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Drugs Abuse and Addiction
   

WHAT IS DRUG ABUSE?
Drug abuse, also called substance abuse or chemical abuse, is a disorder that is characterized by a destructive pattern of using a substance that leads to significant problems or distress. Teens are increasingly engaging in prescription drug abuse, particularly narcotics (which are prescribed to relieve severe pain), and stimulant medications, which treat conditions like attention deficit disorder and narcolepsy.

WHAT IS DRUG ADDICTION?
Drug addiction, also called substance dependence or chemical dependency, is a disease that is characterized by a destructive pattern of drug abuse that leads to significant problems involving tolerance to or withdrawal from the substance, as well as other problems that use of the substance can cause for the sufferer, either socially or in terms of their work or school performance.
The term dual diagnosis refers to the presence of both a drug-abuse or dependence issue in addition to a serious mental-health problem in an individual. Substance abuse or dependence unfortunately occurs quite commonly in people who also have severe mental illness. Individuals with dual diagnosis are also at higher risk of being noncompliant with treatment.

TYPES OF DRUGS ARE COMMONLY ABUSED.
Virtually any substance whose ingestion can result in a euphoric ("high") feeling can be abused. While many are aware of the abuse of legal substances like alcohol or illegal drugs like marijuana (in most states) and cocaine, less well known is the fact that inhalants like household cleaners are some of the most commonly abused substances. The following are many of the drugs and types of drugs that are commonly abused and/or result in dependence:

Alcohol: Although legal, alcohol is a toxic substance, particularly to a developing fetus when a mother consumes this drug during pregnancy. One of the most common addictions, alcoholism can have devastating effects on the alcoholic individual's physical health, as well as his or her ability to function interpersonally and at work.

Amphetamines: This group of drugs comes in many forms, from prescription medications like methylphenidate (Ritalin, Concerta) and dextroamphetamine and amphetamine (Adderall) to illegally manufactured drugs like methamphetamine ("meth"). Overdose of any of these substances can result in seizure and death.

Anabolic steroids: A group of substances abused by bodybuilders and other athletes, this group of drugs can lead to terrible psychological effects like aggression and paranoia, as well as devastating long-term physical effects like infertility and organ failure.

Caffeine: While it is consumed by many, coffee, tea and soda drinkers, when consumed in excess this substance can be habit forming and produce palpitations, insomnia, tremors, and significant anxiety.

Cannabis: More commony called marijuana; the scientific name for cannabis is tetrahydrocannabinol (THC). In addition to the negative effects the drug itself can produce (for example, infertility, paranoia, lack of motivation), the fact that it is commonly mixed ("cut") with other substances so drug dealers can make more money selling the diluted substance or expose the user to more addictive drugs exposes the marijuana user to the dangers associated with those added substances. Examples of ingredients that marijuana is commonly cut with include baby powder, oregano, embalming fluid, PCP, opiates, and cocaine.

Cocaine: A drug that tends to stimulate the nervous system, cocaine can be snorted in powder form, smoked when in the form of rocks ("crack" cocaine), or injected when made into a liquid.

Ecstasy: Also called MDMA to denote its chemical composition (methylenedioxymethamphetamine), this drug tends to create a sense of euphoria and an expansive love or desire to nurture others. In overdose, it can increase body temperature to the point of being fatal.

Hallucinogens: Examples include LSD and mescaline, as well as so-called naturally occurring hallucinogens like certain mushrooms. These drugs can be dangerous in their ability to alter the perceptions of the user. For example, a person who is intoxicated with a hallucinogen may perceive danger where there is none and to think that situations that are truly dangerous are not. Those misperceptions can result in dangerous behaviors (like jumping out of a window because the individual thinks they are riding on an elephant that can fly).

Inhalants: One of the most commonly abused group of substances due to its accessibility, inhalants are usually contained in household cleaners, like ammonia, bleach, and other substances that emit fumes. Brain damage, even to the point of death, can result from using an inhalant just once or over the course of time, depending on the individual.

Nicotine: The addictive substance found in cigarettes, nicotine is actually one of the most addictive substances that exists. In fact, nicotine addiction is often compared to the intense addictiveness associated with opiates like heroin.

Opiates: This group is also called narcotics and includes drugs like heroin, codeine, Vicodin, OxyContin, Percocet, and Percodan. This group of substances sharply decreases the functioning of the nervous system. The lethality of opiates is often the result of the abuser having to use increasingly higher amounts to achieve the same level of intoxication, ultimately to the point that the dose needed to get high is the same as the dose that is lethal for that individual by halting the person's breathing (respiratory arrest).

