Substance Abuse; Causes, Symptoms, Diagnosis, Treatment

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Substance abuse is when you take drugs that are not legal. It’s also when you use alcohol, prescription medicine, and other legal substances too much or in the wrong way. So substance abuse, also known as drug abuse, is a patterned use of a drug in which the user consumes the substance in amounts or with methods which are harmful to themselves or others, and is a form of the substance-related disorder. Widely differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases, criminal or anti-social behavior occurs when the person is under the influence of a drug, and long-term personality changes in individuals may occur as well. In addition to possible physical, social, and psychological harm, use of some drugs may also lead to criminal penalties,

Types of Substance Abuse

Cigarettes

  • A distinctive smell on the breath and clothing
  • Cigarettes and lighter in his or her possession
  • Cigarette butts outside a bedroom window or in other odd places around the home.

Alcohol

  • Alcoholic beverages missing from the home storage cabinet
  • Alcohol or mouthwash (used to cover up alcohol) breath or hangover symptoms (nausea, vomiting, or a headache), if recently used.

Marijuana

  • Sweet smell on clothing or bloodshot eyes, if recently used, and frequent use of eyedrops to reduce the redness
  • Drug paraphernalia (pipes) in his or her possession
  • Carelessness in grooming, increased fatigue, and changes in eating and sleeping patterns, if using regularly

Inhalants

  • Chemical breath, red eyes, or stains on clothing or face, if recently used
  • Soaked rags or empty aerosol containers in the trash

Club drugs

  • Skin rash similar to acne
  • Small bottles with liquid or powder in his or her possession

Stimulants

  • A persistent runny nose and nosebleeds, injection marks on arms or other parts of the body, or long periods of time without sleep
  • Possession of drug paraphernalia, such as syringes, spoons with smoke stains, small pieces of glass, and razor blades

LSD or other Hallucinogens

  • Trance-like appearance with dilated pupils, if recently used
  • Small squares of blotter paper (sometimes stamped with cartoon characters) or other forms of the drug in his or her possession

Heroin

  • Very small pupils and a drowsy or relaxed look, if recently used
  • Possession of injecting supplies called an outfit or rig, that may consist of a spoon or bottle cap, syringe, tourniquet, cotton, and matches

Anabolic steroids

  • An unpleasant breath odor
  • Mood changes, including increased aggression
  • Changes in physical appearance that can’t be attributed to expected patterns of growth and development
  • Possession of medicines or syringes

Other general signs

  • Changes in sleeping patterns
  • Changes in appetite or weight loss
  • Changes in dress
  • Loss of interest and motivation
  • Hoarseness, wheezing, or a persistent cough

Causes and Effects of Substance Abuse

While many individuals experiment with drugs and/or alcohol, there is a fine line that can be crossed that differentiates between experimentation and substance abuse. When an individual abuses a substance or substances to such a degree that it begins to negatively affect his or her life and ability to function on a daily basis, that person is likely suffering from an addiction.

According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, a person who is struggling with an addiction to drugs and/or alcohol will meet some or all of the following diagnostic criteria:

  • The consumption of the substance occurs in larger amounts, and more often than intended
  • Despite a desire to end, one’s substance abuse, unsuccessful attempts have been made
  • A great deal of time is spent acquiring, using, and recovering from the abuse of a substance
  • Overpowering cravings for one’s substance of choice are present
  • Failure to adhere to responsibilities occur due to substance abuse
  • Substance abuse continues despite problems caused by the substance abuse
  • Activities are given up in favor of substance abuse
  • Substance abuse occurs in a situation where it could be dangerous
  • One continues to abuse substances despite knowing that it has caused problems
  • Tolerance to a given substance or substances develops
  • Withdrawal symptoms manifest when one is not able to abuse a substance

If you or someone you care about meets the criteria listed above, it is important to seek treatment. By seeking treatment for a substance abuse problem, a brighter, happier, healthier tomorrow can be achieved.

 Statistics of Substance Abuse

The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that as many as twenty million Americans suffer from addictions to substances, but that only fifteen percent of those individuals actually seek treatment. Additionally, research conducted by the National Institute on Drug Abuse (NIDA) states that somewhere between eighty and ninety percent of people in the United States have abused substances during their lifetimes, with alcohol, marijuana, and prescription drugs being the most frequently abused substances in today’s society.

