Understanding Drug Abuse and Addiction

According to the National Survey on Drug Use and Health, 21.5 million American adults (aged 12 and older) battled a substance use disorder in 2014. Almost 80% of individuals suffering from a substance use disorder in 2014 struggled with an alcohol use disorder.1Drug addiction is a complex disease, and quitting usually takes more than good intentions or a strong will. Drugs change the brain in ways that make quitting hard, even for those who want to change.2

Addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences. The initial decision to take drugs is voluntary for most people, but repeated drug use can lead to brain changes that challenge an addicted person’s self-control and interfere with their ability to resist intense urges to take drugs.

These brain changes can be persistent, which is why drug addiction is considered a “relapsing” disease—people in recovery from drug use disorders are at increased risk for returning to drug use even after years of not taking the drug. As with other chronic health conditions, treatment should be ongoing and should be adjusted based on how the person responds.

What happens to the brain when a person takes drugs?

Most drugs affect the brain’s “reward circuit” by flooding it with the chemical messenger dopamine. This reward system controls the body’s ability to feel pleasure and motivates a person to repeat behaviors needed to thrive, such as eating and spending time with loved ones. This overstimulation of the reward circuit causes the intensely pleasurable “high” that can lead people to take a drug again and again.

As a person continues to use drugs, the brain adjusts to the excess dopamine by making less of it and/or reducing the ability of cells in the reward circuit to respond to it. This reduces the high that the person feels compared to the high they felt when first taking the drug—an effect known as tolerance.

They might take more of the drug, trying to achieve the same dopamine high. It can also cause them to get less pleasure from other things they once enjoyed, like food or social activities.

Long-term use also causes changes in other brain chemical systems and circuits as well, affecting functions that include:

  • Learning
  • Judgment
  • Decision-making
  • Stress
  • Memory
  • Behavior

Despite being aware of these harmful outcomes, many people who use drugs continue to take them, which is the nature of addiction.2

Can drug addiction be cured or prevented?

As with most other chronic diseases, such as diabetes, asthma, or heart disease, treatment for drug addiction generally isn’t a cure. However, addiction is treatable and can be successfully managed. People who are recovering from an addiction will be at risk for relapse for years and possibly for their whole lives. Research shows that combining addiction treatment medicines with behavioral therapy ensures the best chance of success for most patients.

The good news is that drug use and addiction are preventable. Results from National Institute on Drug Abuse (NIDA)-funded research have shown that prevention programs involving families, schools, communities, and the media are effective for preventing or reducing drug use and addiction. Although personal events and cultural factors affect drug use trends, when young people view drug use as harmful, they tend to decrease their drug taking.

Therefore, education and outreach are key in helping people understand the possible risks of drug use. Teachers, parents, and health care providers have crucial roles in educating young people and preventing drug use and addiction.2

Treatment for Drug Abuse

Drug addiction can be treated, but it’s not simple. It must help the person do the following:

  • Stop using drugs
  • Stay drug-free
  • Be productive at home, at work, and in society

Successful treatment has several steps:

  • Detoxification
  • Behavioral counseling
  • Medication (for opioid, tobacco, or alcohol addiction)
  • Evaluation and treatment for co-occurring mental health issues such as depression and anxiety
  • Long-term follow-up to prevent relapse

Medications can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions.3

Behavioral therapies help patients:

  • Modify their attitudes and behaviors related to drug use
  • Increase healthy life skills
  • Persist with other forms of treatment, such as medication

Finding Treatment Services

Visit https://findtreatment.samhsa.gov to find a treatment service near you or call SAMHSA’s National Helpline:

  • 1-800-662-HELP (4357)
  • 1-800-487-4889 (TTY)

Free and confidential information in English and Spanish for individuals and family members facing substance abuse and mental health issues – 24 hours a day, 7 days a week.

Road to Recovery

If you or a family member are recovering from drug addiction, focus on the following to help prevent relapse:

  • Keep going to your treatment sessions.
  • Try mindfulness breathing, yoga or meditation to reduce stress.
  • Avoid triggers such as spending time with the people you used drugs with, places, things, or emotions that can make you want to use drugs again.
  • Take care of your body to help it heal from the harmful effects of drug use and to feel better. Be sure to add daily exercise, and eat healthy foods.
  • Find new activities and goals to replace the ones that involved drug use.
  • Spend more time with family and friends you lost touch with; consider not seeing friends who are still using drugs.

