In the past, addiction was viewed as a moral failing or a sign of a weakness. Today, we realize that drug addiction is a devastating, chronic brain disease. Each year, millions of Americans try drugs like marijuana, cocaine, or heroin for the first time, and a disturbing percentage of these people will be unable to stop without help. If you’re concerned about your own drug use, or you’re worried that a loved one may be addicted to drugs, our FAQ section can provide some answers.
Drug abuse begins when the user starts to develop a tolerance for the substance, or the need to take larger amounts to achieve the same high. According to the Merck Manual, users at this stage are vulnerable to physical and psychological dependence. If the user goes without taking the drug for a certain period of time, or tries to reduce the dose, he or she may experience uncomfortable symptoms like headaches, nausea, anxiety, paranoia, muscle pain, and cravings. While the user may have some control over his or her habit, the need to seek and use the substance is becoming more compulsive. The user has started to experience negative consequences, such as physical illness, relationship conflicts, or problems at work; however, these consequences usually aren’t severe enough to motivate him or her to stop.
Abuse evolves into addiction when the user no longer has control over his or her use of the substance. Any attempt to quit results in withdrawal symptoms and overpowering cravings. Depending on the drug of choice, these symptoms may include tremors, nausea and vomiting, muscle or bone pain, sweats, fever, insomnia, high blood pressure, seizures, agitation, depression, or severe paranoia. In spite of serious health problems, job loss, personal issues, or legal complications, the addict continues to use. Seeking, obtaining, and using the drug consume most of his or her time and energy. Without medical detox and a drug treatment program, the addict will probably continue to relapse again and again.
- Marijuana has become one of the most widely used — and abused — drugs in the United States. The Journal of the American Medical Association notes that while the prevalence of marijuana use in the US hasn’t changed much since the 1990s, the prevalence of cannabis abuse and addiction has greatly increased. The 2012 Monitoring the Future survey, which tracks drug use among American teens, showed that marijuana use has increased among high school students in recent years, while disapproval of cannabis among teens has declined. At one time, marijuana was not considered to be addictive, but recent studies have shown that this drug can cause symptoms of dependence and addiction, including cravings, insomnia, anxiety, depression, and agitation.
- This central nervous system stimulant remains one of the most popular drugs of abuse in the United States. Its euphoric, energizing effects are not only seductive, but also highly addictive. The 2012 National Survey on Drug Use and Health reported that nearly 640,000 American adults tried cocaine for the first time in that year, an average of almost 2,000 per day. Over 1 million Americans met the criteria for dependence on cocaine that same year. Crack cocaine, a more potent form of the drug, is between 75 and 100 percent more powerful than the powdered form, according to the Foundation for a Drug-Free World. Crack is highly addictive, causing changes in brain chemistry that quickly lead to compulsive abuse and dependence.
- Known as “meth,” “crank,” “ice,” “crystal,” “glass,” and many other street names, methamphetamine is a central nervous system stimulant that has become increasingly popular in recent years. The effects of meth are similar to the effects of cocaine, but methamphetamine is generally less expensive and easier to obtain. The production of meth in underground labs around the US has become increasingly common, contributing to the rise in addiction. The U.S. Department of Justice reports that in 2011, there were over 13,000 incidents involving the discovery of meth labs, dump sites, or lab equipment in this country.
- This group of potent pain-relieving substances includes all drugs that are derived from opium, a compound found in the opium poppy. Some of these drugs, like morphine and codeine, are classified as non-synthetic opiates, while others, like heroin, hydrocodone, methadone, and oxycodone, are produced synthetically in laboratories. Until recently, heroin was considered to be the most addictive of the opiates. Today, however, opiate pain medications have surpassed heroin and cocaine in their popularity as drugs of abuse. According to Harvard University, the number of opiate addicts in the US increased threefold between 1991 and 2001, largely because of the increase in nonmedical use of drugs like hydrocodone (Vicodin), oxycodone (OxyContin, Percocet) and hydromorphone (Dilaudid). Harvard estimates that as of 2007, approximately 2 million people in the US were dependent on opiates, a number that continues to increase.
- Hallucinogenic drugs. Hallucinogens are psychoactive drugs that affect the way you experience the world around you. A few of the most popular 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. These psychedelic substances are popular among young people, many of whom are introduced to hallucinogenic drugs at clubs, raves, concerts, or parties. Although hallucinogenic drugs are commonly believed to be non-addictive, clinical research has shown that drugs like Ecstasy can cause signs of physical and psychological dependence, including withdrawal symptoms, obsessive thoughts, and cravings.
