Drug Dependency
Drug Abuse
• Drug abuse is an intense desire to use
increasing amounts of a particular substance
or substances to the exclusion of other
activities.
Drug Dependence
Definition
Drug dependence means that a person
needs a drug to function normally. Abruptly
stopping the drug leads to withdrawal
symptoms.
Drug Addiction
• Drug addiction is the compulsive use of a substance, despite its
negative or dangerous effects.
• A person may have a physical dependence on a substance without
having an addiction.
• For example, certain blood pressure medications do not cause
addiction but they can cause physical dependence. Other drugs,
such as cocaine, cause addiction without leading to physical
dependence.
Cause
• People who use drugs for pain relief may become
dependent
• Peer pressure can lead to drug use or abuse,
• Children who grow up in an environment of illicit
drug use may first see their parents using drugs.
Who Becomes Addicts
People who are more likely to abuse or become dependent
on drugs include those who:
• Have depression, bipolar disorder, anxiety disorders, and
schizophrenia
• Have easy access to drugs
• Have low self-esteem, or problems with relationships
• Live a stressful lifestyle, economic or emotional
• Live in a culture where there is a high social acceptance
of drug use
Symptoms and Behaviors of
Drug Dependence
• Confusion
• Continuing to use drugs even when health, work, or family are being harmed
• Episodes of violence
• Hostility when confronted about drug dependence
• Lack of control over drug abuse - being unable to stop or reduce alcohol
intake
• Making excuses to use drugs
• Missing work or school, or a decrease in performance
• Need for daily or regular drug use to function
• Neglecting to eat
• Not caring about physical appearance
• No longer taking part in activities because of drug abuse
• Secretive behavior to hide drug use
Types of Drugs causing
Dependence
Central nervous system (CNS) stimulants :
Include amphetamines, cocaine, methamphetamine, and methylphenidate (Ritalin). These
drugs have a stimulating effect, and people can start needing higher amounts of these drugs
to feel the same effect (tolerance).
Central nervous system depressants :
Include alcohol, barbiturates (amobarbital, pentobarbital, secobarbital), benzodiazepines
(Valium, Ativan, Xanax), chloral hydrate, and paraldehyde. These substances produce a
sedative and anxiety-reducing effect, which can lead to dependence.
Hallucinogens include LSD, mescaline, psilocybin ("mushrooms"), and phencyclidine (PCP or
"angel dust"). They can cause people to see things that aren't there (hallucinations) and can
lead to psychological dependence.
Tetrahydrocannabinol (THC) is the active ingredient found in marijuana (cannabis) and
hashish.
Route of Addiction
Substances can be taken into the body in several ways:
• Oral ingestion (swallowing) as with alcohol or Ecstasy
• Inhalation (breathing in) or smoking as with tobacco cigarettes
or marijuana
• Injection into the veins (shooting up) as with heroin
• Depositing onto the mucosa (moist skin) of the mouth or nose
(snorting) as with cocaine
• Most agents cause a change in level of consciousness -- usually a decrease in responsiveness. A person using
drugs may be hard to awaken or may act bizarrely.
• Suppression of brain activity can be so severe that the person may stop breathing, which can cause death.
• Alternatively, the person may be agitated, angry, anxious, and unable to sleep.
• Hallucinations are possible.
• Abnormal vital signs (temperature, pulse rate, respiratory rate, blood pressure) are possible and can be life
threatening. Vital sign readings can be increased, decreased, or absent completely.
• Sleepiness, confusion, and coma are common. Because of this decline in alertness, the drug abuser is at risk for
assault or rape, robbery, and accidental death.
• Skin can be cool and sweaty or hot and dry.
• Chest pain is possible and can be caused by heart or lung damage from drug abuse.
• Abdominal pain, nausea, vomiting, and diarrhea are possible. Vomiting blood, or blood in bowel movements,
can be life threatening.
Withdrawal syndromes are variable depending on the agent but can be life threatening.
People with drug dependency often develop a tolerance to their drug of choice in that it takes more of the
substance over time to achieve the desired effect.
Sharing IV needles among people can transmit infectious diseases, including HIV (the virus that causes AIDS) and
hepatitis types B and C.
Many common household drugs and chemicals can be abused. Gasoline and other hydrocarbons are frequently
abused by adolescents and preadolescents as inhalants.
Over-the-counter drugs, such as cold medications, are commonly taken in excessive doses by adolescents and
young adults to get high.
Prescription medications are additional examples of drugs that are abused and that can be obtained illegally
(without a prescription).
Amphetamines and cocaine cause impotence in men. Sildenafil (Viagra) has been used by users of cocaine,
methamphetamine, and other and amphetamines to counteract impotence.
Treatment for
Drug Dependence & Abuse
• The key to treatment, also called recovery, is stopping the abuse of the drugs or substances.
• Agitated or violent people need physical restraint and may need sedating medications in the
emergency department until the effects of the drugs wear off.
• Very few antidotes are available for drug intoxications. In most cases, the only way to eliminate a
drug is for the body to metabolize it -- in other words, let it run its course.
• In some acute intoxications, the doctor may administer certain agents to help prevent absorption
in the stomach or to help speed metabolism of the drug.
• The dose of some agents (for example, benzodiazepines and barbiturates) must be reduced slowly
to prevent withdrawal. Withdrawal from some drugs can cause significant problems, and stopping
these drugs should only be done under the supervision of an appropriate health care professional.
• Counseling programs may be suggested. Programs similar to Alcoholics Anonymous, such as those
listed through the Web of Addictions, are helpful for some people.
