People use drugs for all sorts of reasons. For some it is to fit in with what their friends are doing, some are looking for a way to ease anxiety or depression and others want to enhance their physical performance. Some people experiment with drugs purely out of curiosity.
Usually these are infrequent or once-off activities, however sometimes they can lead to abuse or addiction. This does not mean that everyone taking drugs will automatically become addicted to them but it can happen. There is no obvious point at which people switch over to becoming addicted. Some people may take a drug for years and never become addicted to it. For example, marijuana or prescription medicines.
The progression from occasional use to full-blown addiction is different for everyone and can depend on any number of factors. It is when the use or habit begins to affect the person’s everyday life – including their work, relationships, health or well-being – that they can be considered to be addicted.
The term ‘drug abuse’ is generally used when the voluntary use of a drug or medication progresses into an unhealthy dependence on it. The dependence can be psychological, physical or both and can involve changes in the chemical pathways in the brain. When this happens, the person can have increasing difficulty maintaining self-control or resisting intense drug cravings.
When the addiction becomes more advanced, the person may develop overwhelming withdrawal symptoms if they have not had the drug for a period of time so they seek out another ‘fix’ thus increasing the downward spiral. Often a person at this stage of addiction can no longer control their drug usage even when it has a negative impact on their family and friends.
In 2013 almost 3 million adult Australians had used illicit drugs in the previous 12 months. Some of these people may have formed a drug addiction but many may not be aware of how far their drug usage has escalated. The line at which regular use tips over into an addiction is very fine which is why it is so hard to detect. Many drug users don’t know when they have crossed that point until it is too late.
A better way to identify an addiction is not how often a drug is used but what consequences follow on from its usage. It doesn’t matter how often a person uses a drug; once it starts to impact their daily life then they are more than likely to have their usage progress into an addiction.
To overcome an addiction, most people will need some form of help or treatment as it is extremely difficult for a person to manage it all on their own. Just acknowledging the addiction is a major challenge for most and accepting help also takes a huge amount of courage. Treatment can take many forms depending on the individual circumstances but it usually involves a combination of one-on-one counselling, self-help groups and withdrawal therapy. However in order for any treatment to be successful the person must be a willing participant.
Drugs can be grouped into different categories such as legal, illegal, hard, soft, downers, uppers, addictive and non-addictive. They can also fall into groups such as stimulants, depressants and hallucinogens based on their side-effects.
Drugs in this category stimulate the brain, increase alertness and elevate respiration and heart rates. They can be prescribed for a number of health conditions however illegal or recreational varieties such as ecstasy, cocaine, amphetamines and nicotine are used for increased vitality and confidence.
Depressants work the opposite way as they have a sedative effect that slows down the function of the central nervous system. Initially they can be prescribed to help manage anxiety and sleep disorders but as people become used to their effects they may be tempted to misuse them. Depressants can include alcohol, heroin, tranquillisers, barbiturates and solvents. Using drugs like these can result in impaired judgement, coordination and balance.
Hallucinogens affect how a person perceives the world around them including how they register input from their senses. These effects can be very erratic and can create false perceptions. For example the person may believe they see and hear things that are not actually there. Some can progress to experience psychotic symptoms like paranoia.
Drugs can also be classified according to how they are used and obtained. The two most common categories are recreational and prescribed drugs. Recreational drugs can include both legal and illegal substances. They ae generally taken for pleasure and include caffeine, tobacco and alcohol and also ecstasy and cocaine.
Prescription drugs such are pain relievers and sedatives are taken for a specific medical purpose and are prescribed by a doctor. Some pain relievers can also be purchased over the counter at pharmacies. Some of these drugs can become addictive if used beyond recommended levels or in a way that does not comply with the labelling instructions.
In Australia the list of substances classified as illegal varies from state to state and the lists are constantly being updated. There are also laws and exceptions in relation to how a substance is used, for example some drugs are allowed for medical purposes under strict conditions.
There isn’t a generic cause or reason for a person to develop a drug addiction. Some people have a higher risk than others due to a number of possible factors but that does not mean they will definitely become addicted. Like many diseases, drug addiction can be triggered by a range of factors including genetics, social circumstances, environment and age or level of development. Access to drugs can also have a bearing on their addictive potential. The more available they are, the harder it can be to resist them.
Evidence suggests that some people could be genetically predisposed to developing addictive behaviours in much the same way that they can be to developing other conditions. In these people tendency towards addiction may not necessarily become active but could be triggered by environmental factors or trauma.
