Is it Abuse? Is it Addiction?

Addiction begins as abuse, or using a substance like marijuana or cocaine. You can abuse a drug (or alcohol) without having an addiction. For example, smoking marijuana a few times doesn’t mean that you have an addiction, but it does mean that you are abusing a drug and that could lead to an addiction.

When you think of addiction, you usually think of illegal drugs alcohol. But people can become addicted to all sorts of medications, cigarettes, even glue! And some substances are more addictive than others: Drugs like crack or heroin are so addictive that they may only be used once or twice before the user loses control.

The medical consequences of drug addiction

Drug addiction and alcoholism are complex disorders that are characterized by an often uncontrollable compulsion to acquire and use substances. The National Institute on Drug Addiction (NIDA) describes addiction as “a chronic, often relapsing brain disease that causes compulsive drug seeking and use despite harmful consequences to the individual who is addicted and to those around them.”

Substance abuse is often accompanied by a wide range of physical, mental, social, and emotional consequences. According to the NIDA, the medical conditions that individuals with a history of drug addiction are at increased risk of suffering from include heart and lung disease; stroke; various types of cancers; disorders of the throat, larynx, pancreas, stomach, kidney, and cervix; and brain damage.

In other words, the vast majority of individuals who eventually become addicted to drugs have no intention of damaging either themselves or others. But the nature of addiction leads to a loss of control and, in many cases, a series of what may be best described as cataclysmic consequences.

People start using drugs for a number of reasons, including curiosity, an attempt to numb themselves to emotional or physical pain, and peer pressure. The problem, of course, is that using the drugs eventually exacerbates the underlying conditions that the user was initially hoping to bring under control. As tolerance, dependency, and addiction begin to take over, the user loses control over the behavior, leading to continued negative effects.

This vicious cycle is often associated with diminished physical and mental health, damage to social and professional relationships, and poor performance at work or in school. It is no exaggeration to state that the compulsion to use drugs can take over an individual’s life.

Drug abuse and mental disorders 

No one has established a definitive cause-effect relationship between drug abuse and mental disorders, but statistics have consistently demonstrated a strong association between the two. In some cases, individuals who are afflicted with certain mental disorders may be more likely to experiment with drugs, while in other situations it is the substance abuse that leads to or exacerbates a mental or emotional vulnerability.

