DRUG ABUSE AND ADDICTION

Drug addiction is a chronic disease characterised by drug seeking and drug use that is compulsive, or difficult to control, despite harmful consequences. People from all walks of life can experience problems with their drug use, regardless of age, race, or background. Abusing drugs can lead to addiction – leaving you feeling helpless, isolated and ashamed. Drug abuse and addiction is less about the type of substance consumed and more about the consequences of that drug use. If your drug use is causing problems in your life – at work, school, home, or in your relationships – you likely have a drug abuse or addiction problem. Recognising that you have a problem is the first step on the road to recovery, one that takes tremendous courage and strength. If you’re ready to seek help, you can overcome your addiction and build a satisfying, drug-free life for yourself.

Why do people abuse drugs and risk getting addicted in the first place?

Some experiment with drugs: • out of curiosity • to have a good time • because friends are doing it • to ease problems such as stress, anxiety or depression

If the drug fulfils a valuable need, you may find yourself increasingly relying on it. You may take illegal drugs to calm or energise yourself or make you more confident. If you are using drugs to fill a void in your life, you’re more at risk of addiction. To maintain a healthy balance in your life, you need to have positive experiences and feel good about your life without any drug use. Drug abuse may start as a way to socially connect. People often try drugs for the first time in social situations with friends and acquaintances. A strong desire to fit into the group can make it feel like doing the drugs with them is the only option.

Abuse of and addiction to prescription medication

It’s not just illegal drugs, such as cocaine or heroin, that can lead to addiction. Prescription medications can cause similar problems. An addiction to opioid painkillers can be so powerful, it has become the major risk factor for heroin abuse. Many people initially start taking prescription drugs to cope with a specific medical problem – to relieve pain, cope with panic attacks, or improve concentration at school or work. However, over time increased doses are needed to achieve the same level of efficacy. So some users can become physically dependent, experiencing withdrawal symptoms if they try to quit. One of the earliest warning signs of a developing problem is going through the medication at a faster-than-expected rate. To avoid developing problems with a prescription medication, it’s important to take it only as directed, use the lowest dose for the shortest period possible, and to talk to your doctor about other methods of treating the problem. Being aware of any signs of dependency can help identify prescription drug problems at an early stage and help to prevent them progressing into an addiction. In other cases, people start abusing medication not prescribed for them to experience a high, relieve tension, increase alertness, or improve concentration.

Drug addiction and the brain

While each drug produces different physical effects, all abused substances share one thing in common: repeated use can alter the way the brain functions: • Taking the drug causes a rush of the hormone dopamine in your brain, which triggers feelings of pleasure. Your brain remembers these feelings and wants them repeated. But you need to take more and more of the substance to achieve the same feelings of pleasure – an effect known as tolerance. These brain adaptations often lead to the person becoming less and less able to derive pleasure from other things they once enjoyed, like food, sex or social activities.

• Long-term use also causes changes in other brain chemical systems and circuits (not only the reward system), affecting functions that include memory, learning, decision-making, stress, etc. The changes in your brain will interfere with your ability to think clearly, exercise good judgment, control your behaviour and feel normal without drugs.

• When you become addicted, the substance takes on the same significance as other survival behaviours, such as eating and drinking.

• No matter which drug you’re addicted to, the uncontrollable craving to use grows more important than anything else, including family, friends, career, and even your own health and happiness.

• The urge to use is so strong that your mind finds many ways to deny or rationalise the addiction. You may drastically underestimate the quantity of drugs you’re taking, how much it impacts your life, and the level of control you have over your drug use.

How drug abuse and addiction develop

There’s a fine line between regular drug use and drug abuse and addiction. Very few drug abusers or addicts are able to recognise when they’ve crossed that line. While the frequency or amount of drugs consumed do not necessarily constitute drug abuse or addiction, they can often be indicators of drug-related problems. As drug abuse takes hold, you may miss or frequently be late for work or school, your job performance may progressively deteriorate, and you may start to neglect social or family responsibilities. Your ability to stop using is eventually compromised. What began as a voluntary choice has turned into a physical and psychological dependence. Eventually drug abuse can consume your life, stopping social and intellectual development. This only reinforces feelings of isolation.

