develop a drug addiction. The length of time can depend on the type of drug being used, the amount taken, and whether a combination of drugs (including alcohol) is used. Other factors, such as physical and psychological health, can also influence drug dependence. However, drug dependence does not often happen immediately. It often takes weeks of heavy, chronic use before a person becomes physically dependent on a drug.
- How long does drug withdrawal last?
Drug withdrawal can range from lasting a few days, weeks or longer. The first stage in drug withdrawal is detoxification. Some of the late signs of drug withdrawal, such as anxiety, depression and cognitive impairment, may linger after the detoxification phase. There are many factors that can influence the duration and severity of withdrawal symptoms, including:
- The drug
- How long you have been using the drug
- Your overall health
- What should I do if I believe a loved one has a drug addiction?
If you’ve noticed the signs or symptoms of drug addiction in someone you love, don’t hesitate to intervene. Many people are reluctant to talk to a friend or family member about drug addiction, either because they’re afraid of jumping to conclusions or because they don’t want to make the problem worse. Although it’s never easy or comfortable to bring up the topic of substance abuse, reaching out to an addicted person could stop the progression of a fatal disease.
Here are a few steps you can take to communicate your concerns while protecting yourself and your loved ones from the repercussions of addiction:
- Initiate a one-on-one conversation: If you don’t bring up the topic of drug addiction, it’s unlikely that your loved one will initiate the discussion. Denial is one of the strongest side effects of addiction, and it’s all too easy for spouses, partners or children to ignore the problem. Have an honest, heart-to-heart talk with your loved one about how their behavior is affecting you and other people in your home.
- Seek advice and support from others: Counselors, therapists and support groups can be valuable sources of advice when you’re trying to deal with an addicted loved one. A substance abuse therapist can give you pointers on how to communicate effectively with someone who’s in denial. Additionally, 12-step groups like Al-Anon or Nar-Anon can offer helpful support and coping strategies.
- Start researching treatment options: It’s never too soon to start exploring drug treatment programs for your loved one. Rehab facilities, recovery services and detox programs are listed publicly. You can also use the internet to find recovery centers in your community or out of state.
- Work with an intervention specialist: If your loved one is in strong denial about the problem, they will probably refuse to get treatment or even to listen to you. A substance abuse counselor or interventionist can help you plan a formal meeting to confront your loved one with the consequences of their behavior and propose a treatment plan.
- How should I tell my loved ones that I have a drug addiction?
The best way to tell your loved ones that you’re addicted is to be as honest and open as possible. Be prepared for the possibility that they won’t understand your disease — even today, many people don’t realize that addiction is a chronic condition on the same level as diabetes or high blood pressure. Your loved ones may criticize you; they may even try to persuade you that you don’t have a problem. It’s important to stand firm in your new self-awareness and stay on track with your plan for treatment.
If you fear that your loved ones will reject or judge you, consider inviting them to a session with a substance abuse counselor or a 12-step meeting. Educating your loved ones about the realities of drug addiction may make them more receptive and supportive. Having the support of professionals and peers will also help you stick with your convictions about recovery.
- What types of medications are available to treat drug addiction?
There are no silver bullets when it comes to treating addiction. However, medications can sometimes make the recovery process easier by easing the cravings and side effects associated with withdrawal. In the advanced stages of recovery from opioid addiction, some people continue to take these medications in order to maintain their sobriety.
Addiction medication should be taken only under a doctor’s supervision. These drugs can have serious side effects, including physical dependence and tolerance. Ironically, the medications used to treat opioid addiction have addictive properties themselves.
Medications that are used to help manage opioid addiction include:
- Methadone is a long-acting opioid that is prescribed to help manage opioid cravings. When taken in small, controlled doses, methadone allows people struggling with other opioids to withdraw gradually and maintain a drug-free life.
- Buprenorphine is an opioid that is prescribed to help addicted individuals manage cravings and reduce the need for opiates.
