Substance Abuse Information

What Is Alcoholism and Drug Abuse

Alcoholism is a dependency on or addiction to alcohol that is characterized by uncontrollable cravings for alcohol and the persistent consumption of alcohol in detrimental quantities. Alcoholism is often progressive, meaning it gets worse with time unless proper treatment is received. Alcoholism is also considered to be chronic, meaning that people who have alcoholism are always at risk of a relapse, even if they receive effective treatment. The large amount of alcohol consumed by alcoholics can contribute to emotional distress, intense mood swings, and “black-out” episodes in which intoxication causes memory loss. When alcoholic patients go without alcohol, they may experience withdrawal symptoms such as nausea, tremors, irritability, and headache. Feelings of withdrawal and an inability to control alcohol consumption separate alcoholism from its close relative, alcohol abuse, which is defined as the use of alcohol despite interferences with professional and personal life.

An estimated 15 million people in the US suffer from alcoholism or alcohol abuse. Specific statistics on alcoholism are difficult to determine because of its close relationship with alcohol abuse and the reluctance of sufferers to be diagnosed.

Drug abuse is the consumption of drugs or controlled substances in quantities that are detrimental to health as well as personal and professional life. Drug addiction occurs when individuals are unable to control their consumption of drugs and experience withdrawal symptoms when not using drugs. The effects of any drug are caused by a chemical reaction between the brain and the drug. The initial reaction between a drug and the brain typically produces feelings of relief, euphoria, and altered perception of reality collectively referred to as a “high”. After the drug wears off, however, these feelings can fade or worsen into feelings of depression, emptiness, and exhaustion. It is easy for the brain to then crave the next high, ultimately leading to abuse and dependency. Because of the wide variety of drugs available, drug abuse and addiction can occur in almost any population, people, or place.

Commonly abused drugs include:

Tobacco
Alcohol
Marijuana
Heroin and other Opioids (including many prescription pain medications)
Cocaine
Amphetamine
Methamphetamine
MDMA , also known as “Ecstasy” or “Rolls” (methylenedioxy-methamphetamine)
Ketamine
PCP
Salvia
LSD (acid)
Psilocybin (magic mushroom)
Anabolic steroids
Inhalants
Other prescription drugs—especially pain medication like OxyContin, Percocet, Vicodin, along with anti-anxiety medications like Xanax, Valium, and others

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What Causes Alcoholism and Drug Abuse

Drug abuse typically arises as a coping mechanism for another problem. In the case of prescription medicines, drug abuse may begin with a medically necessitated prescription. The use of the drug provides temporary relief from the problem at hand but not a solution, causing the person to continue using it. Repeated chemical interactions between the drug and the brain seen during drug abuse can eventually cause physical changes in the brain that lead to an increased dependency or addiction (including alcoholism). Once physical changes occur in the brain, it is very difficult to discontinue drug use, as users experience symptoms of withdrawal. The specific chemical interactions that occur in the brain vary from drug to drug due to the different chemical compositions of various drugs.

Common triggers of drug abuse/addiction include:

Genetic predisposition
Poor self-perception
Depression
Stress
Traumatic life events including accidents, deaths, and episodes of abuse
Emotional disorders
Peer pressure
Feelings of hopelessness

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Risk Factors For Alcoholism and Drug Abuse

There are several factors that can increase your likelihood of drug use/addiction. These include:

Family history. Having a close relative who abuses drugs/ is addicted to drugs makes you more likely to suffer from drug abuse/addiction.
Age. Those who start using a drug at a young age (especially as a teen, when the brain is still developing) have a much higher chance of becoming dependent.
Mental health disorders. Drug abuse and addiction are in many ways mental illnesses. Therefore, people with existing mental health disorders are more likely to abuse drugs or develop a drug addiction.
Social environment. A social environment that is centered around drugs, or involves heavy drug use can facilitate drug abuse.
Prolonged drug use. Because of the chemical interactions that occur within the brain with drug use, prolonged drug use or abuse greatly increases the risk of physical changes occurring in the brain, causing addiction.

