Drug Abuse and Drug Addiction

Drug abuse is a disease characterized by continued misuse of drugs even when faced with drug-related job, legal, health, or family difficulties.
Substances used may include:
  • Cocaine
  • Heroin
  • Morphine
  • LSD
  • Marijuana
  • Sedatives
  • Speed
  • PCP
  • Ecstasy
  • Other illegal and prescription drugs
Problems associated with drug abuse must have existed a minimum of 12 months to meet the diagnosis.
Drug dependence refers to long-term, compulsive drug use, perhaps with attempts to stop but repeatedly returning to drugs. Drug dependence also means that your body has begun to require the drug in higher and higher doses in order to avoid withdrawal symptoms.
Drug abuse and drug dependence are not terms that should be used to describe people who are taking appropriate dosages of prescribed drugs (pain medication, for example) and who have become physically dependent on them. Diagnosis of both drug abuse and drug dependence requires the presence of behavioral symptoms.

Causes

The cause of drug abuse and dependence is unknown, although there are a variety of theories. One theory holds that there may be a genetic component that predisposes a person toward using and abusing drugs. Another theory is that drug abuse is a learned behavior and that people begin to use drugs by copying the behavior of those around them. Medical professionals have not been able to target a specific cause. Brain chemicals may alter the user's perception of the drug's effects. Long-term drug use changes brain function and may reinforce the desire to keep using drugs regardless of the consequences.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Family members with substance abuse problems
  • Drug use
  • Age: youth
  • Social and peer pressure
  • Stress
  • Associating with people who abuse drugs
  • Sex: male
  • Easy access to drugs
  • Depression
  • Panic disorders

Symptoms

Denial that a drug problem exists is common. Drug abuse can occur without physical dependence.
Abuse symptoms must have lasted for at least 12 month. They include:

  • Repeated work, school, or home problems due to drug use
  • Continued use of drugs even though it means risking physical safety
  • Recurring trouble with the law related to drug use
  • Continuing to use drugs despite drug-related problems in personal relationships
Drug abuse often progresses to drug dependence. Symptoms of drug dependence include at least three of the following:
  • Craving for the substance
  • Inability to stop or limit drug use
  • Tolerance, taking greater amounts to feel the same effect
  • Withdrawal symptoms that occur when the drug is stopped
  • Significant amounts of time trying to acquire drugs and recover from their effects.
  • Giving up activities in order to use drugs or recover from the effects
  • Drug use continues even when it causes or worsens health and/or psychological problems
  • Wanting to stop or cut down and not being able to

Diagnosis

The doctor will ask about:
  • Drug use
  • How often you use drugs
  • Which drugs you use
  • What amount and if you have increased the amount to receive the same desired effect
  • Emotional problems that may have occurred while using drugs
  • Problems with a job, your family or the law
Tests may include:
  • Blood and urine tests to check for the presence of drugs

Treatment

There is no treatment to cure drug abuse or drug dependence. There are three main treatment goals:
  • To help patients stop using drugs
  • To decrease the toxic effects of the drugs being used
  • To prevent relapse
Successful treatment depends on the drug user's recognition of the problem and desire to change. Recovery takes a long time and is not an easy process. Patients may need multiple courses of treatment.
Therapies include:
Medications
Drugs may help alleviate symptoms of withdrawal. In some cases, medication may be ordered to help prevent relapse. Heroin addicts may be given methadone to help taper them off. Methadone also may be given on a long-term basis to improve the chance the addict will stay in treatment. Methadone is a narcotic drug that blocks cravings as well as the pleasurable effects.
Counseling
Therapy raises awareness of underlying issues and lifestyles that promote drug use. It works to improve coping and problem-solving skills and to develop other ways of dealing with stress or pain. Through counseling, a person can learn how to handle situations associated with drug use and replace drug-using activities with other meaningful activities. Family support is encouraged.
Self-help Organizations
There are numerous organizations dedicated to helping people stop using drugs. Two examples are Narcotics Anonymous and Cocaine Anonymous. Members of these organizations meet regularly and talk about their drug-related troubles. They provide a network of support for each other.

Prevention

Not using illegal drugs and not misusing prescription drugs prevent abuse, dependence and addiction. Suggested strategies include:
  • Learn about risks related to drug use.
  • Do not spend time with people who are using illegal drugs.
  • Learn ways to handle peer pressure.
  • Seek counseling for anxiety, depression and other mental health problems.