Drug Abuse - Addiction

Why do people use drugs?
Drugs are used in the practice of medicine for a variety of purposes: to relieve pain, fight infection and treat symptoms of disease, to name a few. For centuries, psychotropic (mood-altering) drugs also have been recreationally:

• To experience feelings of relaxation or euphoria
• To fight stress or depression
• To enhance performance to"expand the mind" by altering the perception of reality
• To numb feelings of guilt, shame or aloneness

Drugs take many forms and are consumed in a variety of ways. They may be herbal substances, such as marijuana, or synthetic chemicals in pill or powder form. They may be taken orally, such as an alcoholic beverage or a pill; or smoked, inhaled or injected under the skin or into a vein. Rehab Treatment Centers

Because the intensity of a drug's effect is determined by its level in the bloodstream, intravenous (IV) drug use is favored by some users. This dangerous practice poses health risks beyond those of the drug itself, including damage to veins, bacterial or viral infections from shared needles (including human immunodeficiency virus, which causes AIDS and hepatitis C), and increased risk of overdose. Drug Treatment Centers

Who becomes a substance abuser?
Why certain people become substance abusers and who is particularly at risk are the subjects of ongoing research. Substance abuse problems occur among people of all ages and circumstances, and it is impossible to predict with certainty who will or will not become addicted. But there are certain risk factors that are strong indicators of potential for addiction or abuse:

• Poverty
• Substance use by parents or other family members
• Substance use by peers and the perception that "everybody's doing it"
• Early (preadolescent) use of alcohol, tobacco or drugs
• Poor adjustment to school and/or low achievement at school
• Poor physical and/or social environment at home or at school
• Being homeless or running away
• Childhood aggression
• Rebellious or sensation-seeking behavior
• Being a victim of physical or sexual abuse

Studies have shown that men and women use drugs for different reasons and may be affected by different risk factors. Men may use drugs to enhance self-importance and feel "powerful," while women may use drugs as "self-medication" to combat feelings of anger or worthlessness. An absent or weak father figure is a risk factor for young men; for adolescent girls, having an adult boyfriend is a risk factor. Locate Drug Rehab Centers

It is now an accepted generalization that alcoholism tends to "run in families," and recent studies indicate that there is a genetic component in abuse of other drugs as well. However, there is no consensus or conclusive evidence about what this genetic component might be or how it works. Many researchers believe that genetic disposition toward substance abuse is caused by a number of genes acting together rather than by a single gene carrying a genetic marker. Genes that control the brain chemical dopamine, which is associated with feeling pleasure, have been identified as likely candidates for influencing substance abuse. Drug Treatment Centers

The children of alcoholics have been studied extensively, and much can be learned from this research about the profound effect on children of growing up in a family damaged by substance abuse. Nearly a third of children of alcoholics become alcoholics themselves, and many will marry into alcoholic families. Even when raised in adoptive families, children of alcoholics are still at higher-than-average risk of becoming substance abusers, confirming the likelihood of a genetic factor. But environmental factors may be even more influential. Close bonding with the alcoholic parent increases the likelihood that a child will experiment with alcohol at a young age, as the parent models drinking behavior and may even offer the child alcohol. Children of alcoholics are more likely to live in disorganized home environments, perform poorly in school, and be abused or witness abuse of other family members - all risk factors in themselves for substance abuse.
How do you know if you have an abuse or addiction problem?
It is difficult to admit, especially to yourself, that you have a substance problem. But acknowledging the problem is the first step in overcoming it, and the realization will help you minimize the damage to yourself and others.

These are some signs that you have an abuse problem or are at risk of developing one:

• You feel guilty about your substance use and feel you should cut down or stop
• A friend or loved one has shown concern about your substance use
• You lie or make excuses about your substance use
• You drink or use drugs alone
• You feel you cannot enjoy yourself without alcohol or other drugs
• Substance use has caused you to be late or absent from work or school, or caused you to perform poorly
• You give up activities you used to enjoy in order to drink or use drugs
• You avoid friends who don't use drugs or alcohol and/or pressure them to do so
• You have had one or more driving accidents or accidental injuries when using drugs or alcohol
• While intoxicated you engage in uncharacteristic and/or risky behavior, such as starting arguments or physical fights; hitting your spouse and/or children; or having unprotected sex, or sex with a person you wouldn't have chosen if you were sober.