- Pharmaceutical drugs. When it comes to prescription drug abuse, opiate pain medications are the most widely abused. The Centers for Disease Control and Prevention (CDC) notes that in 2012, over 250 million prescriptions were written for analgesics like Vicodin, Norco, and Percocet. At the same time, the CDC estimates that 46 Americans die every day from overdoses on narcotic pain relievers, and that addiction to prescription drugs now surpasses both heroin and cocaine. However, opiates aren’t the only prescription medications that can cause dependence and addiction. Other commonly abused prescription drugs include sedatives in the benzodiazepine family (Valium, Klonopin, Ativan, Xanax), stimulants used to treat attention deficit hyperactivity disorder (Adderall, Ritalin, Concerta), and prescription sleeping pills (Ambien, Lunesta).
Even now, many people assume that drug addiction is caused by a failure of willpower or by weak character. But the medical community now recognizes that addiction is a brain disease, not a character flaw. WebMD notes that 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 your brain processes and responds to neurotransmitters, chemicals that control emotion, energy levels, pain response, judgment, sleep patterns, and metabolism.
The more you use these drugs, the more your brain and nerves come to rely on these substances to produce feelings of pleasure, excitement, relaxation, or euphoria. 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.
- Unintentional weight loss
- Loss of sleep
- Skin problems (lesions, scratch marks, rashes, pimples, bruises, or needle marks at an intravenous injection site)
- Cool, unnaturally pale skin
- Bloodshot eyes
- Unusual odors (may be chemical smells or strong body odors)
- Tremors or loss of motor coordination
- Slurred speech
- Frequent nausea
- Irregular heart rate
- Shallow breathing
Drugs affect the way a person thinks, feels, and behaves as well as the way he or she looks. Here are a few of the psychological and behavioral changes that you might observe in a drug addict:
- Uncharacteristic lying
- Memory loss or blackouts
- Stealing money or medications
- Unusual personality changes or mood swings
- Failure at school or on the job
- Increased secrecy
- Legal problems
If you see the signs and symptoms of addiction in yourself or in someone you care about, don’t wait to get help. Substance abuse professionals can help you intervene on behalf of a loved one if you feel uncomfortable about a personal confrontation.
- Loss of appetite and weight loss
- An abnormally slow or rapid heart rate
- Slow or rapid breathing
- Increased blood pressure
- Heart attack
- Respiratory distress
- Muscle spasms
- Increased risk of accidental injuries
- Exposure to blood-borne diseases (for IV drug users)
Physical dependence on a drug can cause serious withdrawal symptoms if the user suddenly stops using the substance or reduces the dose. Withdrawal itself can be uncomfortable, painful, and dangerous. Some of the classic signs of withdrawal include tremors, cold sweats, involuntary movements (jerking, twitching, or shaking), nausea and vomiting, muscle cramps, and bone pain.
- Mood swings
- Irregular sleep patterns
- Cognitive impairment
Many of the neurological processes and brain structures that are involved in addictive behavior are also involved in cognitive tasks like reasoning, learning, and memory. With heavy drug use, you may find that you have more difficulty learning or remembering things, or that you lose your focus when you’re trying to concentrate on a task.
- Kidney damage
- Liver disease
- Cardiac problems
- Respiratory illness
- Gum disease and tooth loss
- Digestive disorders (stomach ulcers, gastric reflux, and constipation)
- Chronic sleep loss
- Muscle weakness
- Weakened immune system
- Menstrual irregularity in women
- Fertility problems
- Sexual dysfunction
Intravenous drug abuse, or the injection of the drug directly into the veins with a needle and syringe, can cause severe secondary side effects: collapsed veins, damage to the tissues at the injection site, blood infections, heart valve dysfunction, and blood-borne diseases (HIV, hepatitis).
The long-term neurological and psychological effects of drug addiction can be just as devastating as the physical side effects. The long-term use of stimulants, sedatives, opiates, or hallucinogenic drugs can cause long-lasting changes in the brain, affecting your intellectual function. Chronic confusion, forgetfulness, distractibility, and memory problems can cause poor performance in the workplace or in academic settings, resulting in depression, low self-esteem, and even job loss. Psychologically, drug addiction can cause long-term changes in the way you feel and behave. You might experience mood swings, depression, anxiety, or panic attacks even after you stop using drugs.
