Drug abuse can lead to drug addiction, but it can also be a danger in its own right. Understanding patterns of drug abuse can help people avoid the issues that may arise with dependence and potential overdose on drugs and alcohol.
What Is Drug Abuse?
While the difference between drug abuse and drug addiction or dependence is drawn on a fine line, abuse is different from dependence in that a person can choose to overuse drugs without developing a physical need to take the drugs. However, these definitions are often conflated. The National Institute on Drug Abuse defines addiction as any drug-seeking behavior that continues despite negative consequences. This can occur whether or not physical dependence has occurred, and it is sometimes a part of drug abuse as well as dependence.
As an example, alcohol abuse is defined by the Centers for Disease Control and Prevention as using alcohol in ways that can damage health, relationships, or responsibilities. In contrast, alcoholism is the physical dependence on the substance that causes extreme cravings and the inability to control drinking.
Drug abuse can lead to drug addiction. If a substance is misused for a long enough period of time, the body can develop a tolerance to the substance, requiring a person to take a larger dose to achieve the same results that a smaller dose achieved previously. This leads to cravings for the drug, which indicate that the body has formed a dependence on the substance.
In other words, abuse is based more on the behaviors around substance use, and addiction is about a physical, chemical dependence on the substance. Drug addiction, therefore, is a type of drug abuse under this definition; this is demonstrated by the fact that the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has defined both drug abuse and drug dependence or addiction as “substance abuse disorders.”
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Causes of Substance Abuse
A number of factors may contribute to a person’s abuse of drugs or alcohol. Some of these factors are related to the person’s physical attributes, some to mental wellbeing, and some to environmental influences. These factors can include:
- Genetic predisposition to addiction or abuse
- Poor social skills or lack of social support structure
- History of mental illness
- Peer pressure
- Chaotic or neglectful childhood environment
- Perception that drug abuse is not a bad thing
- Not fitting into a social group
Any of these influences can factor into risky substance use behaviors. In addition, people who might not otherwise have a drug abuse problem might develop one based on use of certain prescription drugs over a long period of time, which can contribute to chemical dependence in the brain, leading to abuse and dependence.
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Most Common Substances of Abuse
There are numerous substances that are commonly abused. Along with illicit drugs, these substances range from prescription drugs like painkillers and anti-anxiety medications to commonly found substances like cough syrup, alcohol, and tobacco.
Alcohol and nicotine are substances found in legal products that are highly addictive, and they are some of the most commonly abused substances. The challenge is that smoking and drinking are generally considered to be socially acceptable pastimes, and many people take part in these activities without suffering from addiction. However, abuse of both substances is common and can lead to health issues, psychological changes, and social consequences.
Alcohol is found in many types of beverages, including beer, wine, liqueurs, and spirits. Alcohol abuse consists of excessive drinking on a single occasion, termed binge drinking, or chronic heavy drinking. Binge drinking does not necessarily lead to addiction, but a recent study demonstrates that the enzymes produced by the body during a bout of binge drinking can contribute to cravings that, over time, can lead to addiction.
Nicotine is a chemical found in tobacco that is highly addictive; it works on the body’s chemistry in ways that are similar to how opiates and cocaine work. Abuse of tobacco through smoking, chewing, and sniffing tobacco products can quickly change brain chemistry and lead to addiction.
Prescription and Over-the-Counter Medications
As mentioned previously, there has been a surge in the abuse of prescription painkillers; however, these are not the only prescription drugs that are commonly abused. Benzodiazepines and prescription stimulants are also part of this trend, as are both prescription and over-the-counter cough syrups. In fact, after marijuana and alcohol, prescription and over-the-counter drugs account for the highest levels of drug abuse in the US. Categories of these drugs include:
- Opiate drugs, such as hydrocodone (Vicodin), oxycodone (OxyContin), morphine, and codeine, are commonly abused. There has also been a recent surge in abuse of fentanyl.
- Benzodiazepines (benzos) like alprazolam (Xanax) and diazepam (Valium) are some of the most commonly prescribed drugs in the US. Use for long periods of time can cause brain chemistry changes that lead to abuse and addiction.
- Stimulants, such as those prescribed for attention deficit and hyperactivity disorder (ADHD) like the amphetamine Adderall, are often abused.
