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People from all walks of life can experience problems with their drug use, regardless of age, race, background, or the reason they started using drugs in the first place. Some people experiment with recreational drugs out of curiosity, to have a good time, because friends are doing it, or to ease problems such as stress, anxiety, or depression.

However, it’s not just illegal drugs, such as cocaine or heroin that can lead to abuse and addiction. Prescription medications such as painkillers, sleeping pills, and tranquilizers can cause similar problems. In fact, next to marijuana, prescription painkillers are the most abused drugs in the U.S. and more people die from overdosing powerful opioid painkillers each day than from traffic accidents and gun deaths combined. Addiction to opioid painkillers can be so powerful it has become the major risk factor for heroin abuse.

When drug use becomes drug abuse or addiction?

Of course, drug use-either illegal or prescription-doesn’t automatically lead to abuse. Some people are able to use recreational or prescription drugs without experiencing negative effects, while others find that substance use takes a serious toll on their health and wellbeing. Similarly, there is no specific point at which drug use moves from casual to problematic [1-3].

Drug abuse and addiction is less about the type or amount of the substance consumed or the frequency of your drug use, and more about the consequences of that drug use. If your drug use is causing problems in your life-at work, school, home, or in your relationshipsyou likely have a drug abuse or addiction problem.

If you’re worried about your own or a loved one’s drug use, learning how drug abuse and addiction develops-and why it can have such a powerful hold-will give you a better understanding of how to best deal with the problem and regain control of your life. Recognizing that you have a problem is the first step on the road to recovery, one that takes tremendous courage and strength. Facing your problem without minimizing the issue or making excuses can feel frightening and overwhelming, but recovery is within reach. If you're ready to seek help, you can overcome your addiction and build a satisfying, drug-free life for yourself [4,5].

Risk factors for drug addiction

While anyone can develop problems from using drugs, vulnerability to substance addiction differs from person to person. While your genes, mental health, family and social environment all play a role, risk factors that increase your vulnerability include:

• Family history of addiction

• Abuse, neglect, or other traumatic experiences

• Mental disorders such as depression and anxiety

• Early use of drugs

• Method of administration-smoking or injecting a drug may increase its addictive potential

• How drug abuse and addiction develops

There's a fine line between regular drug use and drug abuse and addiction. Very few drug abusers or addicts are able to recognize when they've crossed that line. While frequency or the amount of drugs consumed do not necessarily constitute drug abuse or addiction, they can often be indicators of drug-related problems [6-8].

If the drug fulfills a valuable need, you may find yourself increasingly relying on it. You may take illegal drugs to calm or energize yourself or make you more confident. You may start abusing prescription drugs to relieve pain, cope with panic attacks, or improve concentration at school or work. If you are using drugs to fill a void in your life, you're more at risk of crossing the line from casual drug use to drug abuse and addiction. To maintain a healthy balance in your life, you need to have positive experiences and feel good about your life without any drug use [9].

Drug addiction and the brain

While each drug produces different physical effects, all abused substances share one thing in common: repeated use can alter the way the brain functions. This includes commonly abused prescription medications as well as recreational drugs.

Taking the drug causes a rush of the hormone dopamine in your brain, which triggers feelings of pleasure. Your brain remembers these feelings and wants them repeated.

When you become addicted, the substance takes on the same significance as other survival behaviours, such as eating and drinking.

Changes in your brain interfere with your ability to think clearly, exercise good judgment, control your behaviour, and feel normal without drugs [10].

No matter which drug you're addicted to, the uncontrollable craving to use grows more important than anything else, including family, friends, career, and even your own health and happiness.

The urge to use is so strong that your mind finds many ways to deny or rationalize the addiction. You may drastically underestimate the quantity of drugs you're taking, how much it impacts your life, and the level of control you have over your drug use [11].

With the right treatment and support, you can counteract the disruptive effects of drug use and regain control of your life. The first obstacle is to recognize and admit you have a problem, or listen to loved ones who are often better able to see the negative effects drug use is having on your life [12].

Signs and symptoms of drug abuse and addiction

Although different drugs have different physical effects, the symptoms of addiction are similar. If you recognize yourself in the following signs and symptoms, talk to someone about your drug use.

Common symptoms of drug abuse

• Neglecting responsibilities at school, work, or home (e.g. flunking classes, skipping work, neglecting your children).

• Using drugs under dangerous conditions or taking risks while high, such as driving while on drugs, using dirty needles, or having unprotected sex.

• Experiencing legal trouble, such as arrests for disorderly conduct, driving under the influence, or stealing to support a drug habit.

• Problems in your relationships, such as fights with your partner or family members, an unhappy boss, or the loss of friends.

Common symptoms of drug addiction

• You've built up a drug tolerance. You need to use more of the drug to experience the same affects you used to attain with smaller amounts.