Myths about drug addiction

Myth: Overcoming addiction is simply a matter of willpower. You can stop using drugs if you really want. Fact: Prolonged exposure to drugs alters the brain in ways that result in powerful cravings and a compulsion to use. These brain changes make it extremely difficult to quit by sheer force of will. Myth: Using drugs like opioid painkillers are safe since they’re prescribed by doctors. Fact: Short-term medical use of opioid painkillers can help to manage severe pain after an accident or surgery, for example. However, regular or longer-term use of opioids can lead to addiction. Misuse of these drugs or taking someone else’s medication can have dangerous – even deadly – consequences. Myth: Addiction is a disease; there’s nothing that can be done about it. Fact: Most experts agree that addiction is a disease that affects the brain, but that doesn’t mean anyone is helpless. The brain changes associated with addiction can be treated and reversed through therapy, medication, exercise, and other treatments. Myth: Addicts have to hit rock bottom before they can get better. Fact: Recovery can begin at any point in the addiction process – and the earlier, the better. The longer drug abuse continues, the stronger the addiction becomes and the harder it is to treat. Don’t wait to intervene until the addict has lost everything. Myth: You can’t force someone into treatment; they have to want help. Fact: Treatment doesn’t have to be voluntary to be successful. People who are pressured into treatment by their family, employer, or the legal system are just as likely to benefit as those who choose to enter treatment on their own. As they sober up and their thinking clears, many formerly resistant addicts decide they want to change. Myth: Treatment didn’t work before, so there’s no point trying again. Fact: Recovery from drug addiction is a long process that often involves setbacks. Relapse doesn’t mean that treatment has failed or that sobriety is a lost cause. Rather, it’s a signal to get back on track, either by going back to treatment or adjusting the treatment approach.

Common signs and symptoms of drug abuse and addiction

Although different drugs have different physical effects, the symptoms of addiction are similar. Drug abuse: • Neglecting responsibilities at school, work, or home (e.g. flunking classes, skipping work, neglecting your children).

• Using drugs under dangerous conditions or taking risks while high, such as driving while on drugs, using dirty needles, or having unprotected sex.

• Experiencing legal trouble, such as arrests for disorderly conduct, driving under the influence, or stealing to support a drug habit.

• Problems in your relationships, such as fights with your partner or family members, an unhappy boss, or the loss of friends.

Drug addiction: • You’ve built up a drug tolerance. You need to use more of the drug to experience the same effects you used to attain with smaller amounts.

• You use to avoid or relieve withdrawal symptoms. If you go too long without drugs, you experience symptoms such as nausea, restlessness, insomnia, depression, sweating, shaking, and anxiety.

• Loss of control over your drug use. You often do drugs or use more than you planned, even though you told yourself you wouldn’t. You may want to stop using, but you feel powerless.

• Your life revolves around drug use. You spend a lot of time using and thinking about drugs, figuring out how to get them, or recovering from the drug’s effects.

• You’ve abandoned activities you used to enjoy, such as hobbies, sports, and socialising, because of your drug use.

• You continue to use drugs, despite knowing it’s hurting you. It’s causing major problems in your life – blackouts, financial issues, infections, mood swings, depression, paranoia – but you use anyway.

Warning signs of drug abuse in teens

Drug abusers often try to conceal their symptoms and downplay their problem. If you’re worried a friend or loved one might be abusing drugs, look for the following warning signs.

Physical warning signs of drug abuse or addiction:

• bloodshot eyes, pupils larger or smaller than usual

• changes in appetite or sleep patterns

• sudden weight loss or weight gain

• deterioration of physical appearance, personal grooming habits

• unusual smells on breath, body, or clothing

• tremors, slurred speech, or impaired coordination

Behavioural warning signs of drug abuse or addiction:

• drop in attendance and performance at work or school

• unexplained financial problems; borrowing or stealing

• engaging in secretive or suspicious behaviours

• sudden change in friends, favourite hangouts and hobbies

• frequently getting into trouble (fights, accidents, illegal activities)

Psychological warning signs of drug abuse or addiction:

• unexplained change in personality or attitude

• sudden mood swings, irritability or angry outbursts

• periods of unusual hyperactivity, agitation or giddiness

• lack of motivation; appears lethargic or spaced out

• appears fearful, anxious or paranoid

Symptoms of commonly abused drugs

• Marijuana: Glassy, red eyes; loud talking, inappropriate laughter followed by sleepiness; loss of interest, motivation; weight gain or loss.

