Drug Addiction and Abuse: Causes, Signs, Symptoms, and More

Drug addiction is challenging but treatable. According to the American Society of Addiction Medicine, it involves connections between brain circuits, heredity, the environment, and a person’s life experiences. The fact that people continue to use substances despite the adverse effects on their lives is a defining characteristic.

Drug addiction affects all parts of a person’s life and is indiscriminate in its reach. It impacts mental and physical health and can destroy personal relationships and careers. Ultimately, it can result in losing everything a person holds dear and, in some cases, death.

Many studies aim to understand why people become addicted to drugs. Traditionally, addiction has been viewed as a disease, with recovery being a lifelong process. More recently, neuroscientists and health professionals have focused on a person’s past traumatic events as a cause of addiction. Many treatment programs aim to address past trauma and the root cause of addiction, and, in doing so, it is possible to overcome both simultaneously.

Identifying the causes of addiction helps to determine prevention strategies and effective treatment plans. Some individuals falsely assume that those with a drug dependency continue to use substances due to a lack of willpower or motivation to stop. In reality, drug use can lead to brain changes that interfere with a person’s self-control and ability to resist the urge to use drugs.

The good news is that regardless of the reason why you are addicted, substance addiction rehabilitation programs are widely accessible. Long-term recovery is possible for everyone through effective addiction treatment.

How Widespread Is Substance Abuse?

Drug abuse is a global problem. The United Nations Office on Drugs and Crime stated that around 275 million people aged 15–64 used drugs at least once in 2016 (approximately 3.7% of the global population). Of these people, more than 11% suffered from drug addictions, otherwise known as substance use disorders (SUDs). SUDs occur when an individual’s drug use is long-term, harmful, and requires treatment. In the US, drug addiction is widespread. The National Center for Drug Abuse Statistics states that SUDs affect over 20 million Americans aged 12 and over.

What Causes Someone to Be Addicted to Drugs?

Addiction is rarely caused by one thing; multiple factors usually contribute to substance misuse. These factors include genetic predispositions, environmental inputs, traumatic experiences, and mental health conditions.

  • Genetic: NIH’s National Institute on Drug Abuse states that as much as half of a person’s risk of becoming addicted to nicotine, alcohol, or other drugs depends on their genetic makeup. If there is a family history of addiction, the chances of becoming addicted increase.
  • Environmental: The people, places, and things someone experiences daily greatly influence their thoughts, feelings, and behavior. For example, adolescents who have witnessed drug-taking at home are far more likely to take drugs themselves.
  • Traumatic: Any life events that have had a psychologically traumatic impact, especially as a child, can significantly increase the risk of drug abuse and addiction. Examples include sexual abuse, witnessing or experiencing violence, and being physically or emotionally neglected.
  • Mental health: There is a link between mental illness and addiction in many cases. Around half of individuals with a substance use disorder will also experience a co-occurring mental disorder. There is no set pattern as to which comes first. Some people start to use substances to cope with the symptoms of their mental health condition. Whereas for others, mental health concerns such as anxiety and depression can be a side effect of taking drugs.

What Are the Four Stages of Drug Addiction?

Addiction doesn’t occur overnight, even if it feels that way from the perspective of the person who is addicted. The reason someone initially uses a drug varies depending on the person and the drug they take. Generally, the path to addiction is similar for everyone, with four distinct stages:

1. Experimentation: The first use of a drug can occur at a party or other social event. Someone may try a drug because others are doing it and are curious to experience its effects. Alternatively, they may be under pressure from their peers to take drugs. For some people, a desire to take a drug stems from a need to alleviate feelings of pain, stress, or the symptoms of a mental health condition such as depression. The drug can be prescribed by a doctor or obtained illegally.

2. Regular use: At this stage, a person may regularly use a drug in social situations or when experiencing certain feelings. Although it is a misuse of substances, it does not yet qualify as an addiction. The person can choose when they use the drug as well as the amount.

3. Harmful use: Once a person’s drug use starts to become detrimental to themselves or others, but they continue to take the drug anyway, this is the beginning of an addiction. The person may take risks and engage in behaviors that show little concern for the consequences. They may begin associating with people who engage in criminal activity, share needles when injecting drugs, or experiment with larger quantities and different drugs.

4. Full drug addiction: By this stage, drugs consume a person’s life. The desire to take drugs overtakes everything else. The drug user may have become estranged from their family, have lost their job, become engaged in criminal activity, or experienced severe health complications. There is no regard whatsoever for the negative consequences of taking the drug. The person’s only concern is how to alleviate their withdrawal symptoms and cravings and obtain their next hit regardless of the means.

What Effect Does Addiction Have on the Brain?

Substance use disorder affects many parts of the body, but the most significant impact is on the brain. It is possible to be both physically and mentally addicted to a drug. Physical addiction is when someone needs the drug to alleviate withdrawal symptoms such as nausea and anxiety. The term “mental addiction” refers to the brain’s perception that it needs to consume the substance and the behaviors accompanying this desire.

Drug abuse can change the brain’s natural balance and neurological pathways. The brain can cause a person to seek out more of the substance to maintain these changes. When drugs are taken, a release of reward and pleasure hormones occurs. As addiction develops, more of the substance is required to have the same effect. With prolonged drug abuse, the brain struggles to produce these hormones. If this happens, an addicted person may no longer be able to find pleasure in activities, people, or situations that do not involve drugs.

What Are The Most Common Drugs That Lead to Addiction?

A person can become addicted to legal and illegal drugs, which have varying levels of harm and risk of addiction. A European study evaluated 20 of the most commonly available substances against a set of harm criteria. The harm was either to the user or others and included factors such as injury, crime, economic impact, loss of relationships, and drug-related mortality. The study identified alcohol, heroin, and crack as the most harmful drugs.

Drugs fall into seven categories: opioids, depressants, stimulants, hallucinogens, dissociatives, inhalants, and marijuana. Often people will start with less potent drugs, such as marijuana, and, once the effect has lessened, they will move on to stronger and more dangerous drugs. Sometimes a person will resort to polydrug use and use different drugs simultaneously to achieve a more significant effect. Some of the most commonly used and addictive drugs are:

Heroin

Heroin is an opioid and provides an immediate rush of pleasure. Considered to be one of the most addictive drugs, the user strongly desires to replicate the high they experienced. As many as 1/4 of people who try heroin develop a debilitating addiction.

Withdrawal symptoms from heroin are extremely unpleasant, so abstaining is hard. Symptoms include diarrhea, vomiting, severe pain, and uncontrollable shaking.

Cocaine

Cocaine, a stimulant derived from coca leaves, causes an increase in dopamine in the brain.  As tolerance develops, users take more to reach the same high. Overdosing on cocaine is possible with potentially deadly consequences. In 2020, approximately 19,447 people died from an overdose involving cocaine in the US.

In addition to the risk of overdose, cocaine addiction can lead to nosebleeds, depression, abnormal heart rhythms, insomnia, and a loss of smell.

Alcohol

14.5 million people in the US had an alcohol use disorder in 2019. As alcohol is legal and widely available, its dangers are not always as recognized as those of illicit drugs. Excessive drinking of alcohol can affect the brain’s chemical balance and increase the likelihood of developing an addiction.

The health risks associated with excessive alcohol consumption can be severe. They include stroke, high blood pressure, depression, liver failure, and cancer.

Tobacco

Tobacco is highly addictive. Although many countries have tried to curb tobacco usage through advertising bans and warning messages, it is still commonly used. Smoking is the leading cause of preventable death resulting in 1 in 5 deaths per year in the UK.

Smoking can cause strokes and heart disease. It is also the cause of multiple cancers, such as lung, throat, and mouth.

Prescription Painkillers

Painkillers are the most abused form of prescription medication. Prescription painkillers include many commonly-used medications such as hydrocodone, tramadol, oxycodone, codeine, morphine, hydromorphone, ibuprofen, and fentanyl. They provide a relaxing high and are frequently used for non-medical reasons, leading to addiction. The National Center for Drug Abuse Statistics states that 70% of prescription drug addicts are addicted to painkillers.

Some side effects of prescription painkillers are drowsiness, nausea, uncontrollable leg shaking, constipation, muscle pain, and intense cravings.

Methadone and Buprenorphine

Used as a treatment for heroin and prescription painkillers, Methadone and Buprenorphine are also opioids and like the drugs they treat, they too are addictive. If taken as prescribed, Methadone can reduce the craving for heroin. However, taking too much in one go is easy due to the high strength of a single dose, leading to opioid overdose or even death.

Side effects of Methadone and Buprenorphine are similar and include nausea and vomiting, dizziness, fatigue, and constipation.

Benzodiazepines

Benzodiazepines (also known as benzos) are sedative-hypnotics with tranquilizing effects. Examples include Valium (diazepam) and Xanax (alprazolam). Benzos are used to treat conditions such as anxiety, seizures, and alcohol withdrawal but can also be misused when taken in a way that a medical provider has not indicated. A 2017 study found that misuse accounted for nearly 20% of Benzo use.

