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drug abuse and addiction

Alternative Names
dependence on substances, substance abuse, chemical abuse and dependence, drug dependence

Definition
Drug abuse occurs when a person feels the need to use a drug repeatedly for various reasons. Drug addiction is said to be present when a person continues to abuse a drug after serious problems related to the drug use have occurred.

What is going on in the body?
Drug abuse is a widespread problem that affects people from all walks of life. The symptoms of abuse and addiction differ slightly based upon the drug being taken. Drug abuse and addiction cause many health-related and social problems.

What are the signs and symptoms of the condition?
Several of the following symptoms or signs occur when a person is addicted to a drug. The person may:
  • develop tolerance for the drug. Tolerance occurs when the body gets used to a drug and increased amounts of the drug are needed to cause an effect.
  • use the drug more often or more heavily than intended. Affected people, for example, cannot "just have one."
  • have cravings or grow irritable when the drug cannot be used.
  • be unable to cut down on drug use when he or she wants to.
  • spend a large amount of time getting, using, or getting over the drug.
  • skip some important activities because of the drug. For example, a person may miss work or school because of drug use.
  • find that the drug causes problems in life, such as getting in trouble with the law or losing a job.
  • continue to use the drug despite the problems it causes.
Physical symptoms vary depending on the drug being abused and the extent of the drug use. The health risks of tobacco, for example, are different than the health risks of drugs like alcohol or cocaine.

What are the causes and risks of the condition?
The exact reason why some people abuse and become addicted to drugs is not known. There appears to be a complex relationship between biological and environmental factors that leads to abuse and addiction.

What can be done to prevent the condition?
The best prevention available now is education. If a person has any symptoms of drug abuse, it is a good idea to seek help. The earlier the treatment, the better the results.

How is the condition diagnosed?
The condition is diagnosed by asking the person about drug use. If several of the symptoms or signs mentioned above are present, the person is said to be abusing drugs and may become or may already be addicted to drugs.

What are the long-term effects of the condition?
Problems associated with drug addiction vary widely among different people. Long-term use may result in changes in brain function that last long after the person stops using drugs. Tobacco dependence is the number one cause of preventable disease and death in Australia. Alcohol is not far behind. People with drug dependence can have financial, social, legal, and other personal problems. These may last long after they stop using the drug. Death is fairly common in those with drug dependence due to harmful effects of the drug on the body.

What are the risks to others?
Drug addiction can cause risks to others, although it is not contagious. There can be a large strain on family and friends who are trying to get a person to seek help or stay off drugs. Physical risks may occur if a person is willing to rob or hurt another person to obtain drugs. Smokers and those who drink or use mind-altering drugs and drive can cause disease, injury, and death in others.

What are the treatments for the condition?
Treatment partly depends on the drug that is used and the personality of the affected person. Treatment is complex. Often it must address the addiction as well as the person's mental and physical health, and any work or social problems that occur. Effective treatment may include behavioural therapy, medications, or some combination of these.

Behavioural therapy helps people:
  • cope with craving
  • avoid contact with drugs
  • prevent or cope with relapse
The best drug abuse programs will provide a combination of therapies and services. Successful treatment recognises or responds to certain important issues:
  • No single treatment will work for all people.
  • Treatment must be readily available for a long enough period of time.
  • Effective treatment meets the multiple needs of the person, not just the drug abuse problem.
  • A plan must repeatedly be assessed and changed to meet changing needs.
  • Counselling and behavioural therapies should be included in the treatment plan.
  • Medications may be needed along with counselling
  • Mental illness and drug abuse must be treated at the same time.
  • Medical detoxification will only work as the first stage of a long-term treatment plan.
  • Treatment does not need to be voluntary to be effective.
  • Possible on-going substance abuse must be monitored.
  • Treatment programs need to detect and treat any infectious diseases and teach people to avoid spreading disease. This is important for those who use needles to inject drugs or trade sex for drugs, for example.
  • Recovery can take a long time and treatment may be needed several times.
What are the side effects of the treatments?
Drug abuse is a chronic problem. There may need to be several kinds and numbers of therapies. The greatest side effect of treatment is the tendency to relapse back into drug abuse and addiction.

What happens after treatment for the condition?
Monitoring and therapy are needed at least until a person can function fully and long-term abstinence, or avoidance of drug use, has been achieved. Self-help programs are often helpful in keeping a person sober or "clean."

How is the condition monitored?
Monitoring may include the use of drug tests. These can be urine, saliva, or blood tests.

Author:
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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