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Diagnosing Alcoholism and Drug Abuse

Diagnosing alcoholism is difficult because alcoholics often underreport their drinking habits. Many times, it takes family members or loved ones to recognize the problem and talk to the person about seeking help. There are several surveys available to health professionals to help diagnose mental health disorders, the most common of which being the CAGE test. The cage test asks four questions:

C– has the patient felt the need to Cut down on alcohol?
A– has the patient felt Annoyed when others discussed their drinking habit?
G– has the patient experienced feelings of Guilt about their drinking?
E– has the patient used alcohol as an “Eye-opener” to cure a hangover in the morning?

There are also a number of medical tests that can help confirm suspicions of alcoholism. These include blood tests to check for high levels of CDT (carbohydrate-deficient transferring) and GGT (gamma-glutamyltransferase) which are found in high levels in the blood of alcoholics. Other blood tests may be done to determine the extent of damage done to the liver by checking for the presence of certain proteins.

The DSM-V, the latest diagnostic manual for mental health disorders lists the diagnostic criteria for alcohol use disorder (AUD) as follows. The term alcohol use disorder encompasses alcohol abuse and alcoholism. The presence of 2-3 symptoms indicates mild AUD (mild alcohol abuse), 4-5 indicates moderate AUD (moderate alcohol abuse/borderline alcoholism), and 6 or more indicates severe AUD (alcohol dependency/addiction)

Alcohol is often taken in larger amounts or over a longer period than was intended
There is a persistent desire or unsuccessful effort to cut down or control alcohol use
A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects
Craving, or a strong desire or urge to use alcohol
Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home
Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol
Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
Recurrent alcohol use in situations in which it is physically hazardous
Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol
Tolerance, as defined by either of the following:
- A need for markedly increased amounts of alcohol to achieve intoxication or desired effect
- A markedly diminished effect with continued use of the same amount of alcohol

Withdrawal, as manifested by either of the following:
- The characteristic withdrawal syndrome for alcohol
- Alcohol (or a closely related substance,, such as benzodiazepine) is taken to relieve or avoid withdrawal.

As with alcoholism, drug abuse can be difficult to diagnose due to the patient’s reluctance to report drug use. The DSM offers the following criteria for substance use disorder, a term combining both drug abuse and drug addiction. The presence of 2-3 symptoms indicates mild AUD (mild drug abuse), 4-5 indicates moderate AUD (moderate drug abuse/borderline addiction), and 6 or more indicates severe AUD (drug dependency/addiction):

Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home.
Recurrent substance use in situations in which it is physically hazardous
Continued substance use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of the substance
The substance is often taken in larger amounts or over a longer period than was intended
There is a persistent desire or unsuccessful efforts to cut down or control substance us
A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects
Important social, occupational, or recreational activities are given up or reduced because of substance abuse
The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance
Craving or a strong desire or urge to use a specific substance
Tolerance, as defined by either of the following:
- A need for markedly increased amounts of the substance to achieve intoxication or desired effect
- Markedly diminished effect with continues use of the same amount of the substance
Withdrawal, as manifested by either of the following:
- The characteristic withdrawal syndrome for the substance
- The same (or closely related) substance is taken to relive or avoid withdrawal symptoms

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Symptoms of Alcoholism and Drug Abuse

The following may be signs of alcoholism, drug abuse, or drug addiction:

Inability to control the amount of substance used or frequency of use
Cravings or urges to use the substance
Failures or problems at work, school, or home due to substance use
Feeling irritable or ill when without the substance
Prolonged use of substances that were intended to be short term
Feelings of guilt towards substance use

The following may be signs of drug/alcohol withdrawal:

Anxiety
Depression
Fatigue
Irritability
Tremors
Mood swings
Nightmares
Confusion
Clammy skin
Dilated pupils
Headache
Insomnia
Loss of appetite
Nausea
Vomiting
Pale complexion
Increased heart rate
Sweating
Fever
Hallucinations (severe cases)
Seizures (severe cases)

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Prognosis

Prognosis for alcoholism and drug abuse varies from case to case. Because of the complicated nature of drug dependency and the physical changes that occur in the brain, it is often impossible to get rid of a drug addiction, especially in cases where it has existed for long periods of time. Recovery may take time, and may occur in stages, as 50-90% of people relapse into drug abuse after their first attempt at recovery. Only about 1/3 of patients recover fully from alcoholism. The number of full recoveries from other abused drugs varies. Finding the proper rehabilitation method is key to a successful recovery.