• You use to avoid or relieve withdrawal symptoms. If you go too long without drugs, you experience symptoms such as nausea, restlessness, insomnia, depression, sweating, shaking, and anxiety.

• Loss of control over your drug use. You often do drugs or use more than you planned, even though you told yourself you wouldn't. You may want to stop using, but you feel powerless [13].

• Your life revolves around drug use. You spend a lot of time using and thinking about drugs, figuring out how to get them, or recovering from the drug's effects.

• You've abandoned activities you used to enjoy, such as hobbies, sports, and socializing, because of your drug use.

• You continue to use drugs, despite knowing it's hurting you. It's causing major problems in your life-blackouts, financial issues, infections, mood swings, depression, paranoia-but you use anyway [14].

Drug abusers often try to conceal their symptoms and downplay their problem. If you're worried that a friend or loved one might be abusing drugs, look for the following warning signs:

Physical warning signs:

• Bloodshot eyes, pupils larger or smaller than usual

• Changes in appetite or sleep patterns

• Sudden weight loss or weight gain

• Deterioration of physical appearance, personal grooming habits

• Unusual smells on breath, body, or clothing

• Tremors, slurred speech, or impaired coordination Behavioral warning signs

• Drop in attendance and performance at work or school

• Unexplained financial problems; borrowing or stealing

• Engaging in secretive or suspicious behaviors

• Sudden change in friends, favorite hangouts, and hobbies

• Frequently getting into trouble (fights, accidents, illegal activities)

Psychological warning signs

• Unexplained change in personality or attitude

• Sudden mood swings, irritability, or angry outbursts

• Periods of unusual hyperactivity, agitation, or giddiness

• Lack of motivation; appears lethargic or “spaced out”

• Appears fearful, anxious, or paranoid

Warning signs of commonly abused recreational drugs Marijuana, Glassy, red eyes; loud talking, inappropriate laughter followed by sleepiness; loss of interest, motivation; weight gain or loss [15].

Stimulants (including amphetamines, cocaine, crystal meth): Dilated pupils; hyperactivity; euphoria; irritability; anxiety; excessive talking followed by depression or excessive sleeping at odd times; may go long periods of time without eating or sleeping; weight loss; dry mouth and nose.

Inhalants (glues, aerosols, vapors): Watery eyes; impaired vision, memory and thought; secretions from the nose or rashes around the nose and mouth; headaches and nausea; appearance of intoxication; drowsiness; poor muscle control; changes in appetite; anxiety; irritability; lots of cans/aerosols in the trash.

Hallucinogens (LSD, PCP): Dilated pupils; bizarre and irrational behavior including paranoia, aggression, hallucinations; mood swings; detachment from people; absorption with self or other objects, slurred speech; confusion [16].

Heroin, Contracted pupils; no response of pupils to light; needle marks; sleeping at unusual times; sweating; vomiting; coughing, sniffling; twitching; loss of appetite.

Warning signs of prescription drug abuse

In recent years, prescription drug abuse has become an escalating problem, most commonly involving opioid painkillers, anti-anxiety medications, sedatives, and stimulants. Many people start taking these drugs to cope with a specific medical problem-taking painkillers following injury or surgery, for example. However, over time, increased doses are needed to achieve the same level of pain relief and some users can become physically dependent, experiencing withdrawal symptoms if they try to quit [17].

One of the earliest warning signs of a developing problem is going through the medication at a faster-than-expected rate. In other cases, people start abusing medication not prescribed for them in order to experience a high, relieve tension, increase alertness, or improve concentration.

When your teen has a drug problem

Discovering your child uses drugs can generate fear, confusion, and anger. It's important to remain calm when confronting your teen, and to only do so when everyone is sober. Explain your concerns and make it clear that your concern comes from a place of love. It's important that your teen feels you are supportive [18].

Warning signs of teen drug abuse

As with adults, teenage drug abuse isn't limited to illegal drugs. In fact, teens are more likely to abuse prescription and over-the-counter drugs, including painkillers, stimulants, sedatives, and tranquilizers. In many cases, these drugs are much easier for teens to procure, yet they can have dangerous, even lethal, side effects [19].

While experimenting with any kind of drug doesn't automatically lead to drug abuse, early use is a risk factor for developing more serious drug abuse and addiction down the road. Risk of drug abuse also increases greatly during times of transition, such as changing schools, moving, or divorce. The challenge for parents is to distinguish between the normal, often volatile, ups and downs of the teen years and the red flags of substance abuse [20,21].

Conclusion

Addiction is a complex problem that affects every aspect of your life. Overcoming addiction requires reaching out for support and making changes to the way you live, deal with problems, and relate to others. Recovery is within your reach but don't try to go it alone; it's very easy to get discouraged and rationalize “just one more.” Whether you choose to go to rehab, rely on self-help programs, get therapy, or take a self-directed treatment approach, support is essential.

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