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Work is still being done to determine the direct causes of substance abuse and mental health issues. While there is still much to be discovered, it is known that a number of factors play into the development of these disorders, and many of these factors are similar across both mental health and substance abuse issues.
For substance abuse, several factors contribute to the abuse of alcohol and drugs. These include:
Other mental health disorders are similarly influenced by a combination of biological, psychological, and environmental factors. Things that may increase risk of developing a mental illness include:
Mental illness and substance abuse can affect the development of each another. Over 50 percent of those with a substance use disorder at some point in their life may also have another form of mental health disorder at some point in their life, and over 50 percent of those with a lifetime mental health disorder may also have a lifetime substance use disorder.
Furthermore, a 2014 survey by SAMHSA found that 39 percent of adults with a substance use disorder in the past year also had a mental illness in the past year, and 18 percent of adults with a mental illness in the past year also had a past year substance use disorder.
Substance abuse can have an effect on a person’s physical and mental health, as well as social relationships, family, work, school, and quality of life. The potential effects of substance abuseinclude:
When a person’s behavior changes, loved ones may immediately suspect that substance abuse of some kind is a factor. There are a number of signs that can be observed in a person who is abusing or addicted to drugs or alcohol. It can be challenging to see outward signs of substance abuse; however, there are some behaviors that can indicate that drug abuse or addiction is occurring.
Various drugs have such a strong enough effect on the body that they can result in changes in a person’s appearance. One of the most well-known substances in this regard is methamphetamine, or crystal meth.
One of the side effects of taking meth is diminished blood flow, and this includes blood flow to the capillaries of the skin, which can result in a number of physical changes. As a result, damage to the skin can take longer to heal, resulting in sores and scarring on the face and body. In addition, the drug dries out the salivary glands and can cause compulsive tooth grinding, resulting in severe damage to teeth, a phenomenon known as meth mouth.
Other drugs that can cause major changes in physical appearance include heroin, cocaine, and steroids. Any substance abuse can result in changes in appearance. The person may neglect personal hygiene, in addition to having bloodshot eyes, persistent dark circles under the eyes, bruises, and potent body odor.
Still, these signs are not necessarily a result of drug abuse. However, if they occur with some of the other signs and symptoms listed above, drug abuse may be a factor.
One of the most notable and disturbing changes in behavior that can occur in a person who is using drugs is sudden or extreme violence. When this type of behavior is prompted by drugs, stimulants are the most likely culprit.
Some of the most recent, well-known instances of extreme behavior caused by stimulants has been the behavior resulting from use of bath salts, a type of psychoactive stimulant drug that creates a high resembling the high from cocaine or meth. The psychological and behavioral effects of these types of drugs include paranoia, agitation, panic attacks, and hallucinations, among other symptoms, which can result in the person becoming highly violent. Other drugs that have a similar reaction include cocaine, meth, and even some prescription drugs used to treat attention deficit hyperactivity disorder. Synthetic marijuana, also known as K2 or Spice, can also have a profound effect on behavior and result in extremely violent outbursts.
People who abuse more than one drug at a time are at particular risk for complications from substance abuse. This is because the effects of one drug can be compounded and multiplied by the effects of another drug. In fact, research has shown that polydrug abuse, particularly when at least two substances are taken together in a single event, can significantly raise the chances that people will experience negative effects or behaviors.
One common polydrug abuse combination is opioid drugs (such as heroin or prescription pain killers) and benzodiazepines (such as alprazolam, diazepam, and other “benzos”). Abuse of these drugs alone can be incredibly risky; together, they can severely depress the respiratory system, quickly resulting in loss of consciousness or death.
Polydrug abuse can also be a major issue when it comes to treating substance use disorders. Managing detox and withdrawal from multiple substances can be challenging for treatment professionals and can complicate the symptoms of withdrawal.
When looking directly at the primary reasons that people begin abusing drugs or alcohol, one common cause of abuse and addiction is a belief that using the drugs will make something better. Whether it’s a need to feel accepted that results in responding to peer pressure, a desire for excitement that drives experimentation, or some form of suffering that a person wants to cover up or medicate, many people turn to drugs or alcohol because they feel that using these substances will help them deal with their problems.
One version of this cause is often referred to as self-medication. Self-medication as a major cause of substance use disorders is one of the primary theories being studied and discussed by addiction researchers and experts.
