Drug Addiction and Abuse
There has long been a negative stigma associated with drug abuse and addiction. While advances in therapy and medical research have changed the way we talk about the disease of addiction, millions of Americans try drugs like alcohol, marijuana, cocaine or heroin for the first time each year, and a large percentage are unable to stop without help.
Finding help for drug addiction often begins with understanding what it is, how it impacts people and what signs and symptoms to look for. By understanding the impact substances have on the body, you can make better decisions for yourself and loved ones who may be struggling with drug addiction.
Commonly Asked Questions about Drug Addiction
- 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 and drug addiction, 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. 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. 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.
- Your primary drug of abuse
- The length of time you’ve been using
- The amount of the drug you’ve been taking
- Your age
- Your size
- 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 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 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 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.
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.
Drug 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.
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Drug Abuse vs. Drug Addiction
Often used interchangeably, the terms “drug abuse” and “drug addiction” have unique implications and meanings. When comparing drug abuse versus addiction, understanding the implications of the two terms can be helpful.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) once referred to substance abuse and substance dependence as diagnostic terms. However, in the updated fifth edition (DSM-5), these terms are replaced by the singular substance use disorder, which is broken into mild, moderate and severe to refer to the physical and mental impairments through recurrent substance use.
Still, understanding substance abuse versus addiction can be confusing and even stigmatizing for some.
What Is Drug Abuse?
Once used as a diagnostic label, substance abuse typically refers to behavioral patterns of drug use that involve impairment and physical and mental distress. Some people may use the term “drug abuse” to reference a marked physical and mental dependence on drugs. Today, drug abuse typically refers to misusing substances, not necessarily being addicted to them. However, drug abuse can often lead to a physical dependence or addiction associated with a focus on obtaining and using drugs and severe withdrawal symptoms.
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 opioids, benzodiazepines and more. Regular drug abuse can lead to serious patterns of behavior that result in a substance use disorder or addiction.
What is Drug Addiction?
The National Institute on Drug Abuse states, “Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.” Addiction can result from a variety of factors and catalysts, including genetic predisposition, circumstances, environment, trauma and mental health disorders. While addiction often starts with drug abuse, it is not an indication of a person’s moral status or stability. In fact, many addictions spring from prescription drug use or casual use of legal substances.
Drug addiction is often used as a synonym for what the DSM-5 describes as substance use disorder, a culmination of symptoms that fall into four categories:
- Impaired control
- Social impairment
- Risky use
- Pharmacological criteria
Medical 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 then broken down into specific drug types such as opioid use disorders, alcohol use disorders and more.
To determine a substance use disorder diagnosis, professionals analyze a collection of behavioral factors over a 12-month period:
- A substance is frequently used for longer periods of time or higher dosages than originally intended.
- Efforts to control or lesson substance use are unsuccessful.
- A significant amount of time is spent on obtaining, using and dealing with the effects of substances.
- A heightened urge or desire to regularly use substances is present.
- Regular drug use prevents completion of obligations at home, school, or work.
- Recurrent substance use despite continued social or relationship issues related to drug use and its effects.
- A reduction or abandonment of valuable or important social activities in favor of drug use.
- Substance use taking place during dangerous situations or times (driving, caring for children, etc.).
- Continued substance use despite underlying medical or physical issues that are exacerbated by the drug.
- Development of a tolerance, which can involve:
- An increased dosage amount to achieve the desired effects.
- Decreased effects or response to the same amount of a particular substance.
Signs and Symptoms of Drug Addiction
Addiction is an all-consuming disease, using much of an individual’s time, energy and resources. There are many physical, mental and emotional signs of addition. If you or a loved one are experiencing a combination of these signs, treatment may be a stepping stone for long-term recovery. Looking for signs and symptoms of drug abuse can be the first step toward identifying an addiction:
- 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
Many of the neurological processes and brain structures involved in addiction are also used in cognitive tasks like reasoning, learning and memory. With heavy drug use, you may find that you have difficulty learning or remembering information or that you lose focus when you’re trying to concentrate on a task. In addition to short-term physical and psychological impacts, long-term drug use can also alter your mental health.
Mental Impacts of Drug Use
Drugs affect the way a person thinks, feels, behaves and how they look. But substance use disorders are often accompanied by co-occuring 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. Either way, it’s important to look out for psychological and behavioral changes in friends or loved ones who might be struggling with addiction:
- Uncharacteristic lying
- Memory loss or blackouts
- Stealing money or medications
- Irregular sleep patterns
- Mood swings
- Unusual personality changes or mood swings
- Failure at school or on the job
- Increased secrecy
- Legal problems
When a person is struggling with both a mental illness and substance use disorder, it can be difficult to identify the issues and treat them both. Many treatment facilities focus solely on the symptoms of substance use, without treating the mental health issues that may contribute to addiction. Finding a center that specializes in co-occurring disorder treatment can help identify the roots of a substance use disorder and equip patients with the tools they need for lifelong recovery.