- Prescription cough syrups with codeine and promethazine are sometimes mixed with soda. This concoction is referred to by many names, including syrup, sizzurp, purple drank, and lean. The combination causes relaxation that can bring on euphoria.
- Many non-prescription cough syrups contain a medicine called dextromethorphan, which is consumed in high doses to bring on a hallucinatory effect.
- Pseudoephedrine, an over-the-counter decongestant, is one of the ingredients used to make the illicit drug methamphetamine. For this reason, purchases of medicines containing this drug are tracked.
The other common substances of abuse are illicit drugs. These drugs are illegal to possess and use due to their highly addictive nature and high risk for harm.
- Marijuana is the most commonly used illicit drug. While it is considered to be legal by the state laws of Colorado and Washington, it is still considered illegal under US law. Short-term abuse of marijuana can cause delayed reactions, problems with balance, and increased heart rate and appetite, among other problems. Long-term abuse can result in loss of cognitive function and mental health problems. Studies have shown that marijuana can even affect babies born to mothers who are using the drug, resulting in children with attention and memory problems.
- Heroin is part of the growing problem of opiate drug abuse around the world. Its use has led to a large increase in overdose deaths – as an example, the death rate from heroin overdose nearly doubled between 2010 and 2011. In some cases, heroin is laced with fentanyl, which greatly increases the likelihood of adverse physical responses to taking the drug.
- Cocaine had been tried by almost 15 percent of US citizens in 2008. Deaths due to cocaine use have decreased since 2006, but still show a 42 percent increase from 2001 to 2014. Cocaine abuse can lead to addiction, but even a single use of cocaine may result in cardiac arrest or seizures.
- Club drugs tend to be abused by younger people at parties, concerts, or nightclubs. These drugs include hallucinogens, stimulants, and depressants like LSD, ecstasy, benzos, or methamphetamines. These substances may have combination effects and are sometimes mixed with alcohol, which can make both the high and the negative effects of these drugs more potent.
A large number of illicit drugs exist, and more are being created all the time, such as bath salts, flakka, and Spice or K2, which is a synthetic drug similar to marijuana. New trends in drug abuse seem to rise on a regular basis, with new opportunities for the adverse effects of abuse and the potential for dependence.
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Issues of Dependence
Drug abuse can lead to addiction or dependence on substances. Dependence on drugs can result in major issues for the person abusing the drug, including problems with physical and mental health and various psychosocial issues. If several of these issues are seen in an individual, it could be a sign of a substance abuse disorder.
The health risks of drug abuse vary widely depending on the substance being abused. Minor issues can be exacerbated with continued abuse and become major disease issues. With certain substances, overdose can cause the most severe physical risks, including death. Other heath risks include:
- Loss of coordination
- Damage to major organs like the brain, heart, and liver
- Muscle tremors, trembling, and pain
- Increased chance of major diseases such as cancer
- Digestive problems like nausea, diarrhea, and appetite changes
- Increased chance of major diseases such as cancer
- Severe damage, disability, or death by overdose
- Respiratory issues and failure
Psychological effects of drug abuse can include minor mental disturbances or major psychological disorders. Psychological effects include:
- Inability to focus
- Depression, anxiety, or suicidal thoughts
- Hallucinations that lead to self-injury or violence
- Aggression and violent behavior
- Sensing things that are not there
- Insomnia and fatigue
Drug abuse can have an adverse effect on social life and daily responsibilities. Signs of this include:
- Lack of interest in activities that used to be enjoyed
- Inability to keep up with responsibilities at home, work, or school
- Trouble or disagreements with friends
- Continuing to use the drug even when aware of consequences
- Violent behavior toward loved ones
- Regularly engaging in dangerous activities while under the influence of the drug
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The Drug Abuse Spiral
Sometimes the above issues that are caused by drug abuse can also contribute to further drug abuse. This creates a spiral that can exacerbate the problem.
When it comes to measures of the effect of mental illness on potential drug abuse, there is research that shows that people with mental illness consume approximately 38 percent of alcohol, 44 percent of cocaine, and 40 percent of cigarettes. People who have had any kind of mental illness in their lives, such as anxiety or depression, consume even more at 69 percent of all alcohol, 84 percent of all cocaine, and 68 percent of all cigarettes.
