Learn More About Drug Addiction
(Substance Use Disorder)

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 and marijuana 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.

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.

As time passes, you may need larger doses of the drug to get high. Soon you may need the drug just to feel normal. As your drug use increases, it’s difficult to go without the drug and attempts to stop may cause intense cravings and make you feel physically ill (withdrawal symptoms).

You may need help from your doctor, family, friends, coworkers, support groups or an organized treatment program to overcome your drug addiction and stay drug-free.

• Feeling that you have to use the drug regularly — daily or even several times a day
• Having intense urges for the drug that block out any other thoughts
• Over time, needing more of the drug to get the same effect
• Taking larger amounts of the drug over a longer period of time than you intended
• Making certain that you maintain a supply of the drug
• Spending money on the drug, even though you can’t afford it
• Not meeting obligations and work responsibilities, or cutting back on social or recreational activities because of drug use
• Continuing to use the drug, even though you know it’s causing problems in your life or causing you physical or psychological harm
• Doing things to get the drug that you normally wouldn’t do, such as stealing
• Driving or doing other risky activities when you’re under the influence of the drug
• Spending a good deal of time getting the drug, using the drug or recovering from the effects of the drug
• Failing in your attempts to stop using the drug

Possible indications that someone is using drugs include:

• Problems at work — frequently missing work, a sudden disinterest in work, a drop in work performance, or causing unsafe situations
• Physical health issues — lack of energy and motivation, weight loss or gain, or red eyes
• Neglected appearance — lack of interest in clothing, grooming or looks
• Changes in behavior — being secretive about where they go, or drastic changes in behavior and in relationships with co-workers
• Money issues — sudden requests for money without a reasonable explanation; or your discovery that money is missing or has been stolen or that items have disappeared, indicating maybe they’re being sold to support drug use

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

Opioid painkillers
Opioids are narcotic, pain relieving drugs produced from opium or made synthetically. This class of drugs includes, among others, heroin, morphine, codeine, methadone and oxycodone. Opioid use may start out as a prescribed medication for pain, but once the prescription ends some people may seek the drug through other means.

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)

Meth, cocaine and other stimulants
Stimulants include amphetamines, meth (methamphetamine), cocaine, methylphenidate (e.g. Ritalin, Concerta) and amphetamine-dextroamphetamine (e.g. Adderall, Adderall XR). They are often used and misused in search of a “high,” or to boost energy, to improve performance at work, 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

Benzodiazepines, barbiturates and hypnotics

Benzodiazepines, barbiturates 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.

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

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 more dangerous mood-altering substances.

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

Long-term (chronic) use is often associated with:

• • Decreased mental sharpness
  • Poor performance at work
  • Reduced number of friends and interests
  • Stunted emotional maturity

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

• Environmental factors, including your family’s beliefs and attitudes and exposure to a peer group or coworkers that encourage drug use, seem to play a role in initial drug use.
• 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.

People of any age, sexual identity 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.
• 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.

Drug use can have significant and damaging short-term and long-term effects. Taking some drugs can be particularly risky, especially if you take high doses or combine them with other drugs or alcohol. Here are some examples.

• Methamphetamine, opiates and cocaine are highly addictive and cause multiple short-term and long-term health consequences, including psychotic behavior, seizures or death due to overdose.
• GHB and flunitrazepam may cause sedation, confusion and memory loss. These so-called “date rape drugs” are known to impair the ability to resist unwanted contact and recollection of the event. At high doses, they can cause seizures, coma and death. The danger increases when these drugs are taken with alcohol.
• Ecstasy or molly (MDMA) can cause dehydration, electrolyte imbalance and complications that can include seizures. Long-term, MDMA can damage the brain.
• Due to the toxic nature of inhalants, users may develop brain damage of different levels of severity.

Dependence on drugs can create a number of dangerous and damaging complications, including:

• Physical addiction appears to occur when repeated use of a drug changes the way your brain feels pleasure. The addicting drug causes physical changes to some nerve cells (neurons) in your brain. Neurons use chemicals called neurotransmitters to communicate. These changes can remain long after you stop using the drug.
• Getting a communicable disease. People who are addicted to a drug are more likely to get an infectious disease, such as HIV, either through unsafe sex or by sharing needles.
• Other health problems. Drug addiction can lead to a range of both short-term and long-term mental and physical health problems. These depend on what drug is taken.
• People who are addicted to drugs are more likely to drive or do other dangerous activities while under the influence.
• People who are addicted to drugs die by suicide more often than people who aren’t addicted.
• Family problems. Behavioral changes may cause marital or family conflict and custody issues.
• Work issues. Drug use can cause declining performance at work, absenteeism and eventual loss of employment.
• Problems at school. Drug use can negatively affect academic performance and motivation to excel in school.
• Legal issues. Legal problems are common for drug users and can stem from buying or possessing illegal drugs, stealing to support the drug addiction, driving while under the influence of drugs or alcohol, or disputes over child custody.
• Financial problems. Spending money to support drug use takes away money from other needs, could lead to debt, and can lead to illegal or unethical behaviors.

The best way to prevent an addiction to a drug is not to take the drug at all. If your doctor prescribes a drug with the potential for addiction, use care when taking the drug and follow the instructions provided by your doctor.

Doctors should prescribe these medications at safe doses and amounts and monitor their use so that you’re not given too great a dose or for too long a time. If you feel you need to take more than the prescribed dose of a medication, talk to your doctor.

Once you’ve been addicted to a drug, you’re at high risk of falling back into a pattern of addiction. If you do start using the drug, it’s likely you’ll lose control over its use again — even if you’ve had treatment and you haven’t used the drug for some time.

• Stick with your treatment plan. Monitor your cravings. It may seem like you’ve recovered and you don’t need to keep taking steps to stay drug-free. But your chances of staying drug-free will be much higher if you continue seeing your therapist or counselor, going to support group meetings and taking prescribed medication.
• Avoid high-risk situations. Don’t go back to the neighborhood where you used to get your drugs. And stay away from your old drug crowd.
• Get help immediately if you use the drug again. If you start using the drug again, talk to your doctor, your mental health professional or someone else who can help you right away.

See a doctor if:

Your drug use is out of control or causing problems, get help. The sooner you seek help, the greater your chances for a long-term recovery. Talk with your primary doctor or see a mental health professional, such as a doctor who specializes in addiction medicine or addiction psychiatry, or a licensed alcohol and drug counselor.

Make an appointment to see a doctor if:

• You can’t stop using a drug
• You continue using the drug despite the harm it causes
• Your drug use has led to unsafe behavior, such as sharing needles or unprotected sex
• You think you may be having withdrawal symptoms after stopping drug use

If you’re not ready to approach a doctor, help lines or hotlines may be a good place to learn about treatment.

Seek emergency help if you or someone you know has taken a drug and:

• May have overdosed
• Shows changes in consciousness
• Has trouble breathing
• Has seizures or convulsions
• Has signs of a possible heart attack, such as chest pain or pressure
• Has any other troublesome physical or psychological reaction to use of the drug