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Causes & Risk Factors for Substance Abuse

There are many reasons why a person may turn to the abuse of drugs and/or alcohol. The following are the causes and risk factors that experts in the field of addiction believe to be true in terms of what makes some individuals more susceptible to abusing substances than others

  • Genetic – Researchers have discovered a set of genes that can make an individual vulnerable to developing a substance abuse problem. Given this information, if a person has a first-degree relative who has struggled with substance abuse, addiction, and/or chemical dependency, that individual is at risk of also struggling with similar challenges at some point during his or her lifetime.
  • Environmental – In addition to genetic influences, the environment and places one spends most of his or her time can have an impact on whether or not an individual will come to abuse substances. For example, those who are exposed to substance abuse from an early age are vulnerable to also abusing substances if they lack effective coping skills and proper social support. Additionally, if an individual resides in an impoverished area, has a history of experiencing trauma, or associates him or herself with others who also abuse drugs and/or alcohol, there is a higher risk for substance abuse to occur at some point in that person’s life.

Risk Factors of Substance Abuse

  • Possessing an impulsive personality
  • Possessing a novelty-seeking temperament
  • Personal history of trauma
  • The family history of substance abuse, addiction. and/or chemical dependency
  • The family history of mental health concerns
  • Personal history of mental health concerns
  • Living in an impoverished area
  • Lacking coping skills
  • Having an inadequate support system

Symptoms of Substance Abuse

Each substance affects people differently, but there are some signs of addiction that are fairly universal

  • The onset of withdrawal symptoms after the person suddenly stops using the substance
  • Feeling as though he or she must consume the substance to deal with the stresses of daily life
  • Increased tolerance levels requiring the person to consume more of the substance to achieve the same effect
  • Uncharacteristic or irrational behavior such as angry or violent outbursts
  • Dramatic changes in appearance like weight loss, hair loss, or skin problems
  • Loss of interesting previously enjoyable activities
  • Loss of important relationships
  • Lying to cover up consumption patterns
  • Impaired performance at work, home, or school
  • Incessantly borrowing money or stealing money
  • Legal, medical, or personal problems associated with consumption of the substance

Or

  • Decreased involvement in activities the person used to enjoy
  • Trouble managing responsibilities at work, school, or home
  • Problems with relationships related to substance use
  • Increase in risk-taking behaviors
  • A lot of time spent seeking the substance, or dealing with its aftereffects (e.g., being hungover)
  • Inability to stop using the substance or change behavior, even when the problems above are present

In some cases, physical or psychological signs may be observed as well

Overall symptoms of Substance Abuse

Behavioral symptoms

  • Possessing drug paraphernalia
  • Abusing drugs and/or alcohol in situations that could be dangerous
  • Poor occupational performance
  • Missing work
  • Failing to adhere to responsibilities and obligations
  • Failed attempts at ending one’s substance abuse
  • Abusing a substance despite a desire to stop
  • No longer participating in activities that were once enjoyed

Physical symptoms

Cognitive symptoms

Psychosocial symptoms

Effects of Substance Abuse

Substance abuse can wreak havoc on a person’s life. Depending on the longevity and severity of the addiction itself, the effects that could result can be life-changing. The effects listed below are among those that may occur if a person continues to abuse substances without seeking professional help:

Co-Occurring Disorders of Substance Abuse

Some individuals who are grappling with mental health concerns turn to the abuse of drugs and/or alcohol as a means of coping with their turmoil. Additionally, there are those who only begin to suffer from mental health disorders once they start abusing substances. In either case, it is possible for a person to seek treatment for an substance abuse and be diagnosed with a mental illness at the same time. The following mental health conditions are among those that people can suffer from at the same time as a substance abuse problem:

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Effects of Withdrawal and Overdose

