Drug Abuse
What is Addiction?
Another word for addiction is "dependence". There are two kinds of substance dependence:- Psychological dependence occurs when a person feels he or she needs the drug to function or feel comfortable (e.g., needing to drink alcohol to feel relaxed in social situations, or needing to be high to enjoy sex). Some people come to feel they need a substance just to be able to cope with daily life.
- Physical dependence occurs when a person’s body has adapted to the presence of a drug. Tolerance has developed, which means that the person needs to use more of the drug to get the same effect. When drug use stops, symptoms of withdrawal occurs.
People often think that psychological dependence is not as serious as physical dependence. This is not necessarily true. Cocaine, for example, does not cause physical dependence—but it is considered one of the easiest drugs to get hooked on and one of the hardest to give up
Why do people keep using?
Substance use can be hard to change. One thing that makes change so difficult is that the immediate effects of substance use tend to be positive. People may feel good, have more confidence and forget about problems. In contrast, the problems from use might not be obvious for some time. People may come to rely on the effects of substances to bring short-term relief from difficult or painful feelings. The effects of substances can make problems seem less important, or make it seem easier to talk and to be with others. People may come to believe that they cannot function or make it through the day without drugs. When people use substances to escape or change the way they feel, using can become a habit, which can be hard to break. Continued substance use, especially heavy use, can cause changes in the body and brain. If people develop physical dependence and then stop using, they may experience distressing symptoms of withdrawal. Changes to the brain may be lasting. These changes may be why people continue to crave substances and slip back into substance use long after they have stopped using. When people who are addicted stop their substance use, they often compare the experience to leaving a relationship that was very important to them.- Alex began using heroin more than 10 years ago. Getting money to buy drugs was always a problem. He grew tired of the stress of always needing to score, and of knowing that if he got arrested again, he’d go to jail. Still, deciding to leave heroin and try methadone treatment was hard. Once the treatment became routine, he felt bored and didn’t know what to do with his time. He wished he could go back to using, but was afraid of what would happen if he did. His counsellor helped Alex to think about what he wanted from life. Alex enrolled in school and got a part-time job. Soon after, he started a new relationship with someone he trusted. Some days are still a struggle, but with time, and keeping busy, it gets easier.
- Alex found it hard to stop using heroin and to continue with his treatment, especially at first. But just as substance use problems don’t start overnight, they don’t get better right away either. By staying in treatment and continuing to get support, Alex began to get his life back on track.
How common is addiction?
Addiction affects many people. Those who have not experienced a substance use problem first-hand are likely to have a family member, friend or colleague who has. Although addiction affects men and women of all ages, rates are: • two to three times higher in men than women • highest among people aged 15 to 24 (Statistics Canada, 2003). A 2002 study of the rates of addiction found that 2.6 per cent of Canadians were dependent on alcohol and that fewer than one per cent were dependent on illegal drugs (Statistics Canada, 2003). These numbers, however, do not reflect the full impact of substance use problems in Canada. Substance use problems can occur even with low levels of alcohol or other drug use, and in people who are not dependent. For example, estimates suggest that more than 25 per cent of men and nearly 9 per cent of women who drink alcohol are “high-risk” drinkers. These are people whose drinking can be said to be hazardous and harmful to themselves or others, even though these people may not be substance dependent (Adlaf et al., 2004). Methadone is useful to prevent withdrawal because it has a long duration of action. For most people a single dose prevents withdrawal for 24 hours. By slowly decreasing the dose over months patients can become opiate free without having to go through withdrawal. Patients that are compliant with their treatment contract are never forced to go off MMT – some stay on indefinitely. Most people get some side effects. Most common are constipation (typical of all opiates), sweating and weight gain (due to better health and appetite), and libido changes (increased or decreased). Taken as directed, methadone is very safe and does not cause long-term damage to organs, even after several years. However, it is a powerful drug and a typical dose for an addict can be fatal to someone that has not developed tolerance.The stigma of addiction
Stigma is another reason why the rates of substance use problems may be higher than studies suggest. Stigma marks substance use problems as shameful and makes people want to hide their addiction. Stigma also affects the families of people with addiction. It makes them hide the problem or pretend it isn’t there at a time when families need support. What can we do about stigma? One simple way you can help is to choose to talk about “people with substance use problems” rather than about “addicts,” “alcoholics,” “junkies” or “stoners.” Try this approach whether you are talking about another person or about yourself. When you do this, you put the person ahead of the problem. This helps to show that you know there is more to a person than a problem. You are also giving the person with an addiction the support and understanding it takes to recover. People use alcohol and other drugs for many reasons. Some use these substances to help them to relax, to feel more lively, to feel less inhibited or to feel pleasure. Some find the effects of substances make it seem easier to cope with problems. Some use substances for religious reasons or to fit in with the crowd. Others may be curious about the effects of a specific drug. No one plans to become addicted. People may think that they can handle their substance use and that they only use when they want to. But when they want to change the way they use, they may find it’s not that simple.Mary's Story
Mary loves going out after work with her friends. Her job is stressful, and having a few drinks with her friends helps her to unwind and relax. Lately, Mary’s regular “after-work drink” has turned into a whole evening of drinking. She often misses dinner and doesn’t get home until late. A couple of times Mary hasn’t remembered how she got home the night before, and she’s been late for work. Her manager has commented that she seems tired and distracted, and wonders if anything is wrong.This example shows how substance use problems can develop slowly, and how it can be easy to overlook some early warning signs that a person’s substance use is becoming a problem.