Mental health disorders have many of the same signs and symptoms as substance use disorders, and in a large percentage of cases, these disorders co-occur. Being able to tell the difference between mental health problems and substance use disorders can be challenging, and even if a person suspects drug or alcohol abuse, mental illness should not be ruled out on that information alone.
One way to verify that there is a separate mental health problem occurring along with a substance use disorder is to figure out when the symptoms began to occur. If there were symptoms before the drug use began to be a problem, it is more likely that there is an underlying mental health disorder. This is most easily diagnosed by a mental health professional.
Often, people who have mental health issues may try to manage them by self-medicating – using drugs or alcohol without a doctor’s guidance to manage the discomfort or suffering caused by the mental health disorder. A well-known example of this is the use of alcohol to manage depression or anxiety.
While mental health problems do not always lead to substance abuse, and substance abuse problems are not always resolved with mental health care, the correlation is strong enough that substance abuse issues can potentially be prevented or lessened if mental health issues are managed adequately. In fact, research has shown that more than 50 percent of people who have had a substance use disorder in their life also had another form of mental health disorder at some point.
Because of this, early diagnosis and treatment of mental health disorders is important, especially in those who have a family history of substance abuse or mental illness.
Anxiety disorders, impulse-control disorders (including ADHD), and mood disorders, in that order, are estimated to be the three most common classes of mental health disorders experienced by Americans at some point in their lives. Major depressive disorder is estimated to be the most common mental illness experienced by Americans in their lifetime.
Depression and anxiety disorders both increase the risk for substance abuse, and this could be a result of self-medication. A study found that people with mood disorders who used drugs to self-medicate their symptoms were more likely to develop substance dependence. Furthermore, people who have a substance use disorder co-occurring with another mental illness often have symptoms that are worse, more enduring, and more difficult to treat than patients who just have one or the other.
There are certain factors that make a person more likely to develop a mental health disorder. These include family history, personal history, biological and environmental factors, stress, genetics, and poor social support such as:
These predispositions do not necessarily mean that a person will develop a mental health disorder, but they can increase the likelihood that one will. Because certain substance use disorders sometimes associate with specific mental health disorders, there may also be a direct correlation between having a particular mental health disorder and developing an addiction to a particular type of drug, and vice versa. This may be a factor in the correlation of alcohol with depression or of stimulants with psychotic disorders.
If there is a mental health problem that has not been addressed, there are several potential outcomes.
First, left untreated, mental health issues can worsen, deteriorating the person’s quality of life and having a negative effect on loved ones and on the person’s responsibilities. In some cases, this can lead to other societal issues, such as homelessness, legal troubles, violence, and victimization.
Also, the person may choose to self-medicate, as discussed above. In this case, the person may develop the additional challenge of a substance use disorder or addiction. If this occurs, the substance may adversely affect the mental illness in a way that is unexpected, causing a spiraling effect that makes both disorders worse, resulting in issues that are more complicated and time-consuming to treat. Without treating all aspects of co-occurring disorders, the individual disorders are more likely to recur, and the person is more likely to relapse into both the mental illness and the substance abuse.
WHAT DRUGS ARE ABUSED THE MOST IN NEW JERSEY?
The most common illicit drug used in New Jersey is marijuana, based on 2015-2016 surveys of past month use. Approximately 511,000 people aged 12 and older had used marijuana in the past month, whereas about 220,000 people aged 12 and older had used illicit drugs other than marijuana in the past month. An estimated 283,000 people aged 12 or older had misused pain relievers in the past year in New Jersey. Approximately 145,000 people aged 12 or older in New Jersey had used cocaine in the past year, and about 38,000 had used heroin in the past year.
Heroin, controlled prescription drugs, and methamphetamine were reported by survey respondents in New York and New Jersey as the greatest drug threats in the area in 2014.
Alcohol is another common substance of abuse in New Jersey, with approximately 1,758,000 individuals aged 12 and older reporting binge drinking in the past month, and about 365,000 individuals aged 12 and older having an alcohol use disorder in the past year.
HOW CAN I GET THE HEROIN OVERDOSE DRUG?
In New Jersey, naloxone can be prescribed by a doctor to someone who is deemed to be in a position to help someone during an opioid overdose. The person who prescribes the drug should make sure that the person receiving the prescription understands the signs of an overdose, the importance of calling 911, and how to care for the person who has overdosed. If the necessary conditions are met, the person who uses naloxone is subject to certain levels of immunity from liability.
IS DRUG TRAFFICKING A MAJOR PROBLEM IN NEW JERSEY?