Because mental illness can be both a contributor to and a result of drug abuse, it is important to be able to provide treatment for all co-occurring conditions. Treating both the psychological issues that led to the abuse and the issue of the abuse itself is more likely to result in a positive outcome when it comes to long-term recovery.
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Treatment for Drug Abuse
Any substance use disorder can be treated with detox and rehabilitation. Because addiction is considered a chronic condition, and because the chance for relapse is high, treatment is part of a continuous plan to maintain recovery from drug abuse. For this reason, most professionals recommend that treatment for drug abuse and addiction be undertaken via long-term, residential treatment in a specialized rehab facility.
In these types of facilities, treatments that can be expected include:
- Detox and withdrawal from the substance, with medical assistance if necessary
- Behavioral therapy to help recognize and address triggers and cravings
- Family or interpersonal therapy to develop, strengthen, or restore supportive relationships
- Provision of tools and strategies to help avoid situations that might encourage relapse
- Introduction to self-help and other support groups and mechanisms after treatment
There may be a perception that these treatments are only necessary for cases of severe, full-addiction. The truth is that anyone struggling with any substance abuse disorder can benefit from this thorough type of treatment. In fact, studies have shown that people who get help with a substance abuse disorder are more likely to avoid relapse in the long run.
- More than 5 million people had what is defined as a substance abuse disorder in 2014. This statistic includes people aged 12 and older.
- About one in 10 people in the US used illicit drugs in 2014, which adds up to 27 million people. The biggest contributors to this number are illegal users of marijuana and those who use prescription painkillers nonmedically.
- In 2014, 9 million people were binge drinking alcohol and 16.3 million were heavy alcohol users. In addition, 2.6 million people had a substance abuse disorder that combined alcohol and illicit drugs.
- Approximately 3 percent of all people in the US had both a mental illness of some kind and a substance use disorder.Substance abuse and mental illness are often found to be co-occurring.
- The US is in the middle of an epidemic of opiate abuse. Globally, between 26.4 million and 36 million people abuse opiate drugs like heroin, fentanyl, and prescription painkillers. Here in the US, about 2.1 million people were suffering from substance abuse disorders involving prescription opiates in 2012, and that number is continuing to rise.
- In 2011, approximately 6 percent of people in the US had used heroin at least once in their lives. It is estimated that about 23 percent of the people who use heroin abuse it and become addicted.
- Drug abuse does not have to involve illicit substances. Sometimes it involves legal substances like alcohol that are overused. Similarly, regular use of tobacco can result in abuse of nicotine, a highly addictive substance. Tobacco use is the leading preventable cause of major health issues in the US, with one out of every five deaths attributed to this substance. For every person who dies as a result of tobacco use, 30 more suffer from at least one severe illness related to tobacco use.
- Generally, only a small percentage of those who have substance abuse disorders get the treatment they need. For example, in 2011, approximately 21.6 million people had a substance abuse disorder, but only 2.3 million got treatment at a specialized treatment facility.
- Drug abuse and addiction are considered to be chronic diseases. The percentage of people who relapse to drug abuse after treatment for addiction (40-60 percent relapse) is similar to rates of relapse for other chronic diseases, such as diabetes (30-50 percent relapse), and asthma and high blood pressure (50-70 percent relapse).
Frequently Asked Questions
- What is drug abuse?
- Is drug abuse different from addiction?
- How does abuse start?
- Is drug abuse genetic?
- What are the most common drugs of abuse?
- What is the detox process like?
- What are treatment options for drug abuse?
What is drug abuse?
Drug abuse is use of a substance to obtain a reward response, even at the risk of health, relationships, or responsibilities. Whether it involves legal substances, improper use of prescription or over-the-counter medicines, or illicit drugs, drug abuse ends up creating more risks than the reward of the “high” is worth. The risks created by drug abuse include:
- Loss of social support structure
- Increased chance of disease
- Legal problems
- Inability to fulfill home, work, or school responsibilities
- Psychological issues
Is drug abuse different from addiction?
Drug abuse is different from addiction in that it is both separate from and a symptom of addiction. Drug abuse is a behavioral pattern, while addiction is a physical and psychological disorder.
