Drug Dependence

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. Problems 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.

	Failure to fulfill work, school or home obligations
	Legal problems, such as getting arrested for disorderly conduct
	Financial problems due to the cost of drugs
	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.

Drug Facts Chart

Type of Drug	Examples/Common Names	Possible Effects	Dangers of Use/Abuse	Withdrawal Symptoms	Signs of Overdose
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	Severe depression, convulsions, heart attack, lung damage, coma, brain damage, risk of infection from using contaminated needles, death	Extreme depression, intense anxiety, irritability, shakiness, fatigue, insomnia, sleeping too much, vivid, complicated dreams	Agitation, convulsions, elevation in body temperature, hallucinations, possible death
Depressants	Alcohol, barbiturates, sedatives, tranquilizers, downers, ludes, reds, yellow jackets	Drowsiness, slurred speech, drunkenness, memory loss, sudden mood shifts, depression, lack of coordination	Overdose, especially when used with alcohol, rigid muscles and even death	Tremors of hands and face, insomnia, nausea, vomiting, rapid heart rate, elevated blood pressure, weight loss, anxiety, seizures, delirium, death	Shallow breathing, dilated pupils, clammy skin, weak and rapid pulse, coma, 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. This can cause distress or impair normal functioning	No physical withdrawal symptoms. Psychological withdrawal symptoms: mood swings, anxiety, depression, insomnia, flashback episode of previous use: feels like you are on the drug when you are not	Psychosis (unconsciousness, seizure, coma, possible with PCP)
Inhalants	Solvents such as glue, paint thinner, 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 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, blood shot eyes, nosebleed, hallucinations	Suffocation, heart failure, unconsciousness, seizures, brain damage, possible death	Chills, headaches, stomachaches, delirium, hallucinations	Unconsciousness, seizures, possible death
Marijuana (from the cannabis class of drugs)	Pot, grass, reefer, bud, herb, jay, joint, a Fatty, 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	In heavy users: nausea, anxiety, irritability, insomnia	Fatigue, paranoia, possible psychosis
Narcotics	Heroin (dope, horse, goods, smack, brown sugar, school boy), codeine (also in prescription medicine, such as Tylenol with codeine), Robitussin A-C, 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	Watery eyes, runny nose, yawning. Anxiety, irritability, panic, tremors, insomnia. Chills and sweating, nausea or vomiting, diarrhea, muscle aches	Slow, shallow breathing, clammy skin. Convulsions, coma, possible death
Stimulants	Speed, uppers, crank, amphetamines	Increased alertness, blood pressure, pulse rate. Elevates mood	Fatigue, confusion, aggressiveness, severe anxiety, appetite and/or weight loss	Apathy, long periods of sleep, depression, irritability, disorientation	Agitation, increase in body temperature. Hallucinations, convulsions, possible death

Treatment

Using drugs can cause physical and emotional problems. Drug use and abuse affects the users, their families, friends and co-workers. 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)
	Your Student Counseling Center
	A drug treatment clinic
	A mental health center or provider
	Self-help groups such as Narcotics Anonymous (NA)

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 for drug overdoses, violent or out-of-control behaviors, etc.
	Medical treatment for physical problems due to the use of a drug(s) and/or for proper care and supervision from drug withdrawal. This 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 includes: Initial and on-going evaluations of the person’s physical, mental, and social needs Diagnostic 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.
	Counseling. This can be individual, couple, 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 or an inpatient basis.
	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 “National Resources”.)

Questions to Ask

Is the person suspected of taking a drug overdose and is he or she not breathing?
	Perform rescue breathing (if you know how)
With a suspected drug overdose, are any of these problems present? Unconsciousness, decreasing level of consciousness, severe shortness of breath, or wheezing Hallucinations, confusion, convulsions, slow and/or shallow breathing, and/or slurring of words

Is the person’s personality suddenly hostile, violent and aggressive?
Note: Use caution. Protect yourself. Do not turn your back to the victim or move suddenly in front of him or her. If you can, see that the victim does not harm you, himself or herself. Call the police to assist if you cannot handle the situation.
In the absence of above symptoms, is evidence present that a person has taken a drug overdose (e.g., pill containers are emptied, etc.)?

Have three 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. Withdrawal symptoms include: Shaking; irritability; sleeplessness; depression; headaches; anxiety; hallucinations. 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.

Has one or more of the following taken place in the last 12 months due to drug use? Failure to fulfill your major role obligations 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. Having unprotected sex. 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-Help

Prevent Dependence on Prescription Medication

	Use the medication only as prescribed and for the intended purpose (i.e., don’t use Adderall to pull an all nighter).
	Discuss with your physician and pharmacist, the effects of taking more than one medicine and/or taking medicine with alcohol. Have your prescriptions filled at the same pharmacy.
	Don’t combine medications, such as Vicodin or Xanax with alcohol to enhance the “buzz.”
	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 non-medicine ways to treat your problem.
	Find out how to gradually reduce the usage of a medicine to avoid harmful side effects.

an check for harmful interactions with all the medicines you take.

There are several ways to lower the chances of letting drugs affect your life or someone else’s life. Techniques that follow can help accomplish this.

	Learn as much as you can about the harmful effects of drugs.
	Contact your Employee Assistance Program (EAP) person or Student Counseling Center for information and suggestions.
	Change your lifestyle. Try to stay out of situations where drugs are available, such as certain parties.
	If your friends insist you take drugs in order to socialize with them, make it clear that you are serious about stopping or that you don’t take drugs.
	Attend self-help group meetings for drug users. Examples include Narcotics Anonymous (NA) and Cocaine Anonymous (CA)(See “National Resources”.)
	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 to feel confident. For example, learn and practice martial arts, sew, paint and/or 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.
	Use the Now Awareness technique (see “Alcohol Problems - Self-Help”.)

Playing sports regularly is a way to get the exercise you need.

What You Can Do for a Friend or Relative

Persons abusing drugs may not realize or admit they have a problem. They may refuse to get treatment. If someone you know has a drug problem, the following tips can help you help them.

	Know the signs of drug abuse and dependence. (See the “Possible Effects” column in the “Drug Facts Chart” above.)
	Encourage them to seek professional help. Give them phone numbers of places where they can get help. (See “National Resources”.)
	Attend a support group. This could be one with your friend or relative, such as Narcotics Anonymous (NA) and/or one for persons affected by someone else’s substance abuse, such as Al-Anon. Find out what’s available on campus or in your community by looking in your phone book for local chapters of support groups. (See also “National Resources”.)
	Avoid codependency. Do not lie or otherwise make excuses for your friend’s or relative’s problems that arise from their drug abuse. This includes not taking financial or social responsibility for your friend or relative or trying to control their drug abuse habits. You cannot make them stop taking drugs by trying to gain control of their life.

A support group can be one-on-one with a friend or relative.