Addiction is a chronic brain disease that causes compulsive substance use despite harmful consequences. Health, finances,relationships, and careers can be ruined. The abuse of drugs and alcohol is by far the leading cause of preventable illnesses and premature death in our society. Drug and alcohol use is associated with high-risk sexual behaviors and injection drug use, two major modes of HIV transmission. The importance of substance abuse treatment cannot be overstated, and fortunately many effective treatments are available. The road to recovery, however, begins with recognition.
Most adults are familiar with alcohol and its effects. Alcohol is a legal drug that can produce pleasant effects with lower amounts, but that can produce dangerous effects with higher amounts. People often drink alcohol during social occasions; it tends to loosen inhibitions. Unfortunately, the recklessness often resulting from excessive drinking is a leading cause of serious injury and accidental death.
Excessive drinking may lead to alcoholism, an illness that tends to run in families and is often associated with depression. Alcoholism can have devastating effects on health, including serious liver damage, greater risk of heart disease, impotence, infertility, and premature aging. Alcohol is the most common cause of preventable birth defects, including fetal alcohol syndrome.
Abruptly stopping alcohol use in a person who is dependent on alcohol can be dangerous. An alcoholic who needs to drink daily should stop their use of alcohol under the supervision of a physician, and may need medication during their withdrawal. There are medications that can help an alcoholic not feel the compelling desire to drink alcohol.
Treatment is more successful early in alcoholism's development than when the illness has been allowed to progress for years. Early treatment can reduce alcoholism's destructive impact.
Table of Common Drugs of Abuse
Marijuana is the most widespread and frequently used illicit drug and is associated with:
• Short-term memory loss
• Accelerated heartbeat
• Increased blood pressure
• Difficulty with concentrating and processing information
• Lapses in judgment
• Problems with perception and motor skills
Years of marijuana use can lead to a loss of ambition and an inability to carry out long-term plans or to function effectively.
Stimulants (cocaine, crack, amphetamines) give a temporary illusion of enhanced power and energy. As the initial elevation of mood fades, however, depression and other serious medical problems may emerge, including:
• Heart attacks
• Violent, erratic, anxious, or paranoid behavior
Cocaine use during pregnancy may result in miscarriages, stillbirths, or low-birth–weight babies who may be physically drug-dependent and may later develop behavioral or learning difficulties. Excessive crack use can lead to a permanent zombie-like state. Long-term amphetamine abuse can result in psychosis with symptoms that include paranoid delusions and hallucinations.
Heroin is an opioid drug (that is, in the same class as medications like morphine). It can be injected with a needle, or also inhaled. Heroin produces an intense feeling of pleasure when a person first begins to use it. However, occasional use of heroin often progresses to dependence (or addiction). When that occurs, the person reports less of a “high” effect. Skipping use of heroin for an addicted person can lead to significant withdrawal symptoms such as:
• Runny nose and eyes
• Abdominal cramps
• Muscle pains
Heroin use during pregnancy may result in miscarriages, stillbirths, premature deliveries, or drug-dependent babies. Those who inject heroin are introducing substances into their bloodstream, which can result in severe damage to the heart, lungs, and brain. Needle sharing puts users at high risk of acquiring chronic blood-borne infections such as HIV and Hepatitis C.
Opiate abuse can bring about significant and long-lasting chemical changes in the brain. These changes cause a person to experience intense cravings and negative emotions when they try to stop. There are several medications that can be used to treat heroin addiction. In some cases, these are used to withdraw the person, and in other cases the person is maintained on the medication. The most commonly used medications for opiate addiction are buprenorphine, methadone, and naltrexone.
Hallucinogens are drugs such as LSD (acid) or the new designer drugs (ecstasy) that are taken orally and cause hallucinations and feelings of euphoria. Dangers from LSD include stressful flashbacks—re-experiencing the hallucinations despite not having taken the drug again, sometimes even years later. Excessive use of ecstasy, combined with strenuous physical activity, can lead to death from dehydration or an exceptionally high fever.
Inhalants are breathable chemicals (glue, paint thinner, lighter fluid). They are commonly abused by teenagers because they are easy to obtain and because they produce mind-altering effects when sniffed or "huffed." These chemicals reach the bloodstream very quickly and can be deadly. High concentrations of inhalant fumes can cause heart failure or suffocation and long-term abuse can cause permanent damage to the nervous system.
Sedatives are highly effective medications prescribed by physicians to relieve anxiety and to promote sleep. Unfortunately, harmful effects can occur when they are taken in excess or without a physician’s supervision. Combining sedatives with alcohol or other drugs greatly increases the likelihood of death by overdose. Women who abuse sedatives during pregnancy may deliver babies with birth defects who also may be physically dependent on drugs.
The U.S. Surgeon General has confirmed that nicotine in tobacco products has addictive properties similar in severity to those of heroin. Quitting is difficult because of the unpleasantness of withdrawal, which involves feelings of irritability, frustration, anger, anxiety, insomnia, and depression. However, continued smoking may lead to far more dire circumstances, including:
• Lung cancer
• Heart attacks
• High blood pressure
The first step on the road to recovery is recognition of the problem, but often this process is complicated by a lack of understanding about substance abuse and addiction or denial. In these cases, the intervention of concerned friends and family often prompts treatment.
Addiction is a chronic illness like heart disease, high cholesterol or high blood pressure. Persons with these chronic diseases are prone to relapse. Because substance abuse affects many aspects of a person’s life, multiple forms of treatment are often required. For most, a combination of medication and individual or group therapy is most effective.
Medications are used to control drug cravings and relieve severe symptoms of withdrawal. Therapy can help addicted individuals understand their behavior and motivations, develop higher self-esteem, and cope with stress. Other treatment methods may include:
• Therapeutic communities (highly controlled, drug-free environments)
• Outpatient programs, including methadone maintenance for heroin addiction
Self-help groups for substance-abusing individuals (Alcoholics Anonymous, Narcotics Anonymous) as well as their family members (Al-Anon or Nar-Anon Family Groups) also are useful in providing support and reinforcing messages learned in treatment.