Effects of withdrawal: The longer than an individual abuses drugs and/or alcohol, the more likely that person will be to develop a tolerance to his or her substance(s) of choice. When this occurs, it can signify that that individual has become chemically dependent on that substance(s) and will thusly experience withdrawal symptoms in the event he or she ceases his or her substance abuse. The process of withdrawing from a substance can be extremely uncomfortable and, unfortunately, trigger a person to seek out his or her substance of choice once more. The following are signs and effects of withdrawal, which also suggest that a person is in need of treatment for his or her addiction:

Effects of Overdose of Substance Abuse

For many substances of abuse, there is an ever-present risk of overdose when drugs and/or alcohol are used on an ongoing basis. Depending on the substance that is being abused, the telltale warning signs of overdose can vary. If any of the following occur, it should heed as a warning that emergency medical attention is needed in order to prevent a grave outcome

Diagnosis of Substance Abuse

If a healthcare provider suspects that you are misusing alcohol or medications, he or she will first confirm that you are dependent on a harmful substance by:

The CAGE questionnaire is often used by healthcare providers to establish whether you have a drinking problem. It has four questions:

  • “Have you ever felt you should cut down on your drinking?”
  • “Have you ever felt annoyed by criticism about your drinking?”
  • “Have you ever felt guilty or bad about drinking?”
  • “Have you ever felt the need for a drink (an “eye-opener”) in the morning to steady your nerves?”
Rational scale to assess the harm of recreational drug use
DrugDrug classPhysical
harm
Dependence
liability
Social
harm
Total
harm
HeroinOpioid2.783.002.542.77
CocaineCNS stimulant2.332.392.172.30
BarbituratesCNS depressant2.232.012.002.08
MethadoneOpioid1.862.081.871.94
AlcoholCNS depressant1.401.932.211.85
KetamineDissociative anesthetic2.001.541.691.74
BenzodiazepinesBenzodiazepine1.631.831.651.70
AmphetamineCNS stimulant1.811.671.501.66
TobaccoTobacco1.242.211.421.62
BuprenorphineOpioid1.601.641.491.58
CannabisCannabinoid0.991.511.501.33
Solvent drugsInhalant1.281.011.521.27
4-MTADesigner SSRA1.441.301.061.27
LSDPsychedelic1.131.231.321.23
MethylphenidateCNS stimulant1.321.250.971.18
Anabolic steroidsAnabolic steroid1.450.881.131.15
GHBNeurotransmitter0.861.191.301.12
EcstasyEmpathogenic stimulant1.051.131.091.09
Alkyl nitritesInhalant0.930.870.970.92
KhatCNS stimulant0.501.040.850.80

Treatment of Substance Abuse

When you drink alcohol with some medications, the alcohol can make the effect of the medication dangerously strong. For example, taking alcohol with pills for sleeping, pain, anxiety, or depression can produce harmful effects. In particular, you should avoid alcohol if you take:

Non-Drug Therapies of Substance Abuse

Substance and Medication Abuse

The following are among the effective treatments that are part of a team approach:

Tobacco Abuse (Cigarette, Cigar or Pipe Smoking)

If you are addicted to smoking, you have probably tried to quit many times. But another serious try is always worth it, even if you are among the very old. Quitting at any age slows the decline in lung function.

Let your healthcare provider know that you want to stop smoking. Together, you will take the following steps

Self-help for substance abuse and co-occurring disorders

In addition to getting professional treatment, there are plenty of self-help steps you can take to address your substance abuse and mental health issues. Remember: Getting sober is only the beginning. As well as continuing mental health treatment, your sustained recovery depends on learning healthier coping strategies and making better decisions when dealing with life’s challenges.

Recovery tip 1

  • Learn how to manage stress  Drug and alcohol abuse often stems from misguided attempts to manage stress. Stress is an inevitable part of life, so it’s important to have healthy coping skills so you can deal with stress without turning to alcohol or drugs. Stress management skills go a long way towards preventing relapse and keeping your symptoms at bay.
  • Cope with unpleasant feelings – Many people turn to alcohol or drugs to cover up painful memories and emotions such as loneliness, depression, or anxiety. You may feel like doing drugs is the only way to handle unpleasant feelings, but Help guide’s free Emotional Intelligence Toolkit can teach you how to cope with difficult emotions without falling back on your addiction.
  • Know your triggers and have an action plan – When you’re coping with a mental disorder as well as a substance abuse problem, it’s especially important to know signs that your illness is flaring up. Common causes include stressful events, big life changes, or unhealthy sleeping or eating patterns. At these times, having a plan in place is essential to preventing a drink or drug relapse. Who will you talk to? What do you need to do to avoid slipping?
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Recovery tip 2