Serious Medical Side Effects of Drug Use
Different drugs affect the body and brain in unique ways. However, there are many similarities in the way drug addiction can damage the body and cause life-threatening symptoms. Some of the most severe side effects may include:
- 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 a person suddenly stops using the substance or severely reduces the dose. The withdrawal process itself can be uncomfortable and dangerous. Some of the classic signs of withdrawal include tremors, cold sweats, involuntary movements (e.g., jerking, twitching, or shaking), nausea and vomiting, muscle cramps and bone pain. Because withdrawal can be dangerous, proper medical detox can be a life-saving step in recovery.
Drug Abuse Facts and Statistics
Drug abuse statistics can be alarming, but the numbers also show a potential for help and healing. The Substance Abuse and MEntal Health Services Administration’s (SAMHSA) National Survey on Substance Abuse and Health states that while 21 million Americans aged 12 and over needed drug or alcohol treatment in 2016, only 3.8 million received 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. The use of illicit drugs such as heroin, cocaine, meth and ecstasy costs the U.S. $11 billion in health care. According to the U.S. Department of Justice, total yearly costs in terms of hospitalization, emergency medical care, lost work productivity, premature death and criminal behavior surpassed $193 billion in 2007.
- Pharmaceutical drug abuse facts from the Centers for Disease Control and Prevention (CDC) indicate that almost 3 percent of Americans age 11 and older had used psychotherapeutic medications (e.g., sedatives, tranquilizers, or stimulants) without a doctor’s prescription in 2012.
- Some drug abuse facts and statistics show a significant and steady increase in American opioid use, contributing to the nation’s growing opioid crisis. The CDC reports a 29.7 percent increase in opioid-overdose emergency room visits from July 2016 to September 2017. Wisconsin and Delaware saw the largest rise in overdose emergency room visits, with an increase of 109 and 105 percent respectively.
- Stimulants like cocaine and meth can cause long-lasting damage to the brain, altering the way you think, feel and experience reality. Drug addiction facts from the Journal of Neurology, Neurosurgery & Psychiatry highlight that chronic cocaine use can cause the brain to shrink, a condition called cerebral atrophy. Long-term cocaine use can cause cognitive impairment even after the drug is no longer used, while those who have used methamphetamine may continue to experience hallucinations and psychotic episodes after quitting.
- SAMHSA’s drug addiction statistics indicate that roughly 20.1 million people over the age of 11 struggled with a substance use disorder in 2016. Alcohol was the most prevalent addiction, with 15.1 million people dealing with an alcohol use disorder, followed by 7.4 million struggling with illicit drugs.
Drug Addiction Treatment
Like any other life-threatening disease, drug addiction requires intensive treatment by credentialed specialists. While some 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 and outpatient services. 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 professionals during their 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: Used as a part of many inpatient and outpatient programs, therapy is one of the cornerstones of drug addiction treatment. Individual, group and family therapy help patients and their loved ones understand the nature and causes of addiction. Therapy teaches coping strategies and life skills needed to live a productive, sober life in the community. For individuals with a co-occurring mental illness, intensive psychotherapy can also address psychiatric symptoms and find the underlying issues that contribute to addiction.
- Addiction medications: If used properly under a professional’s care, medications can be one of the most powerful recovery tools for an individual struggling with drug abuse. Medication-Assisted Treatment can help reduce withdrawal symptoms, make cravings more manageable and reduce urges after leaving a treatment center.
- Inpatient treatment: Inpatient or residential treatment provides intensive therapy, 24-hour monitoring and a full spectrum of rehab services for patients who need structure 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. Consistent meetings with a therapist on a regular basis allow people to maintain the strides they’ve made in residential care. If a person is opting for outpatient treatment from the start, it’s important that they have a strong support system at home.
- Aftercare and sober living: Following a drug addiction treatment program, an aftercare plan can provide continued support with local doctors, support groups and counseling. Sober living homes offer a safe place for those in recovery to live and begin to rebuild their life alongside others with similar goals.
If you or a loved one are seeking drug addiction treatment, there are resources available in every state. Finding a program that best suits your needs can be the first step toward lifelong recovery. The Recovery Village offers several full-service treatment centers in convenient locations throughout the country. Call today to learn more about treatment options and how the Recovery Village can help you find lasting healing.
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.
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.