Having mental health issues such as depression or anxiety may also possibly increase a person’s risk of developing an addiction, especially if they are also using prescription drugs to assist with their condition.
Those who have experienced family abuse, neglect or other types of trauma in childhood have a higher risk of developing some form of drug abuse. However there are numerous other environmental factors that can also make them more susceptible. These include ongoing stress, peer pressure and parenting styles. If these circumstances result in a person feeling a void or lacking a basic emotional need (such as an uncaring or distant parent) then they may be more prone to developing a drug addiction of some kind.
People of any age can develop a drug addiction including young children. In fact when environmental triggers occur at critical stages of a child’s development they can be even more likely to begin addictive behaviours and take risks. This is because at these stages, the brain is still developing key skills of decision-making, judgement and self-control.
Some drugs may have an impact on the brain’s communication system by influencing how the nerves send, receive and process information. This can happen in one of two ways – they can imitate the brain’s chemical messengers (neurotransmitters) and / or they can overstimulate the brain’s ‘reward’ circuit.
Some drugs like heroin and marijuana can mimic the function of neurotransmitters and fool the brain’s receptors into sending abnormal messages around the body. Other drugs such as cocaine can trick the nerve cells into releasing unusually high levels of neurotransmitters like dopamine and inhibit the normal regeneration of these chemicals. Dopamine affects emotions, motivation and feelings of pleasure. The influx of these emotions creates a euphoric response and sets up a cycle that draws people back to repeat the rewarding behaviour.
Those who have developed a drug addiction are often so fixated on when and how to get their next fix that they don’t recognise when their health and well-being begin to suffer. Instead they are more focused on relieving the cravings and avoiding the unpleasant symptoms of withdrawal. For this reason, it is often the person’s friends and family who notice when the habit starts to become an addiction.
While some substances will produce different physical side-effects, in general the signs of drug addiction are very similar. If you are concerned someone you know may have developed an abusive habit, it may be helpful to look out for some of the warning signs below.
If you believe that someone close to you has a problem with drugs, you need to think very carefully about how to handle the situation before saying anything to them. If possible, try to talk sensitively to them about your concerns but bear in mind that they may be in complete denial and resent your ‘accusations’ about their behaviour. While this can be very frustrating it is important to remember that you cannot force someone to change or accept responsibility when they are not ready to.
If you are able to enter into a discussion with them, give them as much support and encouragement as you can. Hopefully they will reach a point where they can face up to the situation. From there you may be able to suggest they see a GP or even make the appointment for them. The GP can diagnose them and provide them with a range of appropriate treatment options.
Treating drug abuse usually involves a combination of counselling, withdrawal therapy and participation in self-help groups. The form that each of these treatment components will take will depend on the individual circumstances. Some people may recover well mainly through counselling however those with more severe addictions usually need a complete structured program that includes all three components.
The most common forms of counselling are talking and behavioural therapies. These can be conducted on a one-on-one basis, in group sessions or a combination of both. During these sessions, the person will be taught new ways to cope with cravings and at the same time they may also learn to deal with any coexisting issues such as anxiety or depression.
Cognitive Behavioural Therapy (CBT) is the most common form of therapy used for treating addictions as it allows the person to recognise and explore the thoughts and emotions that lead to the addictive behaviour. The therapist can then show them ways to avoid these negative triggers and replace them with more constructive and positive ones.
Withdrawal therapy is a gradual process. The more severe the addiction, the longer it may take. It involves the person gradually reducing their dose of the drug and replacing it with other less addictive substances with fewer side-effects (such as Methadone). During this stage, the person is likely to experience some very unpleasant withdrawal symptoms as their body adjusts to all the changes. It is during this phase that self-help groups are most valuable and they provide empathy, compassion, understanding and motivation for the person to persevere though their recovery and overcome their addiction.
In Australia there are currently no laws that specify what qualifications or training a counsellor needs to have before being allowed to offer addiction counselling services. However there are a number of tertiary and professional development courses that are available. Practitioners can also apply to be registered with the Australian Counselling Association (ACA), the Psychotherapy and Counselling Federation of Australia (PACFA) and other industry associations.
It is generally recommended that people struggling to overcome addiction undertake a detox program alongside CBT or similar therapy. When that person is in a relationship or has a family then couples or family counselling may be also needed so finding a professional with experience with addiction in these circumstances would be very beneficial.