Many users experience a condition called anhedonia after they give up drugs. Stimulants like cocaine or methamphetamine, or opiates like heroin, alter the way the brain responds to pleasure. Without the presence of these chemicals, the user may have difficulty experiencing pleasure in day-to-day life. Daily experiences that used to bring happiness or satisfaction, like watching a good movie or eating a delicious meal, now feel flat and joyless in comparison to a drug-induced high. Anhedonia is often accompanied by depression, self-isolation, cravings for the drug, and suicidal impulses. Learning how to find joy in a drug-free life is one of the most critical tasks of recovery.
Your primary drug of abuse
The length of time you’ve been using
The amount of the drug you’ve been taking
Your physical condition
Your psychological health
With opiate abuse (heroin, morphine, OxyContin, Vicodin), withdrawal symptoms usually start within a matter of hours and last for several days. With stimulants like cocaine or methamphetamine, withdrawal may be more extensive, with cravings, depression, and anxiety lasting for several months. Withdrawal from prescription medications, such as sedatives in the benzodiazepine family (Valium, Xanax, Ativan) may require a drug taper lasting a number of weeks to clear the chemical safely from your system.
- Initiate a one-on-one conversation. If you don’t bring up the topic of 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 along with the addict. 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. Twelve-step groups like Al-Anon or Nar-Anon can offer support and coping strategies, as well.
- 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, he or she will probably refuse to get treatment or even to listen to you. A substance abuse counselor or therapist who specializes in intervention can help you plan a formal meeting to confront your loved one with the consequences of their behavior and propose a treatment plan.
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 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.
- Drug detox. Detox, short for “detoxification,” is the first phase in most drug treatment programs. During the detox phase, the addict is monitored by clinical personnel while he or she goes through withdrawal from drugs. Medications, nutritional supplementation, and fluid replacement may be provided to relieve withdrawal symptoms. At the same time, counseling is provided to encourage the patient to move forward to the next phase of rehabilitation.
- Substance abuse therapy. Therapy is one of the cornerstones of addiction treatment. Individual, group, and family therapy help the addict and his or her loved ones understand the nature and causes of addiction. Therapy teaches the addict the coping strategies and life skills that she or he needs to live a productive, sober life in the community. For individuals with a co-occurring mental illness, intensive psychotherapy can also address psychiatric symptoms.
- Addiction medications. If used properly under a professional’s care, anti-addiction medication can be one of the most powerful recovery tools for an individual struggling with drug abuse. These medications can help reduce withdrawal symptoms, make cravings more manageable, and reduce the urge to start using again.
- Inpatient treatment. Inpatient or residential treatment provides intensive therapy, 24-hour monitoring, and a full spectrum of rehab services for patients who need structure and supervision in the early stage of recovery. Inpatient facilities include hospitals, mental health facilities, and residential treatment centers. Patients live full-time at the center so they can focus exclusively on the healing process without the stressors or distractions of everyday life.
- Outpatient treatment. Outpatient therapy is ideal for those who have completed a residential treatment program. Via consistent meetings with a therapist on a regular basis, recovering addicts can maintain the gains they’ve made in residential care. For addicts who suffer from less severe or short-term addictions, outpatient treatment may be sufficient care in place of inpatient rehab. If an addict is opting for outpatient treatment from the start, it’s important that they have a strong support system at home.
Listed below are three medications that have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of drug addiction:
- Methadone is a synthetic opioid that has been prescribed since the 1960s as a form of treatment for heroin addiction. When taken in small, controlled doses, methadone allows heroin addicts to withdraw gradually and to maintain a drug-free life.
- In 2002, the FDA approved buprenorphine for the treatment of opioid addiction. Buprenorphine is a semi-synthetic opioid that is prescribed to help addicts manage their cravings and reduce the need for opiates. Buprenorphine is sold under a number of brand names, including Suboxone, Butrans, and Buprenex.
- Naltrexone was approved by the FDA in 1994 for the treatment of alcoholism; however, it is currently prescribed for the treatment of opioid addiction. Sold in oral or injectable forms (ReVia and Vivitrol), naltrexone can help block the effects of opioids on the brain, making it less pleasurable to use these powerful drugs. Naltrexone is prescribed for opiate users who have been through the withdrawal phase and who 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.
Addiction is a chronic disease, and relapse is one of its major symptoms. It’s important for a recovering addict to realize that relapse is the rule rather than the exception. Relapse prevention therapy can help addicts learn how to avoid lapses, or how to minimize the severity of a relapse if they do slip. The sooner you seek help after a relapse, the sooner you’ll get back on track with your 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 recovering addicts during the vulnerable transitional period from drug treatment back to the community.
