WHAT IS DRUG ABUSE?
Drug abuse or substance abuse simply refers to the use of certain chemicals for the purpose of creating pleasurable effects on the brain. There are currently over 190 million drug users around the world and the problem has been increasing at alarming rates, especially among young adults under the age of 20.
TYPES OF DRUGS:
WHAT ARE THE CAUSES OF DRUG ABUSE?
Drug abuse are usually psychoactive drugs that are used by people for various different reasons which may include:
i. Curiosity and peer pressure, especially among school children and young adults.
ii. The use of prescription drugs that were originally intended to target pain relief may have turned into recreational use and become addictive.
iii. As a means of obtaining creative inspiration.
WHAT ARE THE CATEGORIES OF DRUGS?
Drugs of abuse can be categorized under the three groups namely:
i. Depressants: These cause depression of the brain faculties and examples include sleeping pills (barbiturates) and heroin.
ii. Stimulants: These cause stimulation of the brain, giving rise to alertness and increased burst of activity. A rapid heart rate, dilated pupils, raised blood pressure, nausea or vomiting and behavioral changes such as agitation and impaired judgement may also result. In severe cases, there may be delusion psychosis which can occur with the use of cocaine and amphetamines.
iii. Hallucinogens: these cause hallucinations and an “out of this world” feeling of dissociation from oneself. Hallucinogens may cause distorted sensory perception, delusion, paranoid and even depression. Examples includes ecstasy, mescaline and LSD.
WHAT IS DRUG ADDICTION?
Drug addiction is a biopsychosocial phenomenon; chronic disease characterized by compulsive or uncontrollable drug seeking and use despite harmful consequences and changes in the brain, which can be long lasting. These changes in the brain can lead to the harmful behaviors seen in people who use drugs. Drug addiction is also a relapsing disease. Relapse is the return to drug use after an attempt to stop.
The path to drug addiction begins with the voluntary act of taking drugs. But over time, a person’s ability to choose not to do so becomes compromised. Seeking and taking the drug becomes compulsive. This is mostly due to the effects of long-term drug exposure on brain function. Addiction affects parts of the brain involved in reward and motivation, learning and memory, and control over behavior.
Addiction is a disease that affects both the brain and behavior.
CAN DRUG ADDICTION BE TREATED AND/OR MANAGED?
Yes, but it’s not so simple. Because addiction is a chronic disease, people can’t simply stop using drugs for a few days and be cured. Most patients need long-term or repeated care to stop using drugs completely and recover their lives.
Addiction treatment must help the person do the following:
- stop using drugs
- stay drug-free
- be productive in the family, at work and in society
PRINCIPLES OF EFFECTIVE TREATMENT
Based on scientific research since the mid-1970s, the following key principles should form the basis of any effective treatment program:
- Addiction is a complex but treatable disease that affects brain function and behavior.
- No single treatment is right for everyone.
- People need to have quick access to treatment.
- Effective treatment addresses all of the patient’s needs, not just his or her drug use.
- Staying in treatment long enough is critical.
- Counseling and other behavioral therapies are the most commonly used forms of treatment.
- Medications are often an important part of treatment, especially when combined with behavioral therapies.
- Treatment plans must be reviewed often and modified to fit the patient’s changing needs.
- Treatment should address other possible mental disorders.
- Medically assisted detoxification is only the first stage of treatment.
- Treatment doesn’t need to be voluntary to be effective.
- Drug use during treatment must be monitored continuously.
- Treatment programs should test patients for HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as teach them about steps they can take to reduce their risk of these illnesses.
WHAT ARE TREATMENTS FOR DRUG ADDICTION?
There are many options that have been successful in treating drug addiction, including:
- Behavioral counseling
- Medical devices and applications used to treat withdrawal symptoms or deliver skills training
- Evaluation and treatment for co-occurring mental health issues such as depression and anxiety
- Long-term follow-up to prevent relapse
A range of care with a tailored treatment program and follow-up options can be crucial to success. Treatment should include both medical and mental health services as needed. Follow-up care may include community- or family-based recovery support systems.
HOW ARE MEDICATIONS AND DEVICES USED IN DRUG ADDICTION TREATMENT?
Medications and devices can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions.