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Living With Alcoholism and Drug Abuse

Living with alcoholism or drug abuse can be disruptive to your personal and professional life. The following tips can help guide you on the path to recovery:

Be honest with yourself. The first step in recovery is acknowledging that you have a problem.
Listen to others. If friends or family point out behavior that they see as problematic, do your best to be open to their thoughts.
Find a support system. Once you have acknowledged your problem, find friends, family, and loved ones that you can talk openly with. Be clear about what role you want them to serve in your recovery. This will help you cope with the difficult stages of withdrawal.
Educate yourself on drug abuse/addiction as well as the specifics for your specific drug. This will help you know what to expect in the future and hopefully better prepare you for what is to come.
Do research before choosing a rehabilitation method. Different addicts have different needs for rehab centers to meet. Know what your priorities are and make sure that your chosen center fulfills them.
Don’t give up, even if you relapse after a period of recovery. Know that 50-90% of people relapse at least once in their path to recovery. Rehabilitation is a journey that takes a lot of trial and tribulation.
Find a new hobby to replace space that the drug had filled. This will help keep your mind off of the drug during times of craving.

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Screening

Most primary care doctors will have patients fill out a survey that includes questions about drug use, which are aimed at identifying substance abuse problems. However, because of the patients’ reluctance to report their drug use, drug use is often underreported. Screening is therefore done in many practices, but is not very effective at identifying drug abuse in many cases.

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Prevention

The following steps can be taken to help prevent drug abuse:

Avoid excess drug or alcohol consumption, even on a short-term basis
Monitor yourself for problematic behavior. Recognize any behaviors that could potentially become addictive and try to change them early.
Take prescribed medications only as prescribed
Only take medication that has been prescribed to you, even if it is for a medical reason
Seek counseling for emotional stress, trauma events, and other concerns. Receiving help for issues before they manifest into something larger can help prevent drug abuse as a coping mechanism

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Medication And Treatment

Treatment for alcoholism and drug abuse aims to completely eliminate the use of the targeted drug. Especially in the case of prolonged abuse, complete elimination of drug use can be very difficult. Many choose to enter a rehabilitation clinic or work with a personal therapist in order to help them recover.

There are three basic steps to drug rehabilitation:

Detox. During this phase, the body is ridding itself of the chemical substances of the drug. This phase can cause very serious side effects as the body adjusts to being without the drug, including:

Anxiety
Shaking/trembling
Excessive sweating
Nausea
Vomiting
Insomnia
Depression
Irritability
Fatigue
Loss of appetite
Seizures
Fever

Rehabilitation. During this phase, patients adjust to living without the drug and learn how to restructure their lives in the absence of the drug. Psychological therapy or counseling is used by many during this phase to help determine the underlying causes of drug addiction. Prescription medications can be used at this point to help control cravings for drugs. These drugs include:

Benzodiazepines
Buprenorphine
Conidine
Vitamins
Anticonvulsants

Maintenance. This can be one of the most difficult phases of recovery, as it never truly ends. Once patients learn how to live without the drug, they must continue their sobriety in their daily lives. Unexpected stresses, life events, and problematic environments can make it easy to relapse. Patients are encouraged to use support systems during this phase to help them through moments of craving or weakness. Family, friends, and drug rehabilitation support groups can be great sources of support.

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Complementary and Alternative Treatment

The following treatments may be helpful in drug/alcohol abuse recovery:

Acupuncture. Acupuncture is a traditional form of Chinese medicine that uses hair-thin needles to target specific points along bodily energy channels. Acupuncture can help reduce the symptoms of withdrawal, as well as post-detox drug cravings and overall stress levels.