Phencyclidine: Commonly referred to as PCP, this drug can cause the user to feel extremely paranoid, become quite aggressive and to have an unusual amount of physical strength. This can make the individual quite dangerous to others.

Sedative, hypnotic, or antianxiety drugs: As these substances quell or depress the nervous system, they can cause death by respiratory arrest of the person who either uses these drugs in overdose or who mixes one or more of these drugs with another nervous system depressant drug (like alcohol, another sedative drug, or an opiate).

THE PHYSICAL AND PSYCHOLOGICAL EFFECTS OF DRUG ABUSE AND ADDICTION.
While the specific physical and psychological effects of drug abuse and addiction tend to vary based on the particular substance involved, the general effects of abuse or addiction to any drug can be devastating. Psychologically, intoxication with or withdrawal from a substance can cause everything from euphoria as with alcohol, Ecstasy, or inhalant intoxication, to paranoia with marijuana or steroid intoxication, to severe depression or suicidal thoughts with cocaine or amphetamine withdrawal. In terms of effects on the body, intoxication with a substance can cause physical effects that range from marked sleepiness and slowed breathing as with intoxication with heroin or sedative hypnotic drugs, to the rapid heart rate of cocaine intoxication, or the tremors to seizures of alcohol withdrawal.

CAUSES AND RISK FACTORS FOR DRUG ABUSE AND ADDICTION.
Like the majority of other mental-health problems, drug abuse and addiction have no single cause. However, there are a number of biological, psychological, and social factors, called risk factors that can increase a person's likelihood of developing a chemical-abuse or chemical-dependency disorder. The frequency to which substance-abuse disorders occur within some families seems to be higher than could be explained by an addictive environment of the family. Therefore, most substance-abuse professionals recognize a genetic aspect to the risk of drug addiction.

Psychological associations with substance abuse or addiction include mood disorders like depression, anxiety, or bipolar disorder, thought disorders like schizophrenia, as well as personality disorders like antisocial personality disorder. Social risk factors for drug abuse and addiction include male gender, being between 18 and 44 years of age, Native-American heritage, unmarried marital status, and lower socioeconomic status. According to statistics by state, people residing in the West tend to be at higher risk for chemical abuse or dependency. While men are more at risk for developing a chemical dependency like alcoholism, women seem to be more vulnerable to becoming addicted to alcohol at much lower amounts of alcohol consumption.

SYMPTOMS AND SIGNS OF DRUG ABUSE AND ADDICTION.
In order to be diagnosed with drug abuse, an individual must exhibit a destructive pattern of drug abuse that leads to significant problems or stress but not enough to qualify as being addicted to a drug. This pattern is manifested by at least one of the following signs or symptoms in the same one-year period:

  • Recurrent drug use that results in a lack of meeting important obligations at work, school, or home
  • Recurrent drug use in situations that can be dangerous
  • Recurrent legal problems as a result of drug use
  • Continued drug use despite continued or repeated social or relationship problems as a result of the drug's effects

In order to be diagnosed with a drug addiction, an individual must exhibit a destructive pattern of drug abuse that leads to significant problems as manifested by at least three of the following signs or symptoms in the same one-year period:

  • Tolerance is either a markedly decreased effect of the substance or a need to significantly increase the amount of the substance used in order to achieve the same high or other desired effects.
  • Withdrawal is defined as either physical or psychological signs or symptoms consistent with withdrawal from a specific drug, or taking that drug or one chemically close to that drug in order to avoid developing symptoms of withdrawal.
  • Larger amounts of the drug are taken or for longer than intended.
  • The individual experiences a persistent desire to take the drug or has unsuccessful attempts to decrease or control the substance use.
  • Significant amounts of time are spent either getting, using, or recovering from the effects of the substance.
  • The individual significantly reduces or stops participating in important social, recreational, work, or school activities as a result of using the substance.

The individual continues to use the substance despite being aware that he or she suffers from ongoing or recurring physical or psychological problems that are caused or worsened by the use of the drug.

THE TREATMENT FOR DRUG ADDICTION.
An unfortunate fact about the treatment of drug addiction is that it remains largely unutilized by most sufferers of this condition. Facts about the use of drug treatment include that less than 10% of people with a substance-abuse disorder and less than 40% of those with a substance-dependence disorder seek professional help. Those statistics do not seem to be associated with socioeconomic or other demographic traits but do seem to be associated with the presence of other mental-health problems (co-morbidity).