Drug Abuse Treatment Resources

National Institute on Alcohol and Alcoholism
Alcohol Abuse and Alcoholism
http://www.niaaa.nih.gov

Association of Addiction Professionals
NAADAC is the premier global organization of addiction focused professionals who enhance the health and recovery of individuals, families, and communities.
http://www.naadac.org

Substance Abuse and Mental Health Services
SAMHSA works to improve the quality and availability of substance abuse prevention, alcohol and drug addiction treatment, and mental health services. Includes links to support groups, information resources, events and articles.
http://www.samhsa.gov

National Clearinghouse for Alcohol and Drug Information
National Clearinghouse for Alcohol and Drug Information (NCADI). Drug and alcohol abuse, prevention, treatment.
http://www.health.org

Lawyers & Attorneys

Treating prescription drug addiction

Years of research have shown us that addiction to any drug, illicit or prescribed, is a brain disease that can, like other chronic diseases, be effectively treated. But no single type of treatment is appropriate for all individuals addicted to prescription drugs. Treatment must take into account the type of drug used and the needs of the individual. To be successful, treatment may need to incorporate several components, such as counseling in conjunction with a prescribed medication, and multiple courses of treatment may be needed for the patient to make a full recovery.

The two main categories of drug addiction treatment are behavioral and pharmacological. Behavioral treatments teach people how to function without drugs, how to handle cravings, how to avoid drugs and situations that could lead to drug use, how to prevent relapse, and how to handle relapse should it occur. When delivered effectively, behavioral treatments - such as individual counseling, group or family counseling, contingency management, and cognitive-behavioral therapies - also can help patients improve their personal relationships and ability to function at work and in the community.

Some addictions, such as opioid addiction, can also be treated with medications. These pharmacological treatments counter the effects of the drug on the brain and behavior. Medications also can be used to relieve the symptoms of withdrawal, to treat an overdose, or to help overcome drug cravings. Although a behavioral or pharmacological approach alone may be effective for treating drug addiction, research shows that a combination of both, when available, is most effective.

Treating addiction to prescription opioids

Several options are available for effectively treating addiction to prescription opioids. These options are drawn from experience and research regarding the treatment of heroin addiction. They include medications, such as methadone and LAAM (levo-alpha-acetyl-methadol), and behavioral counseling approaches.

A useful precursor to long-term treatment of opioid addiction is detoxification. Detoxification in itself is not a treatment for opioid addiction. Rather, its primary objective is to relieve withdrawal symptoms while the patient adjusts to being drug free. To be effective, detoxification must precede long-term treatment that either requires complete abstinence or incorporates a medication, such as methadone, into the treatment plan.

Methadone is a synthetic opioid that blocks the effects of heroin and other opioids, eliminates withdrawal symptoms, and relieves drug craving. It has been used successfully for more than 30 years to treat people addicted to opioids. Other medications include LAAM, an alternative to methadone that blocks the effects of opioids for up to 72 hours, and naltrexone, an opioid blocker that is often employed for highly motivated individuals in treatment programs promoting complete abstinence. Buprenorphine, another effective medication, is awaiting Food and Drug Administration (FDA) approval for treatment of opioid addiction. Finally, naloxone, which counteracts the effects of opioids, is used to treat overdoses.

National Center on Addiction and Substance Abuse at Columbia University (CASA). Missed Opportunity: National Survey of Primary Care Physicians and Patients on Substance Abuse, New York: CASA, 2000.

