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Drug Addiction

Drug addiction is characterized by compulsive, uncontrolled cravings that force the patient to spend his life looking for and using his drug of choice. Even when a patient suffers devastating consequences in his family life, at work or at school, he is unable to stop using the drug. For many patients, drug addiction is chronic, with relapses even after long periods of remission. Physical addiction occurs with repeated drug use as the drug changes the patient’s brain but patients can also have emotional and psychological addictions to drugs. Drug Addiction often involves other dysfunctional behavior like stealing and taking great risks. Drug addicted patients are also at increased risk for other health problems brought on by risky sexual behavior, or intravenous drug use, and by the toxic effects of the drugs on their organs and body.

Your image of a drug addicted person may be that of a heroin junkie, shooting up in a back alley, but most addicts do not fit that profile at all. Patients can be addicted to doctor-prescribed tranquilizers, pain pills prescribed for a back injury, or street drugs like heroin and ecstasy. Drug addiction occurs in all age groups and professions, including lawyers, doctors, high school students, cleaning ladies, teachers, politicians and homemakers. Drugs, like narcotics and cocaine, are more physically addicting, and require less use before the patient is addicted. While personality, heredity and peer pressure can affect a person’s chances of becoming addicted, there is no one primary cause for drug addiction. About 50% of drug-addicted patients have other psychological problems like depression, attention-hyperactive deficit disorder and post-traumatic stress disorder.

Children exhibiting signs of aggression or lack of self-control, and those who are neglected or lack emotional connection to family may be at greater risk.

What are the symptoms?

The symptoms of drug addiction depend on the drug the patient is using.

Marijuana: Rapid or loud speech, laughing followed by red eyes, sleepiness, stupor in later stages. Odor on clothing or breath, forgetfulness, distorted sense of time, driving slowly, increased sense of taste, sight and sound, increased blood pressure and heart rate. Paraphernalia: rolling papers, pipes, bongs, roach clips

Depressants: Symptoms similar to drunkenness, poor coordination, confused, impaired memory, absence of expression or animation, slurred speech, slow heart rate, dizziness, drowsiness, frequent visits to different doctors for prescriptions that treat anxiety, nervousness and stress

Narcotics, Prescription Drugs, Opiates, Heroin, Codeine, Oxycontin: Drowsiness, apathy, lethargy, red nostrils, small pupils, scars on arms or other body parts from injections, slurred speech. Paraphernalia: needles, rubber tubing, spoons, bottle caps and eyedroppers. In prescription drug addiction the patient frequently visits doctors for non-specific pain, increased frequency and amount of prescription medication dosage.

Cocaine, Crack Cocaine, Methamphetamines, Stimulants: Dilated pupils, irritable, combative, nervous, talkative, no interest in food or sleep, restlessness, bad breath, dry mouth or nose, frequent lip licking. Chronic runny nose or nosebleed. Paraphernalia: razor blades, mirror, bottle or bag of white powder, straws, spoons.

Inhalants, Solvents, Aerosols and Glue: Odor on breath or clothes, runny nose, watery eyes, lack of muscle control, drowsiness, unconsciousness. Impaired speech and coordination, nausea, vomiting, pain in chest, muscles, or joints. Depression, fatigue, loss of appetite, heart or bronchial spasm, sores on nose or mouth, bizarre behavior. Severe reaction can include death. Paraphernalia: containers of glue, paint thinner, correction fluid, felt tip marker fluid, gasoline, cleaning fluid, other aerosol products

Hallucinogens, LSD: Dilated pupils, profuse sweating, clammy or warm skin, rapid heart rate, tremors, distorted senses including sense of time and motion, possible visual and audio hallucinations. Mood, behavior change, flashbacks even after drug has worn off. SOME hallucinogens can constrict pupils (but most do not)

PCP: Mood swings, unpredictable behavior (going from passive to aggressive for no reason), paranoia, appears intoxicated, euphoria, delusions, hallucinations, disoriented, agitated, sweating, feeling flushed, fear, extreme anxiety, uneven gait, rigid muscles, loss of sensory perception and pain reflex, pupils dilated or floating, little or no facial expression, nausea, vomiting, drooling. In severe cases, patient may become comatose.

Ecstasy: Confused, memory loss, depression, headache and dizziness (hangover), panic attacks, paranoia, muscle tension (may carry pacifier or lollipops to stop jaw clenching), sore jaw, nausea, vomiting, blurred vision, rapid eye movement, dilated pupils, chills, sweats, feeling overheated, feeling faint, high blood pressure, increased heart rate, transfixed on sights or sounds, becomes very affectionate.

How is it diagnosed and treated?

Drug addiction is often diagnosed when the family expresses concern about a patient’s behavior. Doctors may ask the patient to see a mental health expert, and they may order blood tests to detect the drug, if the patient denies addiction.

Doctors look for at least 3 of the following criterion to diagnose drug addiction. These must have occurred for 30 days, or repeatedly over time.

• The patient wants to quit and may have tried unsuccessfully to cut down or quit a number of times
• Family, social work or school activities are reduced or abandoned because of drug use
• The drug is used in larger doses as time goes on
• A lot of time is spent getting, using and recovering from the effects of the drug
• Patient continues to use drug in spite of problems that are caused by its use.

The goal of treatment is to halt drug use and return the patient to a productive life. Drug addiction treatment is usually as successful as treatment of any chronic disorder (diabetes, high blood pressure etc).

Treatment duration depends on the patient, but research shows that most patients show significant improvement at about 3 months, and additional treatment thereafter produces more progress.

Because every drug and every patient is different, treatment will vary, and can include:

• Medication: Antidepressants, mood stabilizers, neuroleptics (for patients with depression, anxiety disorder, bipolar disorder, psychosis). Methadone, levo-alpha-acetylmethadol (LAAM) (for addiction to heroin, other opiates). Naltrexone (for some opiates, and those with co-occurring alcohol dependence).
• Education and therapy for the patient and family
• Psychotherapy
• Hospitalization and detoxification, as required, possible periodic monitoring and testing for relapse
• Comprehensive treatment plan specific to patient age; gender; ethnicity; and social environs, to include treatment of health problems from drug use (like HIV, Hepatitis, etc), legal issues, and vocational rehabilitation; and social and caseworker assignment as necessary.
• Self-Help and Group programs (like Narcotics Anonymous (NA)
• Cognitive behavioral therapy
• Coping skills to learn and use alternative activities and problem solving to mitigate relapse

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