A longitudinal study of drug-dependent individuals who participated in a six-month aftercare program showed that participants were less likely to relapse into drug or alcohol use. This study, published in Addictive Behaviors, indicates that the support, information, and coping strategies gained from aftercare play a big part in the success of a recovery program.
Statistics and research
The statistics and research on drug addiction can be alarming. The National Institute on Drug Abuse states that while over 9 percent (nearly 24 million) Americans needed drug or alcohol treatment in 2009, just over 11 percent (close to 3 million) actually got the help they needed at a specialized treatment facility. Other research sources on drug addiction show that:
- Drug abuse takes a financial toll on all Americans — even those who don’t abuse substances. The abuse of illicit drugs, such as heroin, cocaine, meth, and Ecstasy, costs the US $11 billion in health care. Total yearly costs, in terms of hospitalization, emergency medical care, lost work productivity, premature death, and criminal behavior, approach $200 billion, according to the U.S. Department of Justice.
- Marijuana is the most widely abused drug in the US, with over 6,500 first-time users a day in 2012, according to the Substance Abuse and Mental Health Services Administration. In that same year, over 5 million Americans reported that they were using marijuana every day, or almost every day.
- Pharmaceutical drug abuse is reaching epidemic proportions in the US. The Centers for Disease Control and Prevention states that almost 3 percent of Americans over age 11 had used psychotherapeutic medications — sedatives, tranquilizers, or stimulants — without a doctor’s prescription in 2012.
- Pharmaceutical drugs are surpassing illicit drugs like cocaine or heroin as a cause of drug toxicity and overdose. The Drug Abuse Warning Network (DAWN) reports that over 4.5 million emergency room visits in 2009 were related to drug use. Out of this number, almost 50 percent were associated with pharmaceutical drugs, and approximately half were related to prescription drug abuse.
- Kids who start using drugs at a young age are at greater risk of developing serious addictive disorders, as well as lasting cognitive impairment. According to the Office of National Drug Control Policy, 90 percent of individuals in the US who become dependent on drugs start smoking or taking drugs as children or teens — a critical time for neurological development. Early drug abuse increases the risk of long-term brain damage.
- Columbia University reports that children and teens who smoke marijuana — a common “gateway” drug — are 85 times more likely to advance to harder drugs, like cocaine. The younger they are when they start smoking marijuana or drinking alcohol, the greater the chances that these children will become heavy drug users later in life.
- Stimulants like cocaine and meth can cause long-lasting damage to the brain, altering the way you think, feel, and experience reality. Chronic cocaine use can cause the brain to shrink, a condition called cerebral atrophy. Long-term cocaine users can suffer from cognitive impairment even after they give up the drug, while methamphetamine users may continue to experience hallucinations and psychotic episodes after quitting, notes the Journal of Neurology, Neurosurgery & Psychiatry.
- Drug addiction often goes hand in hand with mental illness. Statistics from the Journal of the American Medical Association indicate that nearly 30 percent of individuals with an addictive disorder also have a mental health disorder, such as depression, bipolar disorder, antisocial personality disorder, or schizophrenia. The co-existence of a substance use disorder and a psychiatric illness, also known as co-occurring disorders, requires specialized treatment at a facility that’s equipped to handle both concerns.
Signs and symptoms
Recognizing the signs and symptoms of drug addiction is the first step in getting the help you need for yourself or a loved one. Addiction manifests itself in the body, mind, and behavior:
Even in healthy people, drug abuse can cause obvious physical symptoms. As the disease progresses, health problems and accidental injuries increase, resulting in a sickly appearance. The effects of sleep loss, poor eating habits, and the chemical influences of drugs can be seen within a few weeks of frequent drug use. Other physical symptoms include:
- Changes in sleeping patterns (sleeping too much or too little)
- Changes in appetite, often leading to weight loss
- Slower than average heart rate and respirations (with narcotics)
- Rapid heart rate and breathing (with stimulants)
- Skin rashes, lesions, or pustules
- Unusual bruises or scratch marks
- Needle marks and skin infections, usually associated with intravenous drug use
- Pale, clammy skin
- Unusual fevers
- Poor motor coordination (stumbling, shaking, difficulty completing manual tasks)
- Muscle cramps or spasms
- Nausea and vomiting
- Constipation or diarrhea
Drugs have a direct influence on the neurotransmitters that regulate emotions, feelings, and moods. As drug dependence evolves into addiction, it doesn’t take long to see the psychological symptoms of drug abuse:
- Changes in personality (becoming isolative, secretive, or irritable)
- Frequent, unpredictable mood swings
- Memory problems
- Cognitive impairment
- Loss of mental focus
- Violent outbursts
- Sensory hallucinations (seeing or hearing things that aren’t there)
- Psychosis (a mental rupture with reality)
Compulsive substance abuse can cause serious changes in a person’s behavior. The need to obtain and use drugs becomes overwhelming, consuming all of the individuals resources. The following behavioral signs are common among addicts:
- Loss of interest in favorite activities
- Neglecting friends and family in favor of drug buddies
- Stealing money or medications from others
- Poor personal grooming and hygiene
- Paranoid or secretive behavior
- A decline in performance at work or at school
- Frequent arguments with family or friends
- Conflicts in intimate relationships
- Constant financial troubles
- Frequent altercations or arrests
“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.
