Drug addiction – or substance use disorder – is a chronic relapsing brain disease that is characterised by the compulsive seeking out and use of drugs, despite the harmful consequences to both physical and mental wellbeing.
The causes of drug addiction are varied, but environmental factors and exposure to addictive substances (in the home or through peer group pressure) may encourage initial drug use. However, repeated use of a drug leads to changes in the structure and function of the brain, leading to dependency.
Drugs are chemicals that interfere with the way the brain functions by imitating the brain’s natural chemical messengers (neurotransmitters) and/or overstimulating the reward circuit of the brain.
For example, when a person takes heroin, the morphine molecule binds to the endorphin receptor site on the neurons and mimics the function of natural endorphins. After the initial rush of endorphins floods the body, a state of euphoria sets in as the morphine is absorbed into the bloodstream. After a period of repeated use, dependency sets in, and continued use is to relieve the painful withdrawal symptoms felt as the endorphins leave the body, rather than to experience the rush or ‘high’.
Drug-use statistics as reported by the United Nations World Drug Report (2014) indicate that drug abuse is a growing concern in South Africa, with 7.06% of the population abusing narcotics (that’s one in 14 people or 3.73 million people in 2013). Further statistics based on the percentage of people treated for that year show primary drug use as follows:
- Cannabis (marijuana): 38.4%
- Methamphetamine: 22.9%
- Heroin: 18.8%
- Cocaine: 5.7%
- Prescription medication: 5.4%
- Hallucinogens (for example, acid/LSD) 3.2%
- Ecstasy 0.3%.
What are its symptoms?
The symptoms and behaviours associated with drug addiction include the following:
- Intense urges to take the drug of choice
- Needing to take the drug regularly, that is, several times a day
- Needing to take more of the drug to achieve the desired effect
- Doing everything in your means to acquire the drug
- Spending money on the drug even if you can’t afford it
- Engaging in unlawful activities to get money for the drugs, for example, stealing and drug dealing
- Being unable to meet family or work responsibilities due to drug use
- Becoming antisocial
- Reduced inhibitions – engaging in risky behaviour when under the influence
- Experiencing withdrawal symptoms when attempts are made to stop using the drug
- Attempts to stop using the drug fail
Different drugs have different short-term effects on the body. Some may stimulate the system (cocaine), while others have a relaxing effect (benzodiazepines, such as Valium).
Long-term symptoms of repeated drug use include a decrease in mental acuity (possibly brain damage), neglect of hygiene and appearance, neglect of friends and social interactions, organ damage, and an inability to meet responsibilities. In addition, drug usage increases the risk of becoming infected with hepatitis C and HIV.
The signs of overdose include:
- Vomiting
- Seizures
- Diarrhoea
- Abdominal cramps
- Loss of balance
- Sleepiness and confusion
- Elevated or decreased vital signs
- Chest pain
Drug overdose is a medical emergency that may lead to coma or death – immediate treatment should be sought.
How is it diagnosed?
A diagnosis of drug addiction is usually done in conjunction with a psychiatrist, psychologist or licensed drug counsellor. Normally the following criteria are followed (as laid out in the Diagnostic and Statistical Manual of Mental Disorders, the standard classification of mental disorders used by mental health professionals).
A substance use disorder is present if the following have occurred over a 12-month period:
- You are unable to cut down or stop taking the substance
- You spend a great amount of time getting the drug, using it and recovering from its after effects
- Your urge for the drug blocks out other thoughts
- You are unable to meet your responsibilities (family, work, social)
- You use the substance in unsafe situations, that is, when you’re driving or working with machinery
- The drug is losing effect, so you need to take larger amounts than before (called ‘tolerance’)
- You experience withdrawal symptoms when you stop taking the drug.
What are your treatment options?
Treatment options can be discussed with your healthcare provider, and may take the form of an in-patient treatment programme in a facility that caters for drug addiction, or on an out-patient basis.
Treatment programmes usually consist of:
- Detoxification: This may be done under supervision in a care facility or hospital, or on an outpatient basis. Different drugs produce different side effects, which will require appropriate treatment. Detox or withdrawal therapy aims to enable the patient to stop taking the drug as safely as possible. This may be done by reducing the dose of the drug gradually, or temporarily substituting it with another substance that is then tapered off.
- Individual, family or group therapy
- A focus on understanding what addiction is, and preventing relapse
- Counselling: Talk therapy or psychotherapy can help you develop ways to cope with drug cravings; offer ways to avoid situations and people associated with the drug addiction; provide a forum where you and your family can talk freely and openly
- Support groups: Groups like Narcotics Anonymous offer a safe and supportive environment that aims to help prevent drug addiction relapse. Support groups can alleviate the sense of loss or isolation that may be felt.
Recovery is possible, but it requires lifetime management and support.
Can it be prevented?
Prevention of drug addiction begins with understanding the risk factors; and avoiding drug use all together. Risk factors include:
- Family history of drug addiction
- Being male: While men are more likely than women to start using drugs, the rate of progression in women is faster, that is, women become addicted more quickly
- Living with a mental health disorder: People who suffer from depression, Attention Deficit Hyperactivity Disorder (ADHD), post-traumatic stress disorder (PTSD) and bipolar disorder are at greater risk of using drugs
- Peer pressure: This is a factor in ‘trying out’ drugs, especially in teenagers and young adults
- Lack of parental supervision and/or lack of strong family ties may increase risk of addictions
- Alleviating loneliness, depression and anxiety: Using drugs may be a way of coping with these often painful feelings
- Certain over-the-counter and prescription medication can become addictive, for example, codeine. Be aware of all the side effects of medication you are taking, and adhere to the doses that have been prescribed.
- Anyone can become addicted to drugs: If you feel you’re merely a recreational drug user, or dabble a bit from time to time in what you consider ‘light’ drugs (for example, marijuana), take care, as usage can escalate, and you may find yourself needing more – or different – drugs more often.
For more info
South African National Council on Alcoholism and Drug Dependence
Nar-Anon Family Groups South Africa
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