• Stimulants (including amphetamines, cocaine, crystal meth): Dilated pupils; hyperactivity; euphoria; irritability; anxiety; excessive talking followed by depression or excessive sleeping at odd times; may go long periods of time without eating or sleeping; weight loss; dry mouth and nose.

• Inhalants (glues, aerosols, vapours): Watery eyes; impaired vision, memory and thought; secretions from the nose or rashes around the nose and mouth; headaches and nausea; appearance of intoxication; drowsiness; poor muscle control; changes in appetite; anxiety; irritability; lots of cans/aerosols in the trash.

• Hallucinogens (LSD, PCP): Dilated pupils; bizarre and irrational behaviour including paranoia, aggression, hallucinations; mood swings; detachment from people; absorption with self or other objects, slurred speech; confusion.

• Heroin: Contracted pupils; no response of pupils to light; needle marks; sleeping at unusual times; sweating; vomiting; coughing, sniffling; twitching; loss of appetite.

• Opioid painkillers (including OxyContin, Vicodin, Norco): Drooping eyes, constricted pupils even in dim light, sudden itching or flushing, slurred speech; drowsiness, lack of energy; inability to concentrate, lack of motivation, decline in performance at work or school; neglecting friendships and social activities.

• Anti-anxiety medications, sedatives, and hypnotics (including Xanax, Valium, Ambien): Contracted pupils; drunk-like, slurred speech, difficulty concentrating, clumsiness; poor judgment, drowsiness, slowed breathing.

• Prescription stimulants (including Ritalin, Concerta, Adderall, Dexedrine): Dilated pupils, reduced appetite; agitation, anxiety, irregular heartbeat, high body temperature; insomnia, paranoia.

Why do some people become addicted to drugs while others don’t?

No one factor can predict if a person will become addicted to drugs. A combination of factors influences risk for addiction. The more risk factors a person has, the greater the chance that taking drugs can lead to addiction.

• Biology. The genes that people are born with account for about half of a person’s risk for addiction. Gender, ethnicity, and the presence of other mental disorders may also influence risk for drug use and addiction.

• Environment. A person’s environment includes many different influences, from family and friends to economic status and general quality of life. Factors such as peer pressure, physical and sexual abuse, early exposure to drugs, stress, and parental guidance can greatly affect a person’s likelihood of drug use and addiction.

• Development. Genetic and environmental factors interact with critical developmental stages in a person’s life to affect addiction risk. Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it will progress to addiction. This is particularly problematic for teens. Because areas in their brains that control decision-making, judgment, and self-control are still developing, teens may be especially prone to risky behaviors, including trying drugs.

Recovery from drug addiction

Professional help is essential for full recovery from drug addiction. Ideally, this will involve an extended stay in a drug rehabilitation centre, followed by long-term support with group and individual therapy. Narcotics Anonymous offers free, long-term group support for recovering drug addicts and is active in most countries. In a drug rehab centre, as with treatment for alcohol addiction, individuals go through detoxification. Detoxification is the set of interventions used to keep a person safe as they readjust to a lack of drugs in the body. Medical detox is extremely important for someone dependent on drugs because withdrawal can cause delirium and potentially life-threatening seizures, along with other very serious symptoms. Treatment centres are designed to provide support in the form of individual therapy, as well as group therapy and educational classes on addiction. During therapy sessions, addicts can explore their reasons behind their drug abuse, as well as what they can do to overcome their abusive behaviour. Counsellors and therapists at treatment centres are trained to provide recovering individuals with the tools to resist cravings and maintain their sobriety.