Substance abuse problems are medical conditions. It is actually the use of a substance in a way that:
- Interferes with the personal relationship between the person and his family or friends;
- Disrupts a person’s ability to perform at work, school and family
- Causes legal problems and dangerous behavior.
Substance abuse (alcohol, drugs or illegal drugs) may also mean using a substance or consuming it in ever-increasing quantities, taking all the means to obtain the substance, feeling withdrawal symptoms during treatment. Stop using it or be unable to stop using it or reduce the quantity used.
Neurodepressants (e.g., alcohol, barbiturates, benzodiazepines), stimulants (e.g. amphetamines, cocaine, MDMA [ecstasy]), hallucinogens (e.g. LSD) and narcotics (e.g. e.g., codeine, heroin and morphine) are the most common examples of abuse substances. Anabolic steroids are sometimes abusively taken to improve athletic performance.
Substance abuse problems are very complex medical issues. As they touch the brain, it’s not just about will problems. There are many negative feelings associated with substance abuse problems and health professionals prefer not to use terms such as “addiction“, “drug addiction” or “addiction”. Instead, they talk about “substance abuse issues” and “people with substance abuse problems“.
Almost all substances associated with addiction problems affect a reward mechanism in the brain. The Dopamine is the primary chemical messenger that provides the brain’s reward mechanism. Whenever the person uses the substance, she feels a sense of well-being, which makes her want to use the substance again. Over time, changes occur in the brain (e.g. a decrease in dopamine production) and the pleasant effects of the substance are reduced; larger quantities of the substance are then needed to achieve the same sensation.
The causes of substance abuse are unclear, although the factors that may play a role are numerous. Heredity (genes) seems to play a role, because the risk of suffering from a problem of substance abuse is higher for people who have in their family other people with the same problem. The person’s environment, such as school, work, friends, and family members, cultural and religious beliefs can also have an impact on substance abuse issues.
Other mental disorders such as anxiety and depression may also play a role. Substance use can also begin at a time when people are trying to cope with unpleasant feelings and emotions (e.g., anger, stress, sadness). People who are subject to discrimination may also be at increased risk of substance abuse.
Symptoms and Complications
One becomes dependent on a substance physically; psychologically or both at once.
Physical dependence involves the development of tolerance to a substance. This means that the body requires increasing amounts of the substance to achieve the same effect it originally had. Stopping the drug triggers withdrawal symptoms that include tremors, headaches, and diarrhea. Stopping a substance can even be dangerous for the life of the person. Mental or psychological problems, such as depression and anxiety, can also occur during weaning.
Some people may be physically dependent on a substance without the psychological factor (addiction) intervening, especially when the substance is used as part of a valid medical condition.
Psychological dependence is a feeling that substance is necessary for the well-being and functioning of the person. These people often feel a sickly need for the addictive substance, to the point of doing the greatest harm to get it and relieve their lack. Psychologically addictive substances act on the brain and produce one or more of the following effects:
- Mood changes (e.g., euphoria)
- Decreased anxiety
- Effects on the senses (e.g. vision, hearing, etc.);
- The feeling of being endowed with superior abilities.
Complications related to addiction are not lacking. The substance can cause physical problems such as liver disease, lungs, heart disease, vitamin deficiencies and brain damage. Some substances cause birth defects while others can damage the immune system and increase the risk of infections.
People taking amphetamines may have heart attacks, strokes, severe anxiety and paranoia. Hallucinogens, because they distort reality, can make people temporarily psychotic or make them try things that are impossible to achieve, such as flying. Conditions such as AIDS or hepatitis, which are spread through shared dirty syringes, are another possible consequence of substance abuse. Overdoses of some substances can even cause death.
Substance abuse can also have social consequences and affect work, family and interpersonal relationships. People who neglect their families generate social problems for their spouse and children. They can go so far as to commit criminal acts, including stealing for the purposes of their personal consumption. Driving under the influence of substances can lead to death or injury to oneself or others. Substances may alter the perception of reality and cause apathy at work or school. A pregnant woman with a substance abuse problem can cause her fetus to depend on the substance she consumes.
Urine and blood tests are used to detect the presence of substances, but cannot distinguish between the mere use and abuse of substances.
The following behaviors are significant for substance abuse:
- Not be able to stop or reduce substance use;
- Feel guilty or defensive when someone makes comments about the use of substances;
- Feel guilty about the use of substances
- Consume substances in the morning as soon as you get up.
If you think that you or someone you know might have a substance abuse problem (alcohol, drug or illegal drug), contact your doctor, local support group or community center for advice. You will probably be referred to a specialized counselor who will assess your situation and help you decide if treatment is needed.
Treatment and Prevention
Substance abuse problems are treatable. The treatment may take a few weeks or months and it is possible that recurrences may occur, but the treatment is effective in the long term for many people.
There are various treatment options. The treatment plan varies according to the needs of the person and takes into consideration the importance of the problem, the support network of the person and the motivation of the person to start the treatment. The plan may need to be modified to accommodate changing needs of the person. Treatment may include support groups, anti-weaning treatments or harm reduction for people who are not ready to completely stop taking the substances involved.
Some medications may also be part of the treatment plan. It is possible to give naltrexone, a medicine that helps reduce the craving for alcohol, or acamprosate, a medicine used to restore the balance of certain chemicals for people who experience abuse problems.
In some cases, other medications are used to treat withdrawal symptoms. During the weaning of certain substances, the person is gradually weaned by receiving smaller and smaller doses. It is also possible to give it less harmful substances than those to which it are accustomed. For example, people who are addicted to heroin are often prescribed methadone. Methadone is not as bad for the brain as heroin or other narcotics.
The treatment plan almost always involves counseling. This treatment helps the person to understand their problem of substance abuse and to develop effective methods to deal with the problem.
Several types of treatment services are available depending on where the person lives. Some programs are community-based and require the person living at home to visit a treatment center on a regular basis. Other programs welcome people to a treatment center for a while. The types of services and treatment approaches may vary by program and center, and someone with a substance abuse problem must be comfortable with the approach used by a program or center.
During recovery, many people will be re-offended. These should be considered as temporary setbacks that can serve as a lesson (e.g. what triggered recidivism and what strategy should be adopted to avoid this in the future). Overcoming each of these recurrences will bring the person closer to healing. The road to recovery may be long for some, but it exists.
Several prevention programs (e.g. at school, by families and in the media) have shown that substance abuse problems can be prevented. When helping young people understand the risks associated with this condition, substance abuse is reduced. Encouraging communication within families helps to reduce the risk of substance abuse problems. Talk to your family about alcohol, drugs and other drugs. If you are not sure how to approach the issue, contact your doctor or community health center for information and resource information.
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