  • Make a face-to-face connection with friends and family a priority – a Positive emotional connection to those around you is the quickest way to calm your nervous system. Try to meet up regularly with people who care about you. If you don’t have anyone you feel close to, it’s never too late to meet new people and develop meaningful friendships.
  • Get therapy or stay involved in a support group – Your chances of staying sober improve if you are participating in a social support group like Alcoholics Anonymous or Narcotics Anonymous or if you are getting therapy.
  • Follow doctor’s orders – Once you are sober and you feel better, you might think you no longer need medication or treatment. But arbitrarily stopping medication or treatment is a common reason for relapse in people with co-occurring disorders. Always talk with your doctor before making any changes to your medication or treatment routine.

Make healthy lifestyle changes

  • Exercise regularly – Exercise is a natural way to bust stress, relieve anxiety, and improve your mood and outlook. To achieve the maximum benefit, aim for at least 30 minutes of aerobic exercise on most days.
  • Practice relaxation techniques When practiced regularly, relaxation techniques such as mindfulness meditation, progressive muscle relaxation, and deep breathing can reduce symptoms of stress, anxiety, and depression, and increase feelings of relaxation and emotional well-being.
  • Adopt healthy eating habits – Start the day right with breakfast, and continue with frequent small meals throughout the day. Going too long without eating leads to low blood sugar, which can make you feel more stressed or anxious. Getting enough healthy fats in your diet can help to boost your mood.
  • Get enough sleep A lack of sleep can exacerbate stress, anxiety, and depression, so try to get 7 to 9 hours of quality sleep a night.

Recovery tip 4

To stay alcohol- or drug-free for the long term, you’ll need to build a new, meaningful life where substance abuse no longer has a place.

  • Develop new activities and interests Find new hobbies, volunteer activities, or work that gives you a sense of meaning and purpose. When you’re doing things you find fulfilling, you’ll feel better about yourself and substance use will hold less appeal.
  • Avoid the things that trigger your urge to use – If certain people, places, or activities trigger a craving for drugs or alcohol, try to avoid them. This may mean making major changes to your social life, such as finding new things to do with your old buddies—or even giving up those friends and making new connections.

Group support for substance abuse and co-occurring disorders

  • As with other addictions, groups are very helpful, not only in maintaining sobriety but also as a safe place to get support and discuss challenges. Sometimes treatment programs for co-occurring disorders provide groups that continue to meet on an aftercare basis. Your doctor or treatment provider may also be able to refer you to a group for people with co-occurring disorders.
  • Just make sure your group is accepting of the idea of co-occurring disorders and psychiatric medication. Some people in these groups, although well-meaning, may mistake taking psychiatric medication as another form of addiction. You want a place to feel safe, not pressured.

Helping a loved one with a substance abuse and mental health problem

  • Helping a loved one with both a substance abuse and a mental health problem can be a roller coaster. Resistance to treatment is common and the road to recovery can be long.

The best way to help someone is to accept what you can and cannot do. You cannot force someone to remain sober, nor can you make someone take their medication or keep appointments. What you can do is make positive choices for yourself, encourage your loved one to get help, and offer your support while making sure you don’t lose yourself in the process.

  • Seek support Dealing with a loved one’s mental illness and substance abuse can be painful and isolating. Make sure you’re getting the emotional support you need to cope. Talk to someone you trust about what you’re going through. It can also help to get your own therapy or join a support group.
  • Set boundaries – Be realistic about the amount of care you’re able to provide without feeling overwhelmed and resentful. Set limits on disruptive behaviors and stick to them. Letting the co-occurring disorders take over your life isn’t healthy for you or your loved one.
  • Educate yourself – Learn all you can about your loved one’s mental health problem, as well as substance abuse treatment and recovery. The more you understand what your loved one is going through, the better able you’ll be to support recovery.

References

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