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Drug abuse and dependence
Alternative namesDrug addiction; Addiction - drug
Drug dependence (addiction) is compulsive use of a substance despite negative consequences which can be severe; drug abuse is simply excessive use of a drug or use of a drug for purposes for which it was not medically intended.
Physical dependence on a substance (needing a drug to function) is not necessary or sufficient to define addiction. There are some substances that don't cause addiction but do cause physical dependence (for example, some blood pressure medications) and substances that cause addiction but not classic physical dependence (cocaine withdrawal, for example, doesn't have symptoms like vomiting and chills; it is mainly characterized by depression).
See also drug abuse and drug abuse first aid .
Causes, incidence, and risk factorsDrug abuse can lead to drug dependence or addiction. Drug dependence may also follow the use of drugs for physical pain relief, though this is rare in people without a previous history of addiction.
The exact cause of drug abuse and dependence is not known. However, the genetic make-up of the individual, the pharmacology of the particular drug, peer pressure, emotional distress, anxiety , depression , and environmental stress are all factors which seem to be involved.
Risk factors that predispose people to drug dependence are different from those that predispose to use or abuse. Peer pressure may lead to use or abuse, but at least half of those who go on to addiction have depression, attention-deficit disorder, post-traumatic stress disorder or another psychological problem.
Children who grow up in an environment of illicit drug use may first see their parents using drugs. This may put them at a higher risk for developing an addiction later in life for both environmental and genetic reasons.
Drug intoxication and drug overdose may be accidental or intentional. Drug withdrawal symptoms can occur when use of a substance is stopped or reduced. Withdrawal symptoms vary, depending on the abused substance. The onset of withdrawal symptoms depends on the length of time the drug normally stays within the body. Drug intoxication, overdose, and withdrawal can be life-threatening in some situations.
SymptomsOPIATES AND NARCOTICS :
Symptoms of use:
Symptoms of withdrawal:
CENTRAL NERVOUS SYSTEM STIMULANTS
Symptoms of cocaine use:
Symptoms of cocaine withdrawal:
CENTRAL NERVOUS SYSTEM DEPRESSANTS
Symptoms of alcohol use:
Symptoms of alcohol withdrawal:
Symptoms of LSD use:
Signs and tests
Toxicology screens (drug testing) done on blood and urine specimens can reveal the presence of many chemicals and drugs in the body. The sensitivity depends upon the substance itself, when the substance was taken, and the testing laboratory. Blood tests are more likely to detect the presence of an abused substance than urine tests, however, urine drug screens are more frequently done.
Opiates and narcotics are usually present in the urine 12 to 36 hours after the last use, depending on the amount used and the frequency.
CNS stimulants such as cocaine can be detected in urine anywhere between 1 to 12 days, again depending in frequency of use.
CNS depressants such as Valium and Xanax are detected up to 7 days after the last day of use, mostly depending on the substance used and how quickly it is eliminated by the body (half-life).
Most hallucinogens are also detectable in the urine up to 7 days after the last use. However, cannabis can be detected up to 28 days in regular users.
Treatment for the person with drug abuse or dependence begins with the recognition of the problem. Though previously "denial" was considered a symptom of addiction, recent research has shown that this symptom can be dramatically reduced if addicts are treated with empathy and respect, rather than told what to do or "confronted."
Treatment of drug dependency involves detoxification, support and abstinence . Emergency treatment may be indicated for acute intoxication or drug overdose. Often, there may be a loss of consciousness and the person may need to be on a mechanical respirator temporarily. The specific treatment depends on the drug.
Rehabilitation is the process that occurs after detoxification and is often needed to prevent relapse. Inpatient and outpatient programs are available. Individual, group, or family therapy is usually part of this process, and may continue for a month or longer. Information/support may also be sought from local 12-step groups, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), which you can locate through your phone directory or online. See chemical dependence - support group .
There are also alternative programs for those who do not like or do not do well in 12-step programs. These include SMART Recovery, Women For Sobriety and LifeRing Recovery which can also be found online.
Aftercare often involves life-long abstinence from drug abuse. Self-help groups such as Narcotics Anonymous can offer support. For heroin addicts, long-term methadone maintenance is the treatment with the best track record of cutting relapse, improving functioning and restoring health.
Support GroupsMany support groups are available in the community. Most of them rely on the 12-Step program used in the Alcoholics Anonymous (AA) groups. Others include Narcotics Anonymous (NA), Ala-Teen, and Al-Anon. These and others can be found in your phone directory. SMART Recovery and LifeRing Recovery are alternatives for those who do not find the 12-step approach helpful.
Expectations (prognosis)Drug abuse and dependence may lead to a fatal drug overdose. Relapses from drug abstinence may occur and lead to recurrent dependence.
Calling your health care providerCall for an appointment with your health care provider if you are addicted to drugs and would like to get off of them or you have been cut off from your drug supply and are at risk of withdrawal. Most employers also offer referral services for their employees with substance use problems.
PreventionDrug education programs may be helpful though none has proved effective in the long term.
Update Date: 11/10/2003Vineeth John, M.D., Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT