Drug Dependence & Abuse

Drug dependence and abuse both involve the misuse of one or more drugs. These can be prescription medicines and/or illicit drugs.

Drug dependence is addiction. A person keeps using a drug even though doing so results in problems that affect the person’s mind, physical health, and/or behaviors. Features of drug dependence include:

• Cravings for the drug
  
• Need for increased amounts of the drug to get the desired effect
  
• Withdrawal symptoms
  

Drug abuse is the repeated use of a drug that results in distress and daily living problems. Examples are:

• Failure to fulfill work, school, or home obligations
  
• Legal problems such as getting arrested for disorderly conduct
  
• Physical harm that results from things such as a car accident
  
• Relationship problems such as arguments or physical fights
  

A person can abuse a drug without becoming addicted to it. Addicts, however, usually have distress and the daily problems that result from drug abuse.

See chart below for facts on different drugs.

Drug Facts

Type of Drug Common Name	Possible Effects	Dangers of Use/Abuse
Cocaine Blow, crack, crank, “C,” coke, nose candy, rock, white girl	Increased alertness and energy, euphoria (followed by depression), increased pulse rate and blood pressure, decreased appetite, insomnia, irritability, paranoia	Severe depression, convulsions, heart attack, lung damage, hallucinations, coma, brain damage, risk of infection (hepatitis, AIDS) from using contaminated needles, death
Depressants Alcohol (see “Alcoholism” on page 176), barbiturates, sedatives, tranquilizers, downers, ludes, reds, yellow jackets	Drowsiness, slurred speech, drunkenness, memory loss, sudden mood shifts, depression, lack of coordination	Shallow breathing, dilated pupils, clammy skin, weak and rapid pulse, coma, possible death
Hallucinogens Acid, LSD, PCP (angel dust), mescaline, designer drugs: DMT, MDA, STP, MMDA, MDMA, ecstasy, peyote	Alter mood and perception of time and space, delusions, hallucinations. Can “see sounds” and “hear colors.” Rapid mood swings. Feelings of loss of control, helplessness, panic. Elevation in body temperature, heartbeat, and breathing. Blurred vision, tremors, lack of coordination	Brain damage, behavior can be unpredictable, unstable (violent with PCP). Can have flashbacks and re-experience symptoms of past hallucinogen use even though not taking the drug at the present time. Psychosis (unconsciousness, seizure, coma possible with PCP)
Inhalants Solvents such as gasoline, kerosene, lighter fluid, nail polish remover; aerosols such as hair sprays, vegetable cooking sprays; anesthetics such as ether, chloroform, nitrous oxide (laughing gas), spray paints, especially gold and silver. {Note: These substances are known as inhalants when the vapors from them are used for the purpose of getting high.}	Slow heart rate, breathing and brain activity. Headaches, dizziness, nausea, lack of coordination, slurred speech, blurred vision. Euphoria, increased energy, bloodshot eyes, nosebleed	Suffocation, heart failure, unconsciousness, seizures, brain damage, possible death
Marijuana Pot, grass, reefer, herb, jay, joint, smoke, weed and AMP (marijuana mixed with formaldehyde)	Euphoria, relaxes inhibitions, increases appetite, dry mouth	Feelings of panic, impaired short term memory, decreased ability to concentrate, fatigue, paranoia, possible psychosis
Narcotics Heroin (dope, horse, smack, brown sugar, schoolboy), codeine (also in prescription medicine such as Tylenol with codeine, Robitussin AC), opium (Dovers powder, paregoric), morphine, methadone, Darvon, Percodan, Demerol	Slowed breathing, heart rate and brain activity. Increase in the body’s tolerance to pain. Constipation, euphoria, relaxation, sense of peace. Impaired memory and/or attention span, slurred speech	Lethargy, weight loss. Risk of infection (hepatitis, AIDS) from using contaminated needles. Impaired judgement in social and/or work functioning. Convulsions, coma, possible death
Stimulants Speed, uppers, crank, amphetamines	Increased alertness, blood pressure, pulse rate. Elevates mood	Fatigue, confusion, agitation, severe anxiety, appetite, and/or weight loss. Hallucinations, convulsions, possible death

Treatment


Using drugs can cause physical and emotional problems. Drug use and abuse affects the users and their families, friends, and coworkers. It is also costly, not only to the drug abusers and their families, but to their employers as well. If you are drug-dependent or abusing drugs, get help. You can get help through:

• Your doctor
• Your Employee Assistance Program (EAP) at work
• A drug treatment clinic
• A mental health center or provider
• Self-help groups such as Narcotics Anonymous (NA). (See “Places to Get Information & Help” under “Alcohol/Drug Abuse” on pages 374 and 375.)

