Alcohol and drug abuse

What is drug abuse?

A drug is any substance that has a biological or biochemical effect on the body. While drugs such as alcohol and tobacco are legal, the possession, smuggling, use, and trafficking of narcotics such as methamphetamines, cocaine, ecstacy, and marijuana are illegal. Not everyone who uses narcotics and "street drugs" becomes addicted, but the use of these substances does affect the body nevertheless. Simply put, substance abuse refers to the harmful use of substances for mood-altering purposes.

Why the word substances and not simply drugs? Generally when most people talk about drug abuse, they are referring to the use of illegal drugs which are potentally addictive and may lead to health complications. Most addictions counselors argue that use of illicit drugs is by definition drug abuse. However, it's important to make the point that although people may use illicit drugs or abuse prescription or over-the-counter drugs, other substances can also be used for their mood-altering effect (i.e. solvents and and inhalants such as Lysol, hairspray, copier fluid, or gasoline) or intoxicating effects (e.g., anabolic steroids).¹

Who uses drugs?

Both men and women abuse drugs. It's estimated that in the United States, nearly four million women use illicit drugs, and more than one million women abuse prescription medications (e.g., sleeping pills and painkillers), using them for purposes other than those for which they are intended. Drug users come from all walks of life, all neighborhoods, and all backgrounds and all are susceptible to the dangers of substance abuse. Substance abuse is the most common cause of premature and preventable illness, disability, and premature death. Some drugs such as Rohypnol and GHB have been linked to sexual assault while others such as nitrous oxide and aerosols have been known to cause sudden death.

Women who use are at risk for sexual and physical abuse, complications during and after pregnancy, high blood pressure, rapid heart rate, poor nutrition, low self-esteem, depression, and sexually transmitted diseases. Those who use intravenous drugs are at increased risk for HIV/AIDS from dirty needles and unprotected sex.²

At present, it's unclear whether there is a genetic link that predisposes some individuals to drug abuse and addiction. Environmental factors play an important role in drug abuse. Peer influences, emotional stress or trauma, low self-esteem, and ease of access to drugs all play a part. Understanding a person's motivation is key in determining why certain people use and abuse drugs.

What drugs and substances are commonly abused?

For more information on commonly used drugs, Women's Web recommends the Commonly Abused Drugs Chart, a publication of the National Institute on Drug Abuse. A PDF version of this publication is also available. (External links will open a new browser window. You require Adobe Reader® to view and print PDF files.) These charts list street names, medical uses, delivery systems, and other information.

What about recreational use?

Some people may argue that the recrational use of some drugs, such as marijuana is not abuse. Those who use medicinal marijuana and those who "smoke pot" recreationally believe marijuana is not addictive and that it has many benefits, unlike illicit drugs. However, research has shown that even a mild drug such as marijuana may have more harmful effects than first believed. NIDA, the National Institute on Drug Abuse, reports that because some individuals develop a pyschological dependence (see below) on marijuana, the drug is in fact addictive.³

Many individuals have difficulty making the distinction between use and abuse. It's really up to the individual to decide whether his or her drug use is the result of addiction.

Types of addiction

While not everyone who uses drugs becomes addicted, there are different levels of substance abuse, all of which are harmful and dangerous.

Substance abuse disorder

When drug use begins to interfere with an individual's life such as absenteeism from a job or poor work performance, driving while stoned, arrests, legal and family problems, the individual's drug use is abusive and is characterized as a disorder.⁴

Chemical dependency

A person is said to be chemically dependent when, despite drug use's interfering in his or her day-to-day life, he or she continues to use, spending more time on drug-seeking behavior and withdrawing from social activities. People with a chemical dependency develop an increased tolerance to their chosen drug(s) and may try, unsuccessfully, to quit using. They may experience withdrawal symptoms during periods of drug abstinence or reduced intake and will return to using as a means to curb withdrawal symptoms.⁵

Physical addiction

Narcotics such as cocaine and heroin are highly addictive, altering the structure of nerve cells in users' brains. Changes in nerve cells mean they cannot function in the absence of the drug—this is physical addiction. During periods of suspended drug use, users experience withdrawal symptoms as nerves begin to adjust to having to function without drugs. There is a great tempation during withdrawal to resume drug use as a means to curb withdrawal symptoms. Addicts suffer a compulsive, continued use of a drug and are completely unable to stop using. They are controlled by drugs.