Patterns of drug abuse can result in chemical changes in the body that lead to dependence and addiction. The physical cravings for more drugs and the psychological inability to stop taking the drugs lead to further drug abuse.
A person who is addicted to drugs can learn to control the temptation to continue abusing drugs with proper treatment. The cycle of addiction can be broken, and drug abuse can be stopped, through medical support and therapy to manage the issues that underlie the drug abuse.
How does abuse start?
There are many contributing factors to drug abuse. These factors can be physical, psychological, or environmental in nature. Some of these factors include:
- A genetic predisposition to addiction
- Peer pressure from others who use the substance
- A perception that drug abuse is not harmful or wrong
- Existing mental illness
- A challenging, chaotic, or neglectful childhood or home life
Addiction is considered to be a developmental disease that often begins in childhood, either as a response to challenging family or environmental circumstances or trauma, or through peer pressure or early exposure to the substance (use then continues into adulthood).
Is drug abuse genetic?
Some scientists believe that genetics may account for between 40 and 60 percent of a person’s potential to have a substance abuse disorder. However, as scientists learn more, there is evidence that this is more complex than the commonly held idea of an “addictive personality.”
Early childhood experiences may actually be able to change the way genes behave and contribute to addiction. In addition, drug abuse is more common in people with co-occurring mental health disorders, which indicates that more than just genetics is involved.
The action of addictive drugs in the body results in direct chemical changes to the brain that can lead to dependence on those drugs. This means that drug abuse can lead directly to addiction. This is seen in drugs like benzos that are not necessarily addictive if used for short periods of time, but that over long periods cause changes in the brain that result in the body becoming dependent where it hadn’t been before.
That said, children of alcoholics are 3-5 times more likely to become alcoholics themselves, regardless of whether or not they are raised by their birth parents. This indicates that whatever the other contributors may be, genetics does play a large role.
What are the most common drugs of abuse?
The most common drugs of abuse include a range of depressants, stimulants, and hallucinogens. These include the following:
- Marijuana (the most commonly used illicit drug)
- Both prescription and over-the-counter cough syrups
- Opiate drugs (used at epidemic abuse levels; both prescription painkillers and illicit drugs, like heroin)
- Club drugs like bath salts, LSD, and ecstasy
- Benzos (the most commonly prescribed drugs)
Some of these drugs are abused intentionally, while others may be prescription drugs that are used for too long or used contrary to doctors’ instructions, leading to the chemical changes described above. These changes can then lead to dependence and further abuse.
What is the detox process like?
Detox depends on the drug being used, the physical attributes and health of the person who used it, the amount of time it was used, and the dosage and frequency of use.
Detox can be an uncomfortable process, resulting in a variety of symptoms. These can include:
- Digestive problems like nausea and diarrhea
- Muscle tremors, unsteadiness, and shakiness
- Anxiety or irritability
- Headache and body aches
- Mood swings
- Insomnia and fatigue
These symptoms can range from mild to severe depending on the factors above. Some symptoms can be more dangerous; during withdrawal from alcohol or benzos, withdrawal can result in seizures, fever, psychotic episodes, and, in the case of alcohol, delirium tremens. Some of these symptoms are potentially fatal.
Going through a professional, medically supported detox process can help to minimize many of these symptoms and keep individuals safe. A research-based, residential treatment program is the best place in which to receive this type of detox. Medical detox, followed by comprehensive addiction treatment, is recommended by experts as the method most likely to help a person reach and maintain recovery from drug abuse and addiction.
What are treatment options for drug abuse?
There are a variety of treatment options available to help a person detox and recover from drug abuse and addiction. It’s important to verify the validity of a program prior to committing to it. Programs that promise rapid detox, instant recovery, and a “cure” for addiction are promising impossibilities and unsafe practices. While rapid detox sounds great, it carries a range of health risks and there is no evidence to show that it reduces withdrawal timelines at all.
Experts generally agree that research-based, residential treatment programs provide the greatest likelihood of long-term recovery and abstinence from drug abuse. These programs provide treatments that make it possible to not only detox from drugs and alcohol, but also learn to manage cravings or triggers that could potentially lead to relapse. Comprehensive drug abuse treatment programs give clients the support mechanisms and tools they need to resist relapse and live safely and happily in recovery.
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