INTRODUCTION

Drug addiction, also called substance use disorder, is a disease that affects a person's brain and behavior and leads to an inability to control the use of a legal or illegal drug or medication. Substances such as alcohol, marijuana and nicotine also are considered drugs. When you're addicted, you may continue using the drug despite the harm it causes.

Drug addiction can start with experimental use of a recreational drug in social situations, and, for some people, the drug use becomes more frequent. For others, particularly with opioids, drug addiction begins with exposure to prescribed medications, or receiving medications from a friend or relative who has been prescribed the medication.

The risk of addiction and how fast you become addicted varies by drug. Some drugs, such as opioid painkillers, have a higher risk and cause addiction more quickly than others.

COMMONLY USED SUBSTANCES INCLUDE:

       Opiates and other narcotics are powerful painkillers that can cause drowsiness, and sometimes intense feelings of well-being, elation, happiness, excitement, and joy. These include heroin, opium, codeine, and narcotic pain medicines that may be prescribed by a doctor or bought illegally.

       Stimulants are drugs that stimulate the brain and nervous system. They include cocaine and amphetamines, such as drugs used to treat ADHD (methylphenidate, or Ritalin). A person can start needing higher amounts of these drugs over time to feel the same effect.

       Depressants cause drowsiness and reduce anxiety. They include alcohol, barbiturates, benzodiazepines (Valium, Ativan, Xanax), chloral hydrate, and paraldehyde. Using these substances can lead to addiction.

       LSD, mescaline, psilocybin ("mushrooms"), and phencyclidine (PCP, or "angel dust") can cause a person to see things that are not there (hallucinations) and can lead to psychological addiction.

       Marijuana (cannabis, or hashish).

There are several stages of drug use that may lead to addiction. Young people seem to move more quickly through the stages than do adults. Stages are:

         STAGES

         Experimental use -- Typically involves peers, done for recreational use; the user may enjoy defying parents or other authority figures.

         Regular use -- The user misses more and more school or work; worries about losing drug source; uses drugs to "fix" negative feelings; begins to stay away from friends and family; may change friends to those who are regular users; shows increased tolerance and ability to "handle" the drug.

         Problem or risky use -- The user loses any motivation; does not care about school and work; has obvious behavior changes; thinking about drug use is more important than all other interests, including relationships; the user becomes secretive; may begin dealing drugs to help support habit; use of other, harder drugs may increase; legal problems may increase.

         Addiction -- Cannot face daily life without drugs; denies problem; physical condition gets worse; loss of "control" over use; may become suicidal; financial and legal problems get worse; may have broken ties with family members or friends.

TYPES AND SYMPTOMS

Recognizing signs of drug use or intoxication

Signs and symptoms of drug use or intoxication may vary, depending on the type of drug. Below you'll find several examples.

Marijuana, hashish and other cannabis-containing substances

People use cannabis by smoking, eating or inhaling a vaporized form of the drug. Cannabis often precedes or is used along with other substances, such as alcohol or illegal drugs, and is often the first drug tried.

Signs and symptoms of recent use can include:

         A sense of euphoria or feeling "high"

         A heightened sense of visual, auditory and taste perception

         Increased blood pressure and heart rate

         Red eyes

         Dry mouth

         Decreased coordination

         Difficulty concentrating or remembering

         Slowed reaction time

         Anxiety or paranoid thinking

         Cannabis odor on clothes or yellow fingertips

         Exaggerated cravings for certain foods at unusual times

K2, Spice and bath salts

Two groups of synthetic drugs synthetic cannabinoids and substituted or synthetic cathinones are illegal in most states. The effects of these drugs can be dangerous and unpredictable, as there is no quality control and some ingredients may not be known.

Synthetic cannabinoids, also called K2 or Spice, are sprayed on dried herbs and then smoked, but can be prepared as an herbal tea. Despite manufacturer claims, these are chemical compounds rather than "natural" or harmless products. These drugs can produce a "high" similar to marijuana and have become a popular but dangerous alternative.

Signs and symptoms of recent use can include:

         A sense of euphoria or feeling "high"

         Elevated mood

         An altered sense of visual, auditory and taste perception

         Extreme anxiety or agitation

         Paranoia

         Hallucinations

         Increased heart rate and blood pressure or heart attack

         Vomiting

         Confusion

Substituted cathinones, also called "bath salts," are mind-altering (psychoactive) substances similar to amphetamines such as ecstasy (MDMA) and cocaine. Packages are often labeled as other products to avoid detection.