Psychological dependence

Psychological dependence can be as damaging to a user even though the effects of drug use do not actually cause physical changes to a user's nervous system. Solvents, for example, can play an important role in a person's life to the point the person feels depressed and irritable in their absence. They crave the "high" they experience while under the influence of drugs and believe they cannot function in day-to-day life without the high.

Tolerance

Through continuous drug use, a user's body develops a tolerance to drugs. Increased amounts of drugs must be used in order to reach the same high. This can lead to a dangerous cycle that is difficult to break and it is in this way that many people become dependent on or addicted to drugs.

What are the signs of addiction?

The following are signs of addiction, and people exhibiting these behaviors should seek help and counseling. Treatment and recovery are possible.

Using alone Substituting one drug for another Manipulating a doctor or lying in order to get prescriptions Stealing drugs or stealing in order to get drugs Regularly using in the morning or before bed Taking one drug to overcome the effects of another Avoiding people or situations that do not approve of drug use Using a drug without knowing what it was Using a drug without knowing its effects Poor school or work performance as a result of drug use Trouble with the law; arrests for drug use, possession or trafficking Lying about drugs and quantities used Putting drugs ahead of financial responsibilities Trying to stop or control drug use

Sleep disturbances caused by drug use Loss of interest in food caused by drug use Fear of running out of drugs Fear of living without drugs Questioning one's sanity Unhappy home life Inability to enjoy life or social activities without drugs Defensive behavior, guilt or shame relating to drug use Preoccupation with drugs Irrational fears Taking drugs you don't particularly like just to get high Using drugs as a means to deal with emotional pain or stress Past drug overdose Continued use despite negative consequences Believing you may be addicted Spending time in jail, in hospital or in drug rehabilitation because of drug use

Diagnosis and treatment for drug addiction

People who exhibit one or several of the above behaviors may very likley suffer from a substance abuse problem. Only once addicts admit they have a problem can they get treatment and work toward recovery.

The first step is to consult with a physician or other health professional. Your doctor will conduct a thorough physical examination and he or she will recommend blood and urine tests to determine toxicology (which drugs are in your body). Your doctor may also recommend psychological testing and refer you to a drug treatment center, hospital or mental health agency that conducts drug evaluations.⁶

Treatment is tailored to the needs of the individual and will depend on which drug is being abused. Treatment may begin with detoxification in a hospital or drug treatment facility. This type of intensive treatment is intended for patients suffering from severe or long-term drug dependency and requires complete hospitalization over a period of a few weeks.⁷

The aim of detoxification is to rid the addict's body of drug residues by completely stopping all drug use. Medically supervised detoxification may involve the use of medications. Once a person is "clean" and off drugs, he or she may be referred to a psychologist or psychiatrist for counseling and behavioral therapy.

Those whose addictions are less severe typically participate in an outpatient treatment program of intensive, structured individual, group, and family therapy.

Many addicts require long-term rehabilitation and support consisting of daily individual counseling, drug education, nutritional guidance, physical exercise, group psychotherapy. They may participate in a group program such as Narcotics Anonymous, an international, community-based association of recovering drug addicts.⁸

Even after treatment, most drug users remain vulnerable to relapses, but they learn to manage this vulnerability. The good news is that many addicts can and do recover. A professional, medically complete treatment program—and education—are your best chance for recovery.

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1. What Is Substance Abuse? About, Inc. (2004)
2. Drug Abuse and Treatment. The National Women's Health Information Center. A project of the U.S. Department of Health and Human Services, Office of Women's Health.
3. What Is Substance Abuse? About, Inc. (2004)
4. What Is Substance Abuse? About, Inc. (2004)
5. What Is Substance Abuse? About, Inc. (2004)
6. There Is Help. Crisis Intervention of Houston, Inc.
7. How Does a Drug Abuse Treatment Program Work? Crisis Intervention of Houston, Inc.
8. How Does a Drug Abuse Treatment Program Work? Crisis Intervention of Houston, Inc.