Drug   Abuse  andAddiction
Drug abuse is a    disorder that is    characterized by a    destructive pattern    of using a substance    that leads to ...
What is drug abuse?Drug abuse, also called substance abuse or chemical abuse, is a disorder that is characterizedby a dest...
What types of drugs are commonly    abused?    Virtually any substance whose ingestion can result in a euphoric (“high”) f...
Cannabis: More commonly called marijuana, the scientific name for cannabis istetrahydrocannabinol (THC). In addition to th...
may perceive danger where there is none and to think                               that situations that are truly dangerou...
While the specific                                  physical and                                  psychological effects   ...
8   Drug Abuse and Addiction
symptoms and signs of drug abuse and addictionIn order to be diagnosed with drug abuse or addiction, an individual must ex...
What are the physical                                and psychological                                effects of drug abus...
addiction include male gender, being between 18 and 44 years of age, Native-American heritage, unmarried marital status, a...
Treatment services     for drug abuse and     addiction remain     largely unutilized     by most sufferers of     these c...
in other mental illnesses, the mental-health screening is to  determine if the individual suffers from bipolar disorder,  ...
in a coordinated way by professionals who are trained and     experienced with helping this specific population.     What ...
symptoms and frequent medical monitoring can be provided.       sobriety support and structure on a daily basis.The medica...
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  1. 1. Drug Abuse andAddiction
  2. 2. Drug abuse is a disorder that is characterized by a destructive pattern of using a substance that leads to significant problems or distress.2 Drug Abuse and Addiction
  3. 3. What is drug abuse?Drug abuse, also called substance abuse or chemical abuse, is a disorder that is characterizedby a destructive pattern of using a substance that leads to significant problems or distress. Itaffects more than 7% of people at some point in their lives. Teens are increasingly engagingin prescription drug abuse, particularly narcotics (which are prescribed to relieve severe pain),and stimulant medications, which treat conditions like attention deficit disorder.What is drug addiction?Drug addiction, also called substance dependence or chemical dependency, is a disease thatis characterized by a destructive pattern of drug abuse that leads to significant problemsinvolving tolerance to or withdrawal from the substance, as well as other problems that useof the substance can cause for the sufferer, either socially or in terms of their work or schoolperformance. More than 2.6% of people suffer from drug addiction at some time in their life.The term dual diagnosis refers to the presence of both a drug-abuse or dependence issue inaddition to a serious mental-health problem in an individual. Substance abuse or dependenceunfortunately occurs quite commonly in people who also have severe mental illness. This isimportant given that people with a serious mental illness are far more at risk of engaging inviolence, being incarcerated, or contracting infection with the human immunodeficiency virus(HIV). Individuals with dual diagnosis are also at higher risk of being noncompliant withtreatment. Drug Abuse and Addiction 3
  4. 4. What 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 develop- ing fetus when a mother consumes this drug during pregnancy. 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 produce palpitations, insomnia, tremors and significant anxiety.4 Drug Abuse and Addiction
  5. 5. Cannabis: More commonly called marijuana, the scientific name for cannabis istetrahydrocannabinol (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 dilutedsubstance or expose the user to more addictive drugs exposes the marijuana user to thedangers associated with those added substances. Examples of ingredients that marijuanais commonly cut with include baby powder, oregano, embalming fluid, PCP, opiates, andcocaine.Cocaine: A drug that tends to stimulate the nervous system, cocaine can be snorted inpowder form, smoked when in the form of rocks (crack cocaine), or injected when made intoa liquid.Ecstasy: Also called MDMA to denote its chemical composition(methylenedioxymethamphetamine), this drug tends to create a sense of euphoria and anexpansive love or desire to nurture others. In overdose, it can increase body temperature to thepoint of being fatal.Hallucinogens: Examples include LSD and mescaline, as well as so-called naturally occurringhallucinogens like certain mushrooms, these drugs can be dangerous in their ability to alterthe perceptions of the user. For example, a person who is intoxicated with a hallucinogen Virtually any substance whose ingestion can result in a euphoric “high” feeling can be abused. Drug Abuse and Addiction 5
  6. 6. 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 habit-forming 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 heroine, codeine, Vicodin, Percocet, and Percodan. This group of substances sharply decrease the functioning of the nervous system. The lethality of opiates Inhalants like household cleaners are some of the most commonly abused substances.6 Drug Abuse and Addiction