The primary goals of drug-abuse or addiction treatment (also called recovery) are abstinence, relapse prevention, and rehabilitation. During the initial stage of abstinence, an individual who suffers from chemical dependency may need help avoiding or lessening the effects of withdrawal. That process is called detoxification or "detox." That aspect of treatment is usually performed in a hospital or other inpatient setting, where medications used to lessen withdrawal symptoms and frequent medical monitoring can be provided. The medications used for detox are determined by the substance the individual is dependent upon. For example, people with alcohol dependence might receive medications like anti-anxiety or blood pressure medications to decrease palpitations and blood pressure, or seizure medications to prevent possible seizures during the detoxification process. For many drugs of abuse, the detox process is the most difficult aspect of coping with the physical symptoms of addiction and tends to last days to a few weeks. Medications that are sometimes used to help addicted individuals abstain from drug use long term also depend on the specific drug of addiction. For example, individuals who are addicted to narcotics like Percodan (a combination of aspirin and oxycodone hydrochloride) heroin, or Vicodin, Vicodin ES, Anexsia, Lorcet, Lorcet Plus or Norco (combinations of hydrocodone and acetaminophen) often benefit from receiving longer-acting, less addictive narcotic-like substances like methadone (Methadose). People with alcohol addiction might try to avoid alcohol intake by taking disulfiram (Antabuse), which produces nausea, stomach cramping, and vomiting when the individual consumes alcohol.

Often, much more challenging and time consuming than recovery from the physical aspects of addiction is psychological addiction. For people who may have less severe drug dependency, the symptoms of psychological addiction may be able to be managed in an outpatient treatment program. However, those who have a more severe addiction, have relapsed after participation in outpatient programs, or who also suffer from a severe mental illness might need the higher structure, support, and monitoring provided in an inpatient drug treatment center, sometimes called "rehab." Following such inpatient treatment, many people with this level of addiction can benefit from living in a sober living community, that is, a group-home setting where counselors provide continued sobriety support and structure on a daily basis.

Also important in the treatment of addiction is helping the parents, other family members, and friends of the addicted person refrain from supporting addictive behaviors (codependency). Whether providing financial support, making excuses or failing to acknowledge the addictive behaviors of the addict, discouraging such codependency of loved ones is a key component to the recovery of the affected individual. A focus on the addicted person's role in the family becomes perhaps even more acute when that person is a child or teenager, given that minors come within the context of a family in nearly every instance. Chemical dependency treatment for children and adolescents is further different from that in adults by the younger addict's tendency to need help completing their education and achieving higher education or job training compared to addicts who may have completed those parts of their lives before developing the addiction.

The treatment of dual diagnosis seems to be less effective when treatment of the individual's mental illness is separate from the treatment of his or her chemical dependency. More successful are integrated treatment programs that include interventions for both disorders. Such interventions are all the more improved by the inclusion of assessment, intensive case management, motivational interventions, behavior interventions, family treatment as well as services for housing, rehabilitation, and medication treatment.

COMPLICATIONS OF DRUG ADDICTION.
Drug addiction puts its sufferers at risk for potentially grave social, occupational, and medical complications. Drug addiction increases the risk of domestic violence in families. Individuals with chemical dependency are also much more likely to lose their job and less likely to find a job compared to people who are not drug addicted. Children of drug addicted parents are at higher risk for poor social, educational, and health functioning, as well as being at higher risk for abusing drugs themselves.

In addition to the many devastating social and occupational complications of drug addiction, there are many medical complications of chemical dependency. From the respiratory arrest associated with heroin or sedative overdose to the heart attack or stroke that can be caused by cocaine or amphetamine intoxication, death is a highly possible complication of drug addiction. People who are dependent on drugs are also at higher risk of developing chronic medical conditions as complications of drug addiction. Liver failure and pancreatitis associated with alcoholism and brain damage associated with alcoholism or inhalants are just two such examples.

CAN DRUG ABUSE AND ADDICTION BE PREVENTED?
A number of different prevention approaches have been found to be effective in decreasing the risk of drug abuse and addiction. Simple lifestyle changes, like increased physical activity and using other stress reduction techniques, are thought to help prevent drug abuse and dependence in teens. More formal programs have also been found to be helpful. For example, the Raising Healthy Children program, which includes interventions for teachers, parents, and students, has been found to help prevent substance abuse and addiction in elementary school children when the program goes on for 18 months or more. The prevalence of easier access to technology has led to the development of computer-based prevention programs. Such programs have been found to be very promising in how they compare to more traditional prevention programs, as well as how many more people can be reached through technology.

 

 

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