Resources

Get Help from Your Doctor

Call for an appointment with your health care provider if you or someone you know is addicted to prescription drugs and needs help stopping or you’re not sure where to start. Reach out to your doctor if you are having withdrawal symptoms that concern you. Your doctor can help you get connected to the care you need.

References

  1. https://americanaddictioncenters.org/rehab-guide/addiction-statistics/
  2. https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction
  3. https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction

Opioid and Substance Abuse & Addictions – A Hidden Workplace Epidemic

Each day, 46 people die from an overdose of prescription painkillers in the U.S. Additionally, health care providers wrote 259 million prescriptions for painkillers in 2012, enough for every American adult to have a bottle of pills.1

Fatalities on the Rise

Close to 19,000 people fatally overdose on opioids each year, which has caused poisonings to overtake motor vehicle crashes as the no. 1 cause of unintentional death among adults in the U.S.2

Drug poisonings, largely from opioid painkillers, now eclipse car crashes as the leading cause of preventable death among adults. Nearly half of Americans are personally impacted by prescription drug addiction, with 44% knowing someone who is addicted to a prescription pain reliever.3

“Seventy-five percent of those struggling with a substance use disorder are in the workforce, revealing a hidden epidemic that many employers are struggling to address.”3.

Key findings from the employer survey conducted by the National Safety Council3 include:

  • 81% of respondents’ policies are lacking at least one critical element of an effective drug-free workplace program.
  • 88% are interested in their insurer covering alternatives to pain relief treatment so that employees can avoid taking opioids.
  • 70% would like to help employees struggling with prescription drug misuse return to their positions after completing treatment.

Painkiller Prescriptions by State

Painkiller Prescriptions by State

Source:  https://www.cdc.gov/vitalsigns/pdf/2014-07-vitalsigns.pdf#page=3

Why are Opioid Painkillers Risky?

People who take opioid painkillers for too long and in doses too large are more at risk of addiction and more likely to die of drug poisoning. Opioids are being overprescribed. According to National Safety Council, four out of five new heroin users started by misusing prescription painkillers.4

Who is At Risk of Addiction?

Research5 indicates that certain factors increase risk, such as:

  • Personal or family history of addiction or substance abuse
  • Depression or anxiety
  • Long-term use of prescription opioids
  • Taking or using multiple drugs, especially drugs for anxiety, depression or other mental health issues

“Addiction should be viewed as a treatable chronic condition like diabetes or heart disease rather than (as) a moral failing. Some people may be more susceptible to addiction due to genetic factors. Organizations that handle this well provide support through their employee assistance programs by offering access to counseling and recovery services that may include medication-assisted treatment, when appropriate.”

– Gregory Eigner, MD, FAAFP, USPM Board of Directors

What Can You Do

  • Avoid taking prescription painkillers more often than prescribed.
  • Dispose of medications properly, as soon as the course of treatment is done, and avoid keeping prescription painkillers or sedatives around “just in case.”
  • Help prevent misuse and abuse by not selling or sharing prescription drugs. Never use another person’s prescription drugs.
  • Talk to your children about proper use of prescription medicines.
  • Get help for substance abuse problems at 1-800-662-HELP. Call Poison Help 1-800-222-1222 if you have questions about medicines.

The National Safety Council provides a free Prescription Drug Employer Kit to help employers establish policies and manage opioid use at work. To request the kit, visit http://safety.nsc.org/rxemployerkit.

For more resources about prescription drug abuse, visit nsc.org/rxpainkillers.

References

  1. https://www.cdc.gov/vitalsigns/opioid-prescribing/
  2. http://www.nsc.org/learn/NSC-Initiatives/Pages/prescription-painkillers-issues-with-chronic-noncancer-pain.aspx
  3. http://www.nsc.org/Connect/NSCNewsReleases/Lists/Posts/Post.aspx?ID=182
  4. http://www.nsc.org/learn/nsc-initiatives/pages/prescription-drug-abuse.aspx
  5. http://www.nsc.org/learn/NSC-Initiatives/Pages/prescription-painkiller-risks.aspx
  6. https://www.cdc.gov/vitalsigns/opioid-prescribing/