Because prescription drugs are produced in laboratories and prescribed by doctors, they are mistakenly perceived as “safer” than street drugs. However, the risks of overdose, respiratory depression, cardiac arrest, and accidental death are equal to any other opioid narcotic. Withdrawal can be extremely uncomfortable, with symptoms that resemble a bad flu, such as a runny nose, nausea, vomiting, diarrhea, muscle aches, shakiness, and cold sweats.
The intravenous use of heroin not only intensifies the response to this drug; it also increases the risk of overdose, communicable disease, tissue infection, blood vessel collapse, and accidental death. Heroin withdrawal is notoriously uncomfortable, driving many addicts back to the drug in spite of their resolve to quit. Medical detox can significantly reduce the physical and psychological discomfort of heroin withdrawal, making it possible to reach your recovery goals.
Current clinical research suggests that marijuana use can have long-lasting effects on learning and memory, especially for users who start in adolescence, when the brain is still developing. Addiction Science & Clinical Practice states that approximately 9 percent of individuals who try marijuana become dependent on the drug, compared to 15 percent of cocaine users and 24 percent of heroin users. However, because marijuana is more readily available than these other illicit drugs, marijuana addiction has become more widespread, and marijuana detox programs have become more common.
The euphoric high, exaggerated self-confidence, and energizing sensations of cocaine have made this drug one of the most popular substances of abuse in the US. Because cocaine acts on the brain’s natural reward circuitry, the drug is highly addictive, and withdrawal can cause an abrupt emotional “crash” into depression. The 2012 National Survey on Drug Use and Health listed cocaine as one of the country’s top three drugs of dependence, with 1.1 million American adults reporting addiction to cocaine or crack. Only marijuana and prescription pain medications were more widely abused.
The methamphetamine binge is followed by a phase called “tweaking,” a state characterized by restlessness, anxiety, paranoia, agitation, sleeplessness, and intense cravings. “Tweakers” may experience delusional thinking, psychotic episodes, hallucinations, and violent impulses. Severe itching and the urge to harm oneself are common at this point. Methamphetamine withdrawal is complicated by the fact that many heavy users are malnourished, dehydrated, and sleep deprived. Meth-induced psychosis can continue for weeks or months after the addict stops using. In a case study published in the Journal of Clinical Psychiatry, one methamphetamine addict continued to have auditory hallucinations, fears of persecution, and paranoid delusions for a year after treatment.
Although Ecstasy declined in popularity after its introduction to the underground club scene in the 1980s and 1990s, a new generation of young users has discovered the drug. Many teens and young adults perceive Ecstasy as a non-addictive, relatively harmless psychedelic drug. However, Ecstasy can cause dangerous side effects, including nausea, vomiting, high blood pressure, dehydration, liver and kidney damage, an irregular heartbeat, and aggressive impulses.
Because Ecstasy affects the brain’s response to the neurotransmitters dopamine and serotonin — naturally produced chemicals that affect mood — the drug can also cause mood swings, depression, and anxiety. Ecstasy is often thought to be non-addictive, but research shows that regular users experience the signs of physical and psychological dependence, including increased tolerance to the drug and the compulsive need to obtain and use it.
Whether you’re struggling with an addiction to prescription drugs, street drugs, marijuana, or other substances, we’re here to help. At The Recovery Village, we offer specialized treatment services to support you through the rehabilitation process, from detox to therapy, discharge planning, and aftercare. Call our intake counselors at any time for information about our recovery services.