The treatment for drug dependence and abuse varies, and depends on the drug(s) being used and the person’s needs. Types of treatment include:

• Emergency medical care. This may be needed for drug overdoses or for violent or out-of-control behaviors.
• Medical treatment for physical problems due to the use of a drug(s) and/or for proper care and supervision from drug withdrawal. Medical treatment can be given in outpatient or inpatient settings. The goal for treatment is to get to the point where all mood-altering chemicals are not used.

Medical treatment involves the use of a number of things. These include:

• An initial and ongoing evaluation of the person’s physical, mental, and social condition
• Diagnostic and lab tests
• “Detoxifying” the person of the abused substance. In many cases, the only thing needed for “detox” is time. In others, such as heroin addiction, another drug (in this case, methadone) is given to replace the heroin so as to minimize withdrawal effects. The amount of methadone is slowly reduced until the person no longer needs it. Some persons may need to be on methadone for a long time.
• Counseling. This can be individual, family, and/or group therapy. Counseling helps the drug addict or abuser identify the needs for drug use and helps the person set up life-coping skills. Counseling can be provided on an outpatient basis or in inpatient settings.
• Medical nutrition therapy from a registered dietitian if the drug abuse has resulted in nutrient deficiencies.
• Support groups such as Narcotics Anonymous (NA), Cocaine Anonymous (CA) and Alcoholics Anonymous (AA). (See “Places to Get Information & Help” under “Alcohol/Drug Abuse” on pages 374 and 375.)

Questions to Ask

Do you suspect the person has taken an overdose of drugs? Is the person not breathing and has no pulse?
Is the person not breathing, but has a pulse?
Is the person unconscious?
Is the person hallucinating, confused, convulsing, breathing slow and shallow and/or slurring their words?
Is the person’s personality suddenly hostile, violent, and aggressive?
Have 3 or more of the following applied to you in the last 12 months due to drug use? You need more of a drug to get intoxicated or reach a desired effect. You get withdrawal symptoms if you stop taking or take less of the drug. Examples of withdrawal symptoms include: Shaking – Irritability Sleeplessness – Depression Headaches – Paranoia Hallucinations – Anxiety You have to take the drug or one similar to it to relieve or avoid withdrawal symptoms. You take the drug in larger amounts often or over a longer period of time than you intended. You have not been able to cut down or control your use of a drug even though you want to. You spend a lot of time doing things necessary to get the drug, use the drug, or recover from its effects. You give up important social, work or leisure activities or do them less often so you can use the drug. You continue to take the drug even though you know it results in physical or psychological problems or makes these problems worse.
Have you or someone else accidentally taken more than the prescribed dose of a prescription or over-the-counter medicine?
Has 1 or more of the following taken place in the last 12 months due to drug use? Failure to fulfill your major duties at work, school, or home Taking part in situations that could cause physical harm while under the influence of a drug, such as driving or operating a machine Legal problems, such as getting arrested for drunk driving or disorderly conduct Relationship problems due to the effects of the drug such as physical fights or arguments with others

Self-Care Tips


To Prevent Dependence on Prescription Medication:

• Use the medication only as prescribed.
• Discuss the effects of taking more than one medicine and/or taking medicine with alcohol with your physician and pharmacist. Have your prescriptions filled at the same pharmacy. The pharmacist can check for harmful interactions with all the medicines you take.
• Don’t increase the dosage or take it more often than your physician tells you to. Consult your physician first.
• Don’t use medicine prescribed for someone else.
• Ask your physician about the risks of addiction when he or she prescribes medicines, especially sleeping pills, tranquilizers, and strong pain relievers. Find out how long you will need to take the medicine. Ask if there are ways to treat your problem without medicine.
• Find out how to gradually reduce the usage of a medicine to avoid harmful side effects.

Ways to Lower the Chances of Letting Drugs Affect Your Life or Someone Else’s Life:

• Learn as much as you can about the harmful effects of drugs.
• Contact your Employee Assistance Program (EAP) person at work for information and suggestions.
• Change your lifestyle. Try to stay out of situations where drugs are available.
• If your friends insist that you take drugs in order to socialize with them, make it clear that you are serious about stopping.
• Attend self-help group meetings for drug users. Examples include Narcotics Anonymous (NA) and Cocaine Anonymous (CA). (See “Places to Get Information & Help” under “Alcohol/Drug Abuse” on pages 374 and 375.)
• Talk to persons who will listen to your feelings and concerns without judging you. You will be less likely to turn to drugs to “drown your sorrows.”
• Listen to calm music.
• Do deep breathing exercises.
• Do things that you know and do well in order to feel confident. For example, learn and practice martial arts, sew, paint, take part in volunteer work.
• Get regular vigorous exercise such as swimming, jogging, or walking.
• Learn something new. Take a night school course or community education class that you are interested in.
• Realize that you are a role model for your children. They learn what they see. When you take prescription drugs, do so responsibly.
• Don’t mix drugs with alcohol, driving, or operating machines. These combinations can be fatal.