Drug abuse is a disease characterized by continued misuse of drugs even when faced with drug-related job, legal, health, or family difficulties. Problems associated with drug abuse must have existed a minimum of 12 months to meet the diagnosis.
Drug dependence refers to long-term, compulsive drug use, perhaps with attempts to stop but repeatedly returning to drugs. Drug dependence also means that your body has begun to require the drug in higher doses to avoid withdrawal symptoms.
Drug abuse and drug dependence are not terms that should be used to describe people who are taking appropriate dosages of prescribed drugs (pain medication, for example) and who have become physically dependent on them. Diagnosis of both drug abuse and drug dependence requires the presence of specific behavioral symptoms.
Some of the most commonly abused substances include:
The cause of drug abuse and dependence is unknown, although there are a variety of theories. One theory holds that there may be a genetic component that predisposes a person toward using and abusing drugs. Another theory is that drug abuse is a learned behavior and that people begin to use drugs by copying the behavior of those around them. Medical professionals have not been able to target a specific cause.
Brain chemicals may alter the user's perception of the drug's effects. Long-term drug use changes brain function and may reinforce the desire to keep using drugs regardless of the consequences.
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:
Denial that a drug problem exists is common. Drug abuse can occur without physical dependence.
To definitively diagnose drug abuse, the symptoms must have lasted for at least 12 months.
Symptoms include:
Drug abuse often progresses to drug dependence. Symptoms of drug dependence include at least three of the following:
The doctor will ask about:
Tests may include:
There is no cure for drug abuse or drug dependence.
There are three main treatment goals:
Successful treatment depends on the drug user's recognition of the problem and desire to change. Recovery takes a long time and is not an easy process. Patients may need multiple courses of treatment.
Therapies include:
Drugs may help alleviate symptoms of withdrawal. In some cases, medication may be ordered to prevent relapse. People addicted to heroin may be given methadone to help taper them off. Methadone may also be given on a long-term basis to improve the chance of staying in treatment. Methadone is a narcotic that blocks cravings as well as the pleasurable effects of heroin and other opiates.
Other drugs that are used in treatment are:
Therapy raises awareness of underlying issues and lifestyles that promote drug use. It works to improve coping and problem-solving skills and to develop other ways of dealing with stress or pain. Through counseling, a person can learn how to handle situations associated with drug use and replace drug-using activities with other activities that are more meaningful . Family support is encouraged.
There are numerous organizations or support groups dedicated to helping people to stop using drugs. Two examples are Narcotics Anonymous and Cocaine Anonymous. These are 12-step programs and members of these organizations meet regularly to talk about their drug-related troubles. They provide a network of support for each other.
Drug education programs may be helpful. Suggested strategies to lower the risk of drug abuse or dependence include:
RESOURCES:
Cocaine Anonymous
http://www.ca.org/
Narcotics Anonymous
http://www.na.org/
National Institute on Drug Abuse
http://www.nida.nih.gov/
CANADIAN RESOURCES:
Centre for Addiction and Mental Health
http://www.camh.net/about_camh/
Narcotics Anonymous
http://www.torontona.org/
References:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders . 4th ed. Text Revision. Washington, DC: American Psychiatric Association; 2000.
Cami J, Farre M. Drug addiction. N Engl J Med . 2003; 349:975-986.
Cecil Textbook of Medicine . 23rd ed. WB Saunders; 2007.
Griffith's 5-Minute Clinical Consult. Lippincott Williams and Wilkins; 2006.
National Institute on Drug Abuse website. Available at: http://www.nida.nih.gov/ .
Last reviewed January 2009 by Theodor B. Rais, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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