FAQ: Addiction & Abuse
Drug abuse and drug addiction are both serious and life-threatening disorders in their own rights. Each one can and will negatively impact the user’s day-to-day experience and ability to function healthfully as well as the lives of friends and loved ones.
The good news is that treatment is available no matter what the drug of choice is, the length of the drug history, or the rate and pattern of use. Here’s what you need to know.
- What’s the difference between abuse and addiction?
- How do you know if someone is addicted to drugs?
- What are the health concerns of drug abuse?
- What are the most addictive drugs?
- Where do illegal drugs come from?
- Why are some drugs illegal while other are not?
- What happens if you mix drugs?
- Is binge drinking a sign of addiction?
- How do drugs make you high?
- What are minimum jail sentences for drug crimes?
What’s the difference between abuse and addiction?
In the simplest terms, substance abuse is defined by heavy use or chronic use of a drug or alcohol that causes negative consequences in the person’s life. Drug addiction usually occurs after a period of drug abuse and is defined by:
- A psychological dependence on the drug of choice (e.g., cravings)
- A physical dependence on the drug of choice and the experience of withdrawal symptoms, physical and/or mental in nature, when without the drug of choice
- Increasing problems caused by use of the drug of choice (e.g., health issues, legal problems, relationship difficulties, etc.)
- An inability to stop using the drug of choice despite a genuine effort
Though substance abuse and addiction are different, it is worth noting that, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) they exist on a spectrum. That is, though the DSM-IV listed substance abuse and addiction as separate disorders, the latest edition acknowledges that both are moderate or severe versions of the same disorder. Someone who lives with addiction likely once would have been diagnosed with substance abuse; likewise, someone who is currently exhibiting substance abuse behaviors is at risk for the development of addiction.
How do you know if someone is addicted to drugs?
- The fact that addiction is a concern: Substance abuse or addiction is rarely ever a concern when it is clear that there is not a problem. Only those who drink heavily and/or use a significant amount of legal or illegal addictive substances on a regular basis are concerned that they may be living with addiction – and in most cases, they are indeed struggling somewhere on the spectrum of a substance use disorder.
- Changes in personality: The person may once have had a sense of humor and loved hanging out with friends, and now would rather be alone. Conversely, if someone was once shy and now regularly drinks heavily and jumps into the spotlight or is suddenly very chatty and social, it can indicate a problem as well. Extreme changes in personality that are not clearly caused by other events (e.g., depression after a divorce or loss of a loved one) when drug or alcohol use is an issue can indicate a disorder.
- Lying, stealing, and other dishonest choices: Generally, people lie when they feel they have something to hide. Similarly, stealing and being dishonest in order to cover the use of drugs and alcohol or to buy more is a clear sign of a problem.
- Significant time spent under the influence: “Normal” use of alcohol is defined by having no more than a drink or two a day, and no use of illegal substances or legal drugs outside of their indicated use is considered appropriate. When someone spends a significant amount of time under the influence, recovering from using, or seeking substances, it’s a sign of addiction.
- Isolating if unable to be with others who drink or get high: Spending time alone or shifting to a pattern of spending time only with others who abuse substances heavily can indicate addiction as well.
What are the health concerns of drug abuse?
Both physical and mental health issues result from chronic drug abuse. However, the specifics as well as the intensity of symptoms and disorders will vary based upon:
- The drug of choice
- Interactions with multiple substances
- The length of time spent living in active addiction
- Trauma and other occurrences during active addiction
- Co-occurring mental health disorders
- The support available during detox, addiction treatment, and beyond
It is not uncommon for those who are physically dependent upon their drug of choice to experience cravings and other withdrawal symptoms that require physical attention. These are acute issues, however, and pass in a few weeks, in most cases, unless the person opts for long-term medication-assisted detox.
Unfortunately, ongoing drug and alcohol use can contribute to the development of chronic physical disorders and, in some cases, mental health disorders as well – or it can exacerbate a co-occurring or underlying condition. Though immediate cessation of use may be able to stop further problems from starting, it may not be possible to reverse the damage completely. Again, it depends heavily on the details of the individual’s experience. No matter what the circumstances, however, getting help to stop using drugs and alcohol as soon