What is Addiction?

Drug or substance abuse, dependence or addiction? Abuse and dependence (sometimes termed addiction) are formal psychiatric diagnoses with specified criteria. These criteria, which apply to all psychoactive substances, are provided in the DSM-IV used in the US and the International Classification of Diseases-10th revision used elsewhere in the world. The concepts, as well as the actual criteria, are actually quite similar.

Dependence refers to a loss of control over use of the drug. This results in continued use despite adverse consequences and inability to control how often or how much is used.

Drug abuse refers to continued drug use, even knowing the dangers and negative effects that are happening to the user. It is possible for people to be physically dependent on drugs without actually being addicted to them. Some blood pressure medications don’t cause addiction, for instance, but can cause a physical dependence. There are also other drugs, like cocaine, that cause addiction but don’t necessarily result in a physical dependence.

Drug tolerance, wherein people need higher doses of drugs to get the same effect, normally goes hand-in-hand with drug addiction.

Risk Factors & Causes

Drug abuse may lead to drug addiction or dependence. People who take drugs in order to relieve pain might also become dependent on them. The exact causes of drug dependence and abuse are currently still debated. However, some of the factors that might lead to it include a person’s genes, peer pressure, the drug’s interaction with internal body systems, emotional distress, environmental stress, anxiety, and depression.

Although it is true that peer pressure might lead to drug abuse or use, most people who get addicted to drugs usually already suffer from a mental health condition, like depression, ADD, or post-traumatic stress disorder.

Children that live in environments where drugs are used illicitly might first watch their parents use various drugs. This could, in turn, place them at a high risk for getting addicted to drugs later on for either genetic or environmental reasons.

The people that are most likely to depend on or abuse drugs are usually those who:

• Have bipolar disorder, addiction, depression, and anxiety disorders.
• Have relationship problems or a low level of self-confidence.
• Live in cultures where drug use is socially accepted.
• Live stressful lives in an emotional or economic sense.

The most commonly abused drugs today include:

• Central nervous system depressants, like alcohol, chloral hydrate, paraldehyde, barbiturates (secobarbital, pentobarbital, amobarbital), and benzodiazepines (Xanax, Ativan, Valium). These substances bring about an anxiety-reducing and sedative effect that could result in dependence.
• Central nervous system stimulants, like cocaine, amphetamines, methamphetamine, dextroamphetamine, and methylphenidate (Ritalin), all of which bring about a stimulating effect. In order to get the same effect out of these drugs in the long run, people tend to begin using higher amounts of them later on (tolerance).
• Hallucinogens, like mescaline, LSD, phencyclidine (“angel dust” or PCP), and psilocybin (“mushrooms”), all of which can make people see certain things that aren’t actually there (hallucinations). These drugs can also result in psychological dependence.
• Narcotics and opiates, which refer to powerful painkillers that can either cause drowsiness (sedation) or make people feel euphoric. These drugs include codeine, opium, heroin, meperidine (Demerol), oxycodone (Oxycontin), and hydromorphone (Dilaudid).
• Tetrahydrocannabinol is an active ingredient that can be found in both hashish and marijuana (cannabis).

There are various drug use stages that might eventually lead to dependence. In general, younger people tend to move much faster through these stages than adults do:

Experimentation — done recreationally and usually involves one’s peers; users might like the thought of defying authority figures, like their parents.

Regular use — users start missing more of school or of work; users start worrying about losing their sources of drugs; might use drugs to get rid of certain negative feelings; might start to avoid family members and friends; might find new friends who use more regularly; might show more tolerance and a professional ability at “handling” the drugs.

Daily preoccupation — users lose motivation; stop caring about school or work; have obviously different behaviors; drugs have become more important than everything else, including relationships; users become secretive; might start dealing drugs in order to support their own habits; might use more drugs or try out harder drugs; legal problems might increase.

Dependence — can’t bear thinking about life without any drugs in it; deny they have problems; physical conditions get worse; can’t control use anymore; might start thinking about suicide; legal and financial problems become worse; might completely break ties with friends or family members.

Complications

Some complications of drug dependence and abuse include:

• Hepatitis, bacterial endocarditis, thrombophlebitis, malnutrition, respiratory infections, and pulmonary emboli caused by injected drug use.
• Depression.
• Overdose.
• An increase in cancer rates, like pharynx and lung because of nicotine use; and stomach and mouth associated to
  HIV infection from sharing needles.
• Concentration and memory problems due to hallucinogen and marijuana (THC) use.
• Drug abuse relapses.
• Unsafe sexual practices that might lead to HIV, hepatitis, unwanted pregnancies, and other sexually transmitted diseases.