Despite the name, these are not bath products such as Epsom salts. Substituted cathinones can be eaten, snorted, inhaled or injected and are highly addictive. These drugs can cause severe intoxication, which results in dangerous health effects or even death.

Signs and symptoms of recent use can include:

         Euphoria

         Increased sociability

         Increased energy and agitation

         Increased sex drive

         Increased heart rate and blood pressure

         Problems thinking clearly

         Loss of muscle control

         Paranoia

         Panic attacks

         Hallucinations

         Delirium

         Psychotic and violent behavior

Barbiturates, benzodiazepines and hypnotics

Barbiturates, benzodiazepines and hypnotics are prescription central nervous system depressants. They're often used and misused in search for a sense of relaxation or a desire to "switch off" or forget stress-related thoughts or feelings.

         Barbiturates. Examples include phenobarbital and secobarbital (Seconal).

         Benzodiazepines. Examples include sedatives, such as diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin) and chlordiazepoxide (Librium).

         Hypnotics. Examples include prescription sleeping medications such as zolpidem (Ambien, Intermezzo, others) and zaleplon (Sonata).

Signs and symptoms of recent use can include:

         Drowsiness

         Slurred speech

         Lack of coordination

         Irritability or changes in mood

         Problems concentrating or thinking clearly

         Memory problems

         Involuntary eye movements

         Lack of inhibition

         Slowed breathing and reduced blood pressure

         Falls or accidents

         Dizziness

Meth, cocaine and other stimulants

Stimulants include amphetamines, meth (methamphetamine), cocaine, methylphenidate (Ritalin, Concerta, others) and amphetamine-dextroamphetamine (Adderall, Adderall XR, others). They are often used and misused in search of a "high," or to boost energy, to improve performance at work or school, or to lose weight or control appetite.

Signs and symptoms of recent use can include:

         Feeling of exhilaration and excess confidence

         Increased alertness

         Increased energy and restlessness

         Behavior changes or aggression

         Rapid or rambling speech

         Dilated pupils

         Confusion, delusions and hallucinations

         Irritability, anxiety or paranoia

         Changes in heart rate, blood pressure and body temperature

         Nausea or vomiting with weight loss

         Impaired judgment

         Nasal congestion and damage to the mucous membrane of the nose (if snorting drugs)

         Mouth sores, gum disease and tooth decay from smoking drugs ("meth mouth")

         Insomnia

         Depression as the drug wears off

Club drugs

Club drugs are commonly used at clubs, concerts and parties. Examples include ecstasy or molly (MDMA), gamma-hydroxybutyric acid (GHB), flunitrazepam (Rohypnol ― a brand used outside the U.S. ― also called roofie) and ketamine. These drugs are not all in the same category, but they share some similar effects and dangers, including long-term harmful effects.

Because GHB and flunitrazepam can cause sedation, muscle relaxation, confusion and memory loss, the potential for sexual misconduct or sexual assault is associated with the use of these drugs.

Signs and symptoms of use of club drugs can include:

         Hallucinations

         Paranoia

         Dilated pupils

         Chills and sweating

         Involuntary shaking (tremors)

         Behavior changes

         Muscle cramping and teeth clenching

         Muscle relaxation, poor coordination or problems moving

         Reduced inhibitions

         Heightened or altered sense of sight, sound and taste

         Poor judgment

         Memory problems or loss of memory

         Reduced consciousness

         Increased or decreased heart rate and blood pressure

Hallucinogens

Use of hallucinogens can produce different signs and symptoms, depending on the drug. The most common hallucinogens are lysergic acid diethylamide (LSD) and phencyclidine (PCP).

LSD use may cause:

         Hallucinations

         Greatly reduced perception of reality, for example, interpreting input from one of your senses as another, such as hearing colors

         Impulsive behavior

         Rapid shifts in emotions

         Permanent mental changes in perception

         Rapid heart rate and high blood pressure

         Tremors

         Flashbacks, a re-experience of the hallucinations even years later

PCP use may cause:

         A feeling of being separated from your body and surroundings

         Hallucinations

         Problems with coordination and movement

         Aggressive, possibly violent behavior

         Involuntary eye movements

         Lack of pain sensation

         Increase in blood pressure and heart rate

         Problems with thinking and memory

         Problems speaking

         Impaired judgment

         Intolerance to loud noise

         Sometimes seizures or coma

Inhalants

Signs and symptoms of inhalant use vary, depending on the substance. Some commonly inhaled substances include glue, paint thinners, correction fluid, felt tip marker fluid, gasoline, cleaning fluids and household aerosol products. Due to the toxic nature of these substances, users may develop brain damage or sudden death.