- Naltrexone can help block the effects of opioids on the brain, which makes opioid use less pleasurable. Naltrexone is prescribed for opiate users who have been through the withdrawal phase and are motivated to stick to a recovery program.
Other medications are prescribed to help manage the pain, muscle spasms, nausea and anxiety of drug withdrawal. When they are used as part of a comprehensive recovery plan, these medications can make withdrawal more tolerable, increasing the chances that the patient will progress to the next stage of recovery.
- What are the recovery rates for people with a drug addiction?
With the help of professional drug treatment programs, many people with addiction have learned to live meaningful, drug-free lives. Relapse rates among recovering opioid users are as high as 90%. However, study participants who completed an inpatient treatment program were more likely to avoid relapse and remain drug-free.
Drug addiction is a chronic disease, and relapse is one of its major symptoms. It’s important for people in recovery to realize that relapse is the rule rather than the exception. Relapse prevention therapy can help addicted people learn how to avoid relapses, or at least how to minimize the severity of a relapse if they do slip. The sooner someone seeks help after a relapse, the sooner they’ll get back on track with their recovery program.
Recovery rates are higher for patients who have access to aftercare support after they are discharged from treatment. Aftercare services include case management, alumni groups, community referrals, counseling services, sober housing, medication management and more. These services provide a source of stability and support for people in recovery while they transition back to daily life in the community.
More on Specific Substances and Illicit Drugs
“Drug addiction” is a general term that covers a very broad range of substances, from prescription medications to illegal street drugs. Technically, alcohol is a drug, as well. Each of these substances has specific side effects, risks and withdrawal symptoms. Learn more about some of the most commonly abused substances.
- Benzos (Ativan, Klonopin, Librium, Valium and Xanax)
- Opioids (Morphine, Codeine, Hydrocodone, Oxycodone)
- See all drugs
McCance-Katz, Elinore F. “The National Survey on Drug Use and Health: 2019.” Substance Abuse and Mental Health Services Administration, September 2020. Accessed March 20, 2021.
National Institute on Drug Abuse. “What is drug addiction?” July 2020. Accessed March 20, 2021.
National Institute on Drug Abuse. “Is there a difference between physical dependence and addiction?” January 2018. Accessed March 20, 2021.
McCabe, Sean Esteban; West, Brady T.; Jutkiewicz, M.; Boyd, Carol J. “Multiple DSM-5 Substance Use Disorders: A National Study of U.S. Adults.” Human Psychopharmacology, July 27. 2017. Accessed March 20, 2021.
Australian Government Department of Health. “Physical and psychological dependence.” 2004. Accessed March 20, 2021.
State of Hawaii Department of Health. “Alcohol and Drug Abuse Prevention.” Accessed March 20, 2021.
National Institute on Drug Abuse. “What are some signs and symptoms of someone with a drug use problem?” Accessed March 20, 2021.
Smyth, BP; Barry, J; Keenan, E; Ducray, K. “Lapse and relapse following inpatient treatment of opiate dependence.” Irish Medical Journal, June 2010. Accessed March 20, 2021.
Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health.” September 2020. Accessed March 20, 2021.
Foundation for a Drug-Free World. “What is Crack Cocaine?” Accessed March 20, 2021.
National Institute on Drug Abuse. “Monitoring the Future Study: Trends in Prevalence of Various Drugs.” December 17, 2020. Accessed March 20, 2021.
Centers for Disease Control and Prevention. “Illicit Drug Use.” March 1, 2021. Accessed March 20, 2021.
World Health Organization. “Prevalence for substance use and substance use disorders.” Accessed March 20, 2021.
U.S. Department of Justice, Drug Enforcement Administration. “Drugs of Abuse 2020.” April 24, 2020. Accessed March 20, 2021.
World Health Organization. “Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.” 2009. Accessed March 20, 2021.
Centers for Disease Control and Prevention. “Overdose Deaths Accelerating During COVID-19,” December 18, 2020. Accessed March 20, 2021.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.