  7. 7. 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.is often the result of the abuser having to use increasinglyhigher amounts to achieve the same level of intoxication,ultimately to the point that the dose needed to get highis the same as the dose that is lethal for that individual byhalting the person’s breathing (respiratory arrest).Phencyclidine: Commonly referred to as PCP, this drugcan cause the user to feel extremely paranoid, becomequite aggressive and to have an unusual amount of physicalstrength.Sedative, hypnotic, or antianxiety drugs: As these substancesquell or depress the nervous system, they can cause death byrespiratory arrest of the person who either uses these drugsin overdose or who mixes one or more of these drugs withanother nervous system depressant drug . Drug Abuse and Addiction 7
  8. 8. 8 Drug Abuse and Addiction
  9. 9. symptoms and signs of drug abuse and addictionIn order to be diagnosed with drug abuse or addiction, an individual must exhibit adestructive pattern of drug use that leads to significant problems or stress as manifested bythe following signs or symptoms in the same one-year period:Signs of abuse Signs of addictionRecurrent use that results in a lack of meeting important obligations at Tolerance is either a markedly decreased effect of the substance or a need towork, school, or home significantly increase the amount of the substance used in order to achieve the same high or other desired effects.Recurrent drug use in situations that can be dangerous Withdrawal is 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.Recurrent legal problems as a result of drug use Larger amounts of the drug are taken or for longer than intended.Continued drug use despite continued or repeated social or relationship The individual experiences a persistent desire to take the drug or hasproblems as a result of the drug’s effects 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. Drug Abuse and Addiction 9
  10. 10. What are 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 While the specific or addiction to any drug can be devastating. Psychologically, effects of drugs intoxication with or withdrawal from a substance can on the brain can cause everything from euphoria as with alcohol, Ecstasy, or somewhat vary depending on the inhalant intoxication to paranoia with marijuana or steroid drug that is being intoxication, to severe depression or suicidal thoughts with used, virtually every drug that is cocaine or amphetamine withdrawal. abused has an effect on the executive functioning areas What causes drug abuse of the brain. Drugs and addiction? particularly affect Like the majority of other mental-health problems, drug the brain’s ability to inhibit actions abuse and addiction have no single cause. However, there that the person would are a number of biological, psychological, and social factors, otherwise delay or called risk factors, that can increase a person’s likelihood prevent. 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, as well as personality disorders like antisocial personality disorder. Social risk factors for drug abuse and10 Drug Abuse and Addiction
  11. 11. 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 higherrisk for chemical abuse or dependency. While men are more at risk for developinga chemical dependency like alcoholism, women seem to be more vulnerable to becomingaddicted to alcohol at much lower amounts of alcohol consumption.effects of drug addition on the brainWhile the specific effects of drugs on the brain can vary somewhat depending on the drug thatis being used, virtually every drug that is abused has an effect on what professionals often callthe executive functioning areas of the brain. The functions of those areas can be rememberedby thinking about the tasks of the chief executive officer in any company: planning, organizing,acting when it is time to act, as well as delaying or preventing action (inhibitory functions)when appropriate. The parts of the brain that tend to harbor the executive brain functionsare the front-most parts of the brain, called the frontal cortex and prefrontal cortex. When aperson takes drugs, the inhibitory functions of the brain are particularly impaired, resulting inthe person using drugs and having trouble stopping him or herself from acting on impulsesthat the brain would otherwise delay or prevent. This disinhibition can result in the substanceabuser engaging in aggressive, sexual, criminal, or other activities that can have devastatingconsequences for the addicted person or those around him or her. Drug Abuse and Addiction 11
  12. 12. Treatment services for drug abuse and addiction remain largely unutilized by most sufferers of these conditions. the diagnosis process As is true with virtually any mental-health diagnosis, there is no one test that definitively indicates that someone has chemical abuse or addiction. Therefore, health- care practitioners diagnose these disorders by gathering comprehensive medical, family, and mental-health information. The practitioner will also either perform a physical examination or request that the individual’s primary-care doctor perform one. The medical examination will usually include lab tests to evaluate the person’s general health and to explore whether or not the individual has a medical condition that might have mental-health symptoms. In asking questions about mental-health symptoms, mental-health professionals are often exploring if the individual suffers from depression and/or manic symptoms but also anxiety, hallucinations, or delusions, as well as some behavioral disorders. Practitioners may provide the people they evaluate with a quiz or self-test as a screening tool for substance abuse or dependence. Since some of the symptoms of drug misuse and dependence can also occur The Cycle of Addiction internal Fantasizing Obsessing Substance abuse frustration12 Drug Abuse and Addiction