New Jersey does have major drug trafficking problems. In 2014 and 2015, a leader of a major drug trafficking organization and 19 other members of the organization were charged with conspiring to distribute heroin in New Jersey. Columbian drug trafficking organizations are the dominant distributors, bringing heroin, marijuana, and cocaine into the region. Dominican, Mexican, Asian, and Jamaican DTOs also pose a risk to the area, among other smaller groups. As of 2015, eight counties in New Jersey and twenty-one in New York are considered to be major drug trafficking areas.
WHAT HEALTH COMPLICATIONS CAN ARISE FROM PROLONGED COCAINE USE?
Used over a long period of time, cocaine can lead to a variety of mental and physical health complications.
Physical issues can depend on the mode of intake, and include:
Mental complications include:
HOW CLOSE IS NEW JERSEY TO LEGALIZING MARIJUANA?
The state of New Jersey already has a medical marijuana program and passed a law requiring schools to develop marijuana administration policies. Even though marijuana is considered to be one of the most highly available illicit substances in the New Jersey/New York area based on 2014 resident surveys, it is not considered to be a major drug threat by the vast majority of those residents.
New Jersey’s new governor Phil Murphy, sworn in January 2018, aims to legalize marijuana for recreational use in the state. He believes this would reduce mass incarceration and help reform the criminal justice system, as well as increase state revenue from taxes. However, it is unclear if this will succeed due to opposition from within the governor’s own party as well as the opposing party. He is also working to increase access to the state’s medical marijuana program.
WHY ARE SOME SYNTHETIC DRUGS ILLEGAL WHILE OTHERS ARE NOT?
Oftentimes, drug manufacturers alter the composition of synthetic drugs in an effort to stay ahead of legislation efforts. Once a particular synthetic drug becomes outlawed, manufacturers change the makeup somewhat so the new drug is “technically” legal. With new synthetic drugs popping up all the time, lawmakers have trouble keeping up with legislation against these new drugs.
WHY DO SOME PEOPLE BECOME ADDICTED TO THEIR PRESCRIPTION MEDICATIONS?
Prescription medications, such as opioid painkillers and benzodiazepines used for anxiety disorders, are addictive substances that can change brain chemistry over time to create an addiction if the drugs are misused. Generally, if the drugs are used as prescribed, people who use them do not become addicted.
However, even low-dose benzos used over long periods of time can cause changes in the brain that result in dependence. In addition, using these types of medicines inappropriately, such as using them more often than directed or at higher doses than prescribed can result in tolerance, or a need to continue increasing the dose to get the same level of effect.
Because of the changes in the brain that occur, these drugs require managed detox in order to make sure that severe withdrawal problems do not occur. If an addiction to benzos is suspected, medical support for detox is necessary.
HOW DIFFICULT IS IT TO AVOID RELAPSE?
Addiction is considered to be a chronic, recurring mental health disorder. As such, relapse is as common as it is for many chronic disorders, including diabetes, asthma, and high blood pressure.
Because of the physical, psychological, and environmental causes of addiction, relapse is very hard to avoid. For this reason, treatment is designed to provide tools that the person can use to manage physical, psychological, and environmental triggers and cravings. These tools take time to learn and require practice, and they help individuals to avoid relapse. Many people consider residential addiction treatment centers to be the method most likely to result in recovery from addiction and maintenance of sobriety, although the research on this is currently inconclusive.
WHO IS MOST AT RISK TO BECOME ADDICTED TO DRUGS OR ALCOHOL?
Those who are most at risk of developing addiction include people who have:
These risks can be minimized by avoiding use or misuse of drugs or alcohol.
ARE BENZODIAZEPINES AS ADDICTIVE AS OPIATES?
Benzodiazepines and opioids are both highly addictive substances when misused, and both are some of the most often abused classes of psychoactive drugs in the world. As stated above, even low-dose benzos taken for too long can cause changes in the brain that result in dependence.
Both opioids and benzos can cause a relaxing effect that is potentially soothing for those with anxiety. When taken together, opioids and benzos both have modulatory effects on each other, meaning that they each impact how the other affects the body. This may increase the desired effects of the opioid and the benzodiazepine, but it can also increase the risk of certain side effects, such as respiratory depression (slow and/or shallow breathing), loss of consciousness, and death. Furthermore, benzodiazepines may slow down the metabolism of opioids, meaning the opioids may have a longer-lasting effect on the mind and body.
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