- Relapse prevention
- Co-occuring conditions:
HOW ARE BEHAVIORAL THERAPIES USED TO TREAT DRUG ADDICTION?
Behavioral therapies help patients:
- Modify their attitudes and behaviors related to drug use
- Increase healthy life skills
- Persist with other forms of treatment, such as medication
Patients can receive treatment in many different settings with various approaches.
Outpatient behavioral treatment includes a wide variety of programs for patients who visit a behavioral health counselor on a regular schedule. Most of the programs involve individual or group drug counseling, or both. These programs typically offer forms of behavioral therapy such as:
- cognitive-behavioral therapy, which helps patients recognize, avoid, and cope with the situations in which they are most likely to use drugs.
- multidimensional family therapy—developed for adolescents with drug abuse problems as well as their families—which addresses a range of influences on their drug abuse patterns and is designed to improve overall family functioning.
- motivational interviewing, which makes the most of people’s readiness to change their behavior and enter treatment.
- motivational incentives (contingency management), which uses positive reinforcement to encourage abstinence from drugs
Treatment is sometimes intensive at first, where patients attend multiple outpatient sessions each week. After completing intensive treatment, patients transition to regular outpatient treatment, which meets less often and for fewer hours per week to help sustain their recovery.
In September 2017, the FDA permitted marketing of the first mobile application, reSET®, to help treat substance use disorders. This application is intended to be used with outpatient treatment to treat alcohol, cocaine, marijuana, and stimulant substance use disorders.
Inpatient or residential treatment can also be very effective, especially for those with more severe problems (including co-occurring disorders). Licensed residential treatment facilities offer 24-hour structured and intensive care, including safe housing and medical attention. Residential treatment facilities may use a variety of therapeutic approaches, and they are generally aimed at helping the patient live a drug-free, crime-free lifestyle after treatment. Examples of residential treatment settings include:
- Therapeutic communities, which are highly structured programs in which patients remain at a residence, typically for 6 to 12 months. The entire community, including treatment staff and those in recovery, act as key agents of change, influencing the patient’s attitudes, understanding, and behaviors associated with drug use.
- Shorter-term residential treatment, which typically focuses on detoxification as well as providing initial intensive counseling and preparation for treatment in a community-based setting.
- Recovery housing, which provides supervised, short-term housing for patients, often following other types of inpatient or residential treatment. Recovery housing can help people make the transition to an independent life—for example, helping them learn how to manage finances or seek employment, as well as connecting them to support services in the community.
Drug addiction can be treated, but it’s not so simple. Addiction treatment must help the person do the following:
o stop using drugs
o stay drug-free
o be productive in the family, at work, and in societySuccessful treatment has several steps:
o behavioral counseling
o medication (for opioid, tobacco, or alcohol addiction)
o evaluation and treatment for co-occurring mental health issues such as depression and anxiety
o long-term follow-up to prevent relapseMedications and devices can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions.Behavioral therapies help patients:
o modify their attitudes and behaviors related to drug use
o increase healthy life skills
o persist with other forms of treatment such as medicationPeople within the criminal justice system may need additional treatment services to treat drug use disorders effectively. However, many offenders don’t have access to the types of services they need.
HOW QUICKLY CAN SOMEONE BECOME ADDICTED TO A DRUG?
There is no easy answer to this common question. If and how quickly you become addicted to a drug depends on many factors, including your biology (your genes, for example), age, gender, environment, and interactions among these factors. Vast differences affect a person’s sensitivity to various drugs and likelihood of addiction vulnerability. While one person may use a drug one or many times and suffer no ill effects, another person may overdose with the first use or become addicted after a few uses. There is no way of knowing in advance how quickly you will become addicted, but there are some clues—an important one being whether you have a family history of addiction.
HOW DO I KNOW IF SOMEONE IS USING OR IS ADDICTED TO DRUGS, AND HOW CAN I FIND HELP?
The signs of drug use and addiction can vary depending on the person and the drug, but some common signs are:
- impaired speech and motor coordination
- bloodshot eyes or pupils that are larger or smaller than usual
- changes in physical appearance or personal hygiene
- changes in appetite or sleep patterns
- sudden weight loss or weight gain
- unusual smells of breath, body, or clothing
- changes in mood or disinterest in engaging in relationships or activities