Dietary supplements. Many supplements can help along the detox, rehabilitation, and maintenance phases. These include:

Detox:

Vitamin C, which has been shown to effectively reduce the withdrawal symptoms of heroin addicts
Selenium, which assists in the body’s use of oxygen
Drug addicts are typically deficient in zinc. Taking a Zinc supplement can help ease the process of quitting
Chromium, which helps to reduce blood sugar levels.

Relaxation:

Calcium and Magnesium, which help strengthen the nervous system, and are typically deficient in addicts
DL-Phenylalanine (DLPA), which increases the body’s use of endorphins (feel good chemicals of the brain.

Herbal medicines. The following herbs may be helpful in treatment and recovery:

Detox:

Milk Thistle
Goldenseal
Dandelion

Relaxation:

Scullcap
Valerian
Passion Flower
Chamomile
Gingko biloba leaf

Adaptation:

Siberian Ginseng
American Ginseng
Astragulus

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Care Guide

Caring for a loved one who is undergoing drug detox, rehabilitation or maintenance can be a challenging experience. The following tips can help you maximize your potential as caregiver:

Do your research. If you suspect that your loved one has a drug or alcohol problem, do research on the condition beforehand. Know about the general process of recovery and available rehabilitation methods before you approach them.
Be encouraging. No matter what stage of recovery your loved one is at, be sure to be a source of positivity and encouragement. Rehabilitation is an extremely difficult process and often involves periods of relapse. Remaining positive and encouraging even during a relapse can be a critical step for your loved one’s recovery.
Know when to intervene. While it is important to give your loved one space to make their own decisions, there are certain moments when you may need to intervene. Examples of this include staging an intervention for an addict, pointing out problematic behaviors during the rehabilitation phase, and averting relapse opportunities during the maintenance phase.
Be open to discussion. Listen to your loved one without making judgments. Establishing a relationship of trust early on in the recovery process is crucial to your role as a support system.
Go to Al Anon meetings. Al-Anon is similar to Alcoholics Anonymous, and exists to help families and friends of alcoholics seek the support of others that are going through the addiction issues with one or more of their loved ones.

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When To Contact A Doctor

If you or a loved one show any symptoms of drug abuse, contact a doctor or mental health professional. He or she will be able to help you find the right treatment method for you.

If you or a loved one show signs of severe drug withdrawal, call emergency services. These include:

Severe depression with thoughts of suicide
Persistent Vomiting
Pale complexion
Increased heart rate
Sweating
Fever
Hallucinations
Seizures

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Questions For A Doctor

You may want to ask your doctor or therapist questions about your treatment and recovery. Example questions may be:

How long will the detox phase last?
What will I experience during the detox phase?
Is there anything that I can do to make quitting easier?
What has caused by addiction?
Do you have recommendations for treatment facilities?
How long will rehabilitation take?
Should I be taking any medications?
Is rehabilitation covered by medical insurance?
How likely is it that I will recover?
What can I do to increase my chances of a full recovery?
What long lasting effects has my addiction had on my health?

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Resources

For more information on drug abuse, visit The National Institute on Drug Abuse

For more information on alcoholism and alcohol abuse, visit The National Institute of Alcohol Abuse and Alcoholism

For more information on drug abuse prevention strategies, visit Surgeongeneral.gov

For more information on starting the road to recovery, visit www.recovery.org and www.alcoholrehabguide.org

For more information on alternative treatments for drug addiction, click here

For more information on treatment facilities and drug addiction support groups, visit Substance Abuse and Mental Health Services Association

For more information related to alcohol and drug addiction treatment centers in New York City, visit Project Know

AddictionCenter.com is a professional webguide that can connect addicts and families with recovery and treatment options. As you may know, over 1.9 million New Yorkers have a substance abuse problem. Our goal is to help these individuals and loved ones by providing them with information on state treatment options and substance abuse information.

Find Women’s Alcohol And Drug Rehab Centers //www.rehabcenter.net/womens-rehab-centers/

Drug Rehab Connections is a community made up of those who want to help and give back. We are here to share our stories of recovery and hope as we begin the steps together towards rehab and recovery.

The Recovery Village Alcohol Abuse and Addiction page is a valuable resource with facts about the dangers of alcohol as well as advice about how to get help.

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