The most common side effect of Benzos is drowsiness. Others include impaired memory, slow pulse, confusion, heavy sedation, and a decline in brain function.

Barbiturates

This prescription drug is a depressant used to treat conditions such as epilepsy. Users find that it relaxes them, lowers inhibitions, and aids sleep. The use of barbiturates is dangerous. The DEA warns that tolerance is easily developed, and overdose occurs easily and can be fatal.

Possible withdrawal effects include nausea, cramps, seizures, vomiting, and hallucinations.

Amphetamines

Amphetamines are prescribed for treating ADHD and other conditions. Adderall and Strattera are examples of prescription amphetamines that can be abused and lead to addiction. Amphetamine is also produced illegally in the form of Methamphetamine (Meth). Meth provides an immediate feeling of euphoria, which is highly addictive. There was a sharp rise in overdose deaths involving meth from 2011 to 2018.

Withdrawal symptoms include fatigue, pain, severe depression, and intense cravings.

Marijuana

According to the SAMHSA (Substance Abuse and Mental Health Services Administration) National Survey of Drug Use and Health, 17.9% (or 49.6 million people) used marijuana in 2020.

Made from the dried leaves of the Cannabis sativa plant, marijuana gives users a natural high due to the presence of tetrahydrocannabinol (THC).

The effects of long-term marijuana use can include mood swings, a lack of motivation, gastrointestinal syndromes, and depression.

Hallucinogens

Hallucinogens can be natural, such as magic mushrooms, or artificial, such as LSD. Hallucinogens cause someone to experience a distorted reality and see and hear things that are not there. MDMA (ecstasy) acts as a hallucinogen while also being a stimulant. Addiction is not as widespread as with some other drugs but still, in the US in 2020, 372,000 people had a hallucinogen use disorder.

In the short term, hallucinogens can cause someone to experience an increased heart rate, high blood pressure, loss of appetite, and sleep problems. Long-term, they can cause psychological issues such as paranoia and visual disturbances.

What Are the Signs of Drug Addiction?

Although each drug has different effects and withdrawal symptoms, there are general warning signs of drug addiction that apply to all substance use:

  • They may exhibit sudden changes in personality and behavior
  • They may become more agitated, moody, or irritable than they were previously.
  • Their priorities in life can shift suddenly.
  • Things they once cared about may become neglected, such as friends, family, work, and hobbies.
  • They may start going to new places and have a new group of friends.
  • As part of their addiction, they may become especially secretive, have money issues, or have developed recent health complaints.

The Surgeon General’s Report on Alcohol, Drugs and Health stated that the most effective way to help someone with a substance use problem who may be at risk for developing a substance use disorder is to intervene early. Sometimes the individual can see the signs themselves, but, in many cases, people close to them notice the changes. Friends and family members often need to intervene due to concern for the health and well-being of the person with the addiction. Over 100,000 people die from drug overdose annually in the US. Knowing the signs of drug addiction and what to do next can be crucial to an addicted person’s survival and long-term recovery.

How to Recognize Drug Addiction Symptoms in a Loved One

It can be challenging to identify a drug addiction if you have not personally seen the use of a substance or found any evidence of drug-taking. There are, however, physical changes and signs of addictive behavior that you can monitor. Below are some of the most common indicators that someone may be abusing drugs:

  • Withdrawal from friends and family: It is typical for someone addicted to drugs to distance themselves from those not participating in the same activity. This is often due to feelings of guilt, shame, or a fear of being judged.
  • Lack of concentration or interest in usual things: If someone takes drugs regularly, it can become difficult for them to care about anything else. The cravings can become so intense that their concentration and efforts are focused only on their next high.
  • A decline in work or school performance: When someone has side effects or withdrawal symptoms, it can be challenging to follow a routine. People with addiction experience a shift in life priorities, and drugs become the most important thing.
  • Financial problems: Sustaining a drug addiction can be expensive. People with addiction can find themselves borrowing, or even stealing, money to fund their habit.
  • Behavioral changes: Drugs can affect a person’s ability to regulate their behavior, decision-making, and moods. People with a drug addiction can appear to have a change of personality and become irritable or angry more quickly than usual.
  • Physical changes: Drug misuse can have visible effects on the body, such as rapid weight loss, skin complaints, and hair loss.