Treating addiction to CNS depressants

Patients addicted to barbiturates and benzodiazepines should not attempt to stop taking them on their own, as withdrawal from these drugs can be problematic, and in the case of certain CNS depressants, potentially life-threatening. Although no extensive body of research regarding the treatment of barbiturate and benzodiazepine addiction exists, patients addicted to these medications should undergo medically supervised detoxification because the dose must be gradually tapered off. Inpatient or outpatient counseling can help the individual during this process. Cognitive-behavioral therapy also has been used successfully to help individuals adapt to the removal from benzodiazepines.

Often the abuse of barbiturates and benzodiazepines occurs in conjunction with the abuse of another substance or drug, such as alcohol or cocaine. In these cases of polydrug abuse, the treatment approach must address the multiple addictions.

Treating addiction to prescription stimulants

Treatment of addiction to prescription stimulants, such as Ritalin, is often based on behavioral therapies proven effective for treating cocaine or methamphetamine addiction. At this time, there are no proven medications for the treatment of stimulant addiction. However, antidepressants may help manage the symptoms of depression that can accompany the early days of abstinence from stimulants.

Depending on the patient's situation, the first steps in treating prescription stimulant addiction may be tapering off the drug's dose and attempting to treat withdrawal symptoms. The detoxification process could then be followed by one of many behavioral therapies. Contingency management, for example, uses a system that enables patients to earn vouchers for drug-free urine tests. The vouchers can be exchanged for items that promote healthy living.

Another behavioral approach is cognitive-behavioral intervention, which focuses on modifying the patient's thinking, expectations, and behaviors while at the same time increasing skills for coping with various life stressors. Recovery support groups may also be effective in conjunction with behavioral therapy.

The National Institute on Drug Abuse

Understanding Drug Abuse and Addiction

Many people view drug abuse and addiction as strictly a social problem. Parents, teens, older adults, and other members of the community tend to characterize people who take drugs as morally weak or as having criminal tendencies. They believe that drug abusers and addicts should be able to stop taking drugs if they are willing to change their behavior.

These myths have not only stereotyped those with drug-related problems, but also their families, their communities, and the health care professionals who work with them. Drug abuse and addiction comprise a public health problem that affects many people and has wide-ranging social consequences. It is NIDA's goal to help the public replace its myths and long-held mistaken beliefs about drug abuse and addiction with scientific evidence that addiction is a chronic, relapsing, and treatable disease.

Addiction does begin with drug abuse when an individual makes a conscious choice to use drugs, but addiction is not just "a lot of drug use." Recent scientific research provides overwhelming evidence that not only do drugs interfere with normal brain functioning creating powerful feelings of pleasure, but they also have long-term effects on brain metabolism and activity. At some point, changes occur in the brain that can turn drug abuse into addiction, a chronic, relapsing illness. Those addicted to drugs suffer from a compulsive drug craving and usage and cannot quit by themselves. Treatment is necessary to end this compulsive behavior.

A variety of approaches are used in treatment programs to help patients deal with these cravings and possibly avoid drug relapse. NIDA research shows that addiction is clearly treatable. Through treatment that is tailored to individual needs, patients can learn to control their condition and live relatively normal lives.

Treatment can have a profound effect not only on drug abusers, but on society as a whole by significantly improving social and psychological functioning, decreasing related criminality and violence, and reducing the spread of AIDS. It can also dramatically reduce the costs to society of drug abuse.

Understanding drug abuse also helps in understanding how to prevent use in the first place. Results from NIDA-funded prevention research have shown that comprehensive prevention programs that involve the family, schools, communities, and the media are effective in reducing drug abuse. It is necessary to keep sending the message that it is better to not start at all than to enter rehabilitation if addiction occurs.

A tremendous opportunity exists to effectively change the ways in which the public understands drug abuse and addiction because of the wealth of scientific data NIDA has amassed. Overcoming misconceptions and replacing ideology with scientific knowledge is the best hope for bridging the "great disconnect" - the gap between the public perception of drug abuse and addiction and the scientific facts.

The National Institute on Drug Abuse

Drug Treatment & Substance Abuse - Addiction Treatment