Drug abuse’s effects on family and friends

In addition to the wide range of personal consequences that have been linked to substance abuse, addiction can also take a severe toll on the health and well being of people who love, care about, or are dependent upon an addicted individual. The following are just three examples of the many ways in which our actions can have devastating effects on others in our lives:
•    Infants & children – Children who are born to mothers who used drugs while pregnant are at risk for many physical and developmental disorders, including being born addicted to drugs and suffering from fetal alcohol syndrome. Many of these children require educational support due to deficits in their ability to behave, pay attention, and retain information.
•    Second-hand smoke – Also referred to as environmental tobacco smoke (ETS), secondhand smoke has been determined to be a source of exposure to a variety of potentially harmful chemicals. Involuntary smoking (or exposure to ETS) has been associated with as much as a 30-percent increased likelihood of suffering from heart disease and lung cancer.
•    Infectious diseases – Injection drug use has been linked with as many as one third of all new cases of HIV infection, and has also been found to be a prime factor in the spread of hepatitis C. Drug users who don’t resort to intravenous injection are still at higher risk for certain infectious diseases, as their intoxication makes them much more likely to engage in dangerous behaviors such as unsafe sex.
Oft-abused substances & their effects
•    Alcohol – Drinking alcohol can inflict significant damage on most of the body’s organs, including (but not limited to) the heart, lungs, liver, and brain. Within the brain, alcohol’s effects are particularly devastating on the cerebral cortex (which controls higher functioning such as problem solving), hippocampus (memory and learning) and cerebellum (coordination). Alcohol abuse has also been associated with cirrhosis of the liver, heart attack, stroke, and the development of certain types of cancers.
•    Amphetamines – In the short-term, amphetamine abuse has been linked to irregular heartbeat, hypertension, and a variety of psychological problems. Longer-lasting effects can include memory loss, mental impairments, and severe dental problems (also known as “meth mouth”). Amphetamine use can also raise body temperature to dangerous heights, and can cause heart problems and seizures.
•    Cocaine – A quick-acting stimulant that is popular in both powder and rock (or “crack”) form, cocaine is a short-acting stimulant that many users will ingest multiple times in a single session. The medical consequences of cocaine abuse include heart damage, impaired respiratory functioning, and damage to the nervous and digestive systems.
•    Heroin – The most addictive and powerful of the opioid family of drugs engenders feelings of intense relaxation and euphoria among users, but at the same time it also slows respiration, causes damage to the livers and kidneys, and introduces infections to the heart. Injecting heroin also puts users at higher risk for infectious disease such as HIV and hepatitis.
•    Inhalants – Volatile (and common) substances such as oven cleaners, gasoline, and aerosol sprays can induce mind-altering effects on individuals who sniff (inhale fumes through the nose) or huff (breathe fumes through the mouth) them. The recreational abuse of these substances has been linked with damage to the heart, lungs, brain, and kidneys – and in many cases has resulted in death.
•    Marijuana is the most commonly abused illicit substance. This drug impairs short-term memory and learning, the ability to focus attention, and coordination. It also increases heart rate, can harm the lungs, and can cause psychosis in those at risk.
•    MDMA (Ecstasy) produces both stimulant and mind-altering effects. It can increase body temperature, heart rate, blood pressure, and heart wall stress. Ecstasy may also be toxic to nerve cells.
•    Nicotine – Found in cigarettes, cigars, and other forms of tobacco, this addictive stimulant increases the odds that a regular user will develop certain types of cancer, emphysema, bronchial disorders, and diseases of the heart and lung. Experts estimate that the use of tobacco is associated with the deaths of as many as 100 million people in the past century.
•    Prescription medications – Over-the-counter drugs and prescription meds are among the most commonly abused substances in America today – a practice that is not only addictive, but in some cases is lethal. Painkillers, sedatives, and stimulants are among the most prevalently abused of these drugs, which (because of the variety of substances that fall under this category) can inflict a wide range of short-term and long-term damage up to and including death.
•    Steroids – No longer a problem only for elite athletes or obsessed bodybuilders, steroid abuse has filtered into U.S. high schools, and is even being used by people for little more than cosmetic purposes. Though the use of the drugs has changes, steroid’s effects – including severe acne, heart disease, liver problems, stroke, infectious diseases, depression, and suicide – remain as devastating as ever.
In addition to the health problems elaborated upon above, myriad other consequences await individuals who are taking different types of drugs at the same time or in close proximity to each other. Even two relatively benign substances can interact with decidedly negative results.

You cross the line between substance abuse and addiction when you are no longer trying the drug to have fun or get high, but because you depend on it.Your life centers on the need for the drug. As an addicted person, whether it’s a physical or psychological addiction or both, you no longer have a choice in taking a substance.
This maladaptive pattern can be identified by the presence of three (or more) of the following occurring at any time in the same 12-month period.

•    The substance is often taken in larger amounts or over a longer period than intended

•    Persistent desire and/or unsuccessful efforts to cut down or control substance use

•    A great deal of time is spent in activities necessary to obtain the substance (e.g., visiting  multiple doctors or driving long distances), use the substance (e.g., chain smoking), or recover from its effects

•    Important social, occupational, or recreational activities are given up or reduced because of time and/or energy and/or money involved in using substance

•    Continued substance use despite knowledge of having a persistent or recurrent psychological, or physical problem that is caused or exacerbated by use of the substance

•    Tolerance for the substance becomes defined by either: 1. Need for greater amounts of the substance in order to achieve intoxication or desired effect; or Markedly diminished effect with continued use of the same amount.

•   Withdrawal from the substance is manifested by either: 1. Characteristic withdrawal syndrome for the substance; or 2. The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.

Treatment Can and Does Work

Extensive data document that drug addiction treatment is as effective as treatments for most other similarly chronic medical conditions. Because of such obstacles to the right facts as personal denial and incorrect information issued by the press, thousands of people are getting misinformation instead of the help they need.

In spite of sound evidence that establishes the effectiveness of professional drug abuse treatment; many people still believe that treatment will be ineffective. Distrusting treatment can also stem from unrealistic expectations. Many people equate addiction with simply using drugs and so they expect a quick cure–and if it is not cured quickly, they think treatment is a failure.

Addiction is more than an uncontrollable desire for substances; it is an underlying behavior pattern with deeply emotional roots. Successful treatment requires digging down and revealing the long-ingrained pattern at the root level. What’s often revealed is behavior born of anger, helplessness, and shame, compounded by intense desires for immediate escape from these unsettling feelings. Because addiction is a chronic disorder, the ultimate goal of successful, long-term abstinence often requires dedication to sustained and repeated treatment.