If You Suspect Drug Addiction, Ask Yourself These 10 Questions

If you think that you may be addicted to drugs, it is vital to seek treatment as soon as possible before your addiction becomes too severe. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has eleven criteria for identifying substance use disorder. These criteria fall into four categories – impaired control, social problems, risky use, and physical dependence. There are some questions that you should ask yourself if you are concerned that you may have an addiction:

1. Do you use drugs daily, alone, or throughout the day and night? If the answer is yes, this could signify that you are addicted. Regular and daily use indicates that your cravings are becoming uncontrollable and that you cannot resist the urge to take the drug regardless of the time of day.

2. Do you frequently consider and look for drugs? The craving for the drug can be so overwhelming that it is impossible to think about or focus on anything else. Addiction occurs when finding and taking the drug becomes the primary focus in a person’s life.

3. Have you lied about drugs to friends and family? You may hide your drug use due to feeling ashamed or fearing judgment. If you cannot stop taking the drug despite knowing the anguish it will cause, you may be addicted.

4. Has your substance use affected others in your life and your relationships with them? If you regularly choose drugs over the people in your life, this could indicate that your priorities have shifted and drugs have taken over.

5. Has your drug use impacted your work or school performance? If your performance is affected due to withdrawal symptoms, cravings, or a lifestyle change, you could be addicted. It can become hard to maintain a routine and focus on things that are not drugs.

6. Do you continue to use substances although you know they harm your life? One of the main indications of addiction is the inability to stop taking the drug despite knowing that other parts of your life are suffering. Everything else is put at risk to satisfy your urge for drugs.

7. Do you require more of the substance or look for alternative ways to get high? If you said yes, you are likely to be developing or have already developed a tolerance to the drug. There are increased risks to your life and health when you use higher quantities and more potent drugs.

8. Have you had drug-related health problems or needed medical attention but kept using? If it happens early enough, a medical scare can be enough to stop someone from retaking the drug. If it has not stopped you, it could be because your addiction has developed to the point where you will risk your health continuously to satisfy your cravings.

9. Do you feel uncomfortable without drugs? If you answered yes, you are experiencing withdrawal symptoms. These feelings increase in severity as addiction develops and enhance the desire to use the drug to alleviate the symptoms.

10. Can’t stop using drugs? If you know that the drug isn’t good for you and it’s negatively impacting your life, but you cannot stop, then you likely have an addiction that needs professional help to overcome.

What to Do if You or Someone You Know Needs Treatment for Drug Addiction

If you believe that a friend or a family member has a drug addiction, or you answered yes to some of the questions above, it is time to seek help. There are things that you can do to aid the path to recovery:

  • SAMHSA’s National Helpline is free, confidential, and available 24 hours a day, 365 days a year. It offers advice and referrals to treatment services for substance use and mental health disorders in English and Spanish. Call: 1-800-662-HELP (1-800-662-4357)
  • There is a wealth of information online. You can find information about particular drugs and their risk factors. The Rehab.com searchable locator map will enable you to find and compare treatment centers locally.
  • Make an appointment with a local doctor, counselor, or therapist. Often they will have a network of other healthcare professionals. Even if they cannot assist themselves, they will be able to recommend others that can.
  • Seek support from friends and family. Often people have experienced similar situations themselves or know others who have that can advise on local resources. Even if this is not the case, having the support of those closest to you can aid your motivation to seek professional help.
  • Whether you have support from family and friends or not, finding a support group of people in a similar situation at the same time can be hugely beneficial. Peer support can assist with motivation to recover and help to prevent relapse. Narcotics Anonymous and Alcoholics Anonymous are well-known examples of this type of group support.
  • If you find something that gives you pleasure, your natural dopamine levels will increase and reduce the urge to take drugs. These activities could include holistic practices such as meditation, yoga, and acupuncture.

What Treatment Options Are Available for Substance Use Disorder?

Addiction treatment is widely available and in high demand. In 2018, nearly 19 million people aged 12 and older needed substance abuse treatment. Treatment plans are tailored to the needs of individual patients and often involve a combination of therapies to maximize the chance of long-term recovery.

Treatment approaches differ between rehab centers. A patient’s treatment options can include detoxification as a first step. Healthcare professionals will manage withdrawal symptoms during detox and offer necessary medication-assisted treatment. Inpatient and outpatient programs are also available and frequently involve counseling, behavioral therapy, and holistic therapies such as meditation.

Drug addiction is common, and does not discriminate. Many people are affected, either directly or indirectly, and their lives are significantly impacted. If you believe that you or a loved one may be addicted to drugs, knowing the symptoms and what to do are essential.

Successful addiction treatment is possible regardless of why the addiction occurred in the first place. By taking prompt action, addiction treatment will be more effective, and the person affected will be on the road to long-term recovery with an improved quality of life.

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