Drug Abuse and Dependence

Is this topic for you?

This topic is about drug abuse and dependence in adults. For information about drug abuse in teens or children, see the topic Teen Alcohol and Drug Abuse. For information about alcohol abuse in adults, see the topic Alcohol Abuse and Dependence.

What is drug abuse and dependence?

Drug abuse is using drugs in a way that harms you or that leads you to harm others. You can abuse illegal drugs, prescription drugs, or over-the-counter drugs.

When you abuse drugs, you are not always able to meet work, home, or school duties. You may be late to work. You may use drugs in dangerous situations, such as when driving or operating machines, or drugs may cause problems in your relationships.

Drug abuse can lead to drug dependence, where you are addicted to a drug. The drug controls your life. Any of the following can happen:

• You take more of the drug over longer periods of time and need more of the drug to feel "high."
• You spend a lot of time trying to get the drug, and you give up other activities to do this.
• You try to quit using the drug, but you are not able to.
• You continue to use the drug even though it harms your relationships and causes you to develop physical problems.
• If you stop using the drug, you feel sick. This is known as withdrawal.

Drug dependence is a disease. It's not a weakness or a lack of willpower. It's your choice to begin using a drug, but as you use it more your brain begins to change. This change can lead to a craving to use the drug, and this can influence how you act.

Which drugs might be a problem?

Drugs that are abused include:

• Marijuana, cocaine, and hallucinogens, such as LSD (lysergic acid diethylamide), mescaline, psilocybin, PCP (phencyclidine), and ketamine.
• Inhalants, such as glues, aerosol sprays, gasoline, paints, and paint thinners.
• Club drugs, such as ecstasy (MDMA).
• Methamphetamine, which is called meth, crank, or speed.
• Opiates, such as heroin, morphine, and codeine.
• Prescription drugs, such as diazepam (Valium), methylphenidate (Ritalin), hydrocodone bitartrate and acetaminophen (Vicodin), and oxycodone (OxyContin). Nonprescription medicines, such as cough syrups or cold pills, also are abused.

What are the signs of drug abuse and dependence?

The signs of drug abuse and dependence depend on the drug and the person using the drug. Behaviors that may be signs of a drug problem include:

• Changes in sleeping or eating habits, less attention to dressing and grooming, or less interest in sex.
• Up and down moods, a mood or attitude that is getting worse, or not caring about the future.
• Anger toward others or treating others badly.
• Sneaky behavior, lying, or stealing.
• Poor family relationships, or relationships that are getting worse.
• New problems at work or school, or problems with the law.
• Dropping old friends and activities, finding new friends, and not wanting old friends to meet them.

Having these signs doesn't always mean a person is using drugs. The behavior could be because of work or school stress, or it could be a sign of depression or another medical problem. But behavior changes like these are common in people who abuse drugs.

Physical signs of drug abuse and dependence include:

• Red eyes, a sore throat, a dry cough, and feeling tired.
• Needle marks on the arm or other area of the body.
• Small, "pinpoint" pupils in the eyes.
• Losing weight without trying to, or not feeling like eating.
• Changes in sleep behavior, such as not sleeping as well.
• Seeing things that don't exist (hallucinations).

Why do people start using drugs?

Drugs can make you feel good for a while. They may make you feel energetic, self-confident, and powerful. You may take a drug to reduce stress or anxiety or to help you forget a problem. Or you may think drugs help you do better at work or school. You may take a drug because you are curious about it or because your friends use it.

How are drug problems diagnosed?

Drug problems may be diagnosed at a routine doctor visit or when you see your doctor for a health or social problem linked to drug use, such as anxiety, depression, or family conflict. If a partner or friend thinks you have a drug problem, he or she may urge you to see your doctor.

Your doctor will ask questions about your symptoms and past health, and he or she will do a physical exam and sometimes a mental health assessment. Your doctor also may ask questions or do tests to look for health problems linked to drug abuse.

If you think you or a loved one might have a drug problem, use this short quiz to check for drug use:

Drug abuse screening test (What is a PDF document?)

How are drug problems treated?

Treatment includes medicine, therapy, and self-help groups.

Your doctor may decide you need detoxification, or detox, before you start treatment. Detox "flushes out" the drugs in your body. You need detox when you are physically addicted to a drug. Being physically addicted to a drug means that when you stop using the drug, you have physical withdrawal symptoms, such as feeling very sick to your stomach or feeling very anxious. So when you go through detox, you may need medicine to help with withdrawal symptoms.

After detox, you focus on staying drug-free. Most people receive some type of therapy, such as group counseling. You also may need medicine to help you stay drug-free.

When you have stopped using drugs, you have taken the first step toward recovery. To gain full recovery, you need to take steps to improve other areas of your life, such as learning to deal with your work, family, and living situation in healthy ways. This makes it easier to stay drug-free.

You will likely need support to stay drug-free and in recovery. This can include counseling and support groups like Narcotics Anonymous. Recovery is a long-term process, not something you can achieve in a few weeks.

What can you do if you or another person has a problem with drugs?

If you feel you have a drug problem, get help. You can visit a doctor or go to a self-help group. The earlier you get help, the easier your recovery will be for you and your family.

Helping someone with a drug problem is hard. If you are "covering" for the person, you need to stop. For example, don't make excuses for the person when he or she misses work.

You may be able to help by talking to the person about what his or her drug use does to you and others. Talk to the person in private, when the person is not using drugs or alcohol and when you are both calm. If the person agrees to get help, call for an appointment right away. Don't wait.