Signs and symptoms of use can include:

         Possessing an inhalant substance without a reasonable explanation

         Brief euphoria or intoxication

         Decreased inhibition

         Combativeness or belligerence

         Dizziness

         Nausea or vomiting

         Involuntary eye movements

         Appearing intoxicated with slurred speech, slow movements and poor coordination

         Irregular heartbeats

         Tremors

         Lingering odor of inhalant material

         Rash around the nose and mouth

Opioid painkillers

Opioids are narcotic, painkilling drugs produced from opium or made synthetically. This class of drugs includes, among others, heroin, morphine, codeine, methadone and oxycodone.

Sometimes called the "opioid epidemic," addiction to opioid prescription pain medications has reached an alarming rate across the United States. Some people who've been using opioids over a long period of time may need physician-prescribed temporary or long-term drug substitution during treatment.

Signs and symptoms of narcotic use and dependence can include:

         Reduced sense of pain

         Agitation, drowsiness or sedation

         Slurred speech

         Problems with attention and memory

         Constricted pupils

         Lack of awareness or inattention to surrounding people and things

         Problems with coordination

         Depression

         Confusion

         Constipation

         Runny nose or nose sores (if snorting drugs)

         Needle marks (if injecting drugs)

CAUSES

Like many mental health disorders, several factors may contribute to development of drug addiction. The main factors are:

         Environment. Environmental factors, including your family's beliefs and attitudes and exposure to a peer group that encourages drug use, seem to play a role in initial drug use.

         Genetics. Once you've started using a drug, the development into addiction may be influenced by inherited (genetic) traits, which may delay or speed up the disease progression.

RISK FACTORS

People of any age, sex or economic status can become addicted to a drug. Certain factors can affect the likelihood and speed of developing an addiction:

         Family history of addiction. Drug addiction is more common in some families and likely involves genetic predisposition. If you have a blood relative, such as a parent or sibling, with alcohol or drug addiction, you're at greater risk of developing a drug addiction.

         Mental health disorder. If you have a mental health disorder such as depression, attention-deficit/hyperactivity disorder (ADHD) or post-traumatic stress disorder, you're more likely to become addicted to drugs. Using drugs can become a way of coping with painful feelings, such as anxiety, depression and loneliness, and can make these problems even worse.

         Peer pressure. Peer pressure is a strong factor in starting to use and misuse drugs, particularly for young people.

         Lack of family involvement. Difficult family situations or lack of a bond with your parents or siblings may increase the risk of addiction, as can a lack of parental supervision.

         Early use. Using drugs at an early age can cause changes in the developing brain and increase the likelihood of progressing to drug addiction.

         Taking a highly addictive drug. Some drugs, such as stimulants, cocaine or opioid painkillers, may result in faster development of addiction than other drugs. Smoking or injecting drugs can increase the potential for addiction. Taking drugs considered less addicting so-called "light drugs" can start you on a pathway of drug use and addiction.

DIAGNOSIS

Drug tests (toxicology screens) on blood and urine samples can show many chemicals and drugs in the body. How sensitive the test is depends on the drug itself, when the drug was taken, and the testing laboratory. Blood tests are more likely to find a drug than urine tests, though urine drug screens are done more often.

TREATMENT

Substance use disorder is a serious condition and not easy to treat. The best care and treatment involves trained professionals.

Treatment begins with recognizing the problem. Though denial is a common symptom of addiction, people who are addicted have far less denial if they are treated with empathy and respect, rather than told what to do or being confronted.

The substance may either be slowly withdrawn or stopped abruptly. Support for physical and emotional symptoms, as well as staying drug free (abstinence) are also key to treatment.

         People with drug overdose may need emergency treatment in the hospital. The exact treatment depends on the drug used.

         Detoxification (detox) is the withdrawal of the substance abruptly in an environment where there is good support. Detoxification can be done on an inpatient or outpatient basis.

         At times, another drug with a similar action or effect on the body is taken, as the dose is slowly decreased to reduce the side effects and risks of withdrawal. For example, for narcotic addiction, methadone or similar drugs may be used to prevent withdrawal and continued use.

Residential treatment programs monitor and address possible withdrawal symptoms and behaviors. These programs use techniques to get users to recognize their behaviors and learn how not to go back to using (relapse).

If the person also has depression or another mental health disorder, it should be treated. In many cases, a person starts using drugs to try to self-treat mental illness.