  13. 13. in other mental illnesses, the mental-health screening is to determine if the individual suffers from bipolar disorder, an anxiety disorder, schizophrenia, schizoaffective disorder and other psychotic disorders, or a personality or behavior disorder like antisocial personality disorder or attention deficit hyperactivity disorder (ADHD), respectively. Any disorder that is associated with sudden changes in behavior, mood, or thinking, like bipolar disorder, a psychotic disorder, borderline personality disorder, or dissociative identity disorder (DID) may be particularly challenging to distinguish from some symptoms of drug abuse or dependence. In order to assess the person’s current emotional state, health-care providers perform a mental-status examination as well. In addition to providing treatment that is appropriate to the diagnosis, determining the presence of mental illnesses that may co-occur (be co-morbid) with substance abuse or dependence is important in promoting the best possible outcome for the person. As previously described, the dual diagnosis of substance abusing or addicted individuals dictates the need for treatment that addresses both issuesLoss of control Guilt overuse Cessation of use Passage of time Drug Abuse and Addiction 13
  14. 14. in a coordinated way by professionals who are trained and experienced with helping this specific population. What is 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 treatment. 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 withdrawal14 Drug Abuse and Addiction
  15. 15. symptoms and frequent medical monitoring can be provided. sobriety support and structure on a daily basis.The medications used for detox are determined by thesubstance the individual is dependent upon. For example, Also important in the treatment of addiction is helpingpeople with alcohol dependence might receive medications the parents, other family members, and friends of thelike anti-anxiety or blood pressure medications to decrease addicted person refrain from supporting addictive behaviorspalpitations and blood pressure, or seizure medications to (codependency). Whether providing financial support,prevent possible seizures during the detoxification process. making excuses or failing to acknowledge the addictiveFor many drugs of abuse, the detox process is the most behaviors of the addict, discouraging such codependency ofdifficult aspect of coping with the physical symptoms of loved ones is a key component to the recovery of the affectedaddiction and tends to last days to a few weeks. Medications individual. A focus on the addicted person’s role in the familythat are sometimes used to help addicted individuals abstain becomes perhaps even more acute when that person is afrom drug use long term also depends on the specific drug child or teenager, given that minors come within the contextof addiction. For example, individuals who are addicted of a family in nearly every instance. Chemical dependencyto narcotics like aspirin and oxycodone hydrochloride treatment for children and adolescents is further different(Percodan), heroin, or hydrocodone/acetaminophen from that in adults by the younger addict’s tendency to(Vicodin, Vicodin ES, Anexsia, Lorcet, Lorcet Plus, Norco) need help completing their education and achieving higheroften benefit from receiving longer-acting, less addictive education or job training compared to addicts who may havenarcotic-like substances like methadone (Methadose). completed those parts of their lives before developing theDisulfiram (Antabuse) produces nausea, stomach cramping, addiction.and vomiting when mixed with alcohol. The treatment of dual diagnosis seems to be less effectiveOften, much more challenging and time consuming when treatment of their mental illness is separate from thethan recovery from the physical aspects of addiction is treatment of the individual’s chemical dependency. Morepsychological addiction. For people who may have less successful are integrated treatment programs that includesevere drug dependency, the symptoms of psychological interventions for both disorders. Such interventions are alladdiction may be able to be managed in an outpatient the more improved by the inclusion of assessment, intensivetreatment program. However, this is not always the case. case management, motivational interventions, behaviorThose who have a more severe addiction, have relapsed after interventions, family treatment as well as services forparticipation in outpatient programs, or who also suffer housing, rehabilitation, and medication treatment.from a severe mental illness might need the higher structure,support, and monitoring provided in an inpatient drugtreatment center, sometimes called “rehab.” Following suchinpatient treatment, many people with this level of addictioncan benefit from living in a sober living community, that is,a group-home setting where counselors provide continuedTreatment servicesfor drug abuse andaddiction remainlargely unutilizedby most sufferers ofthese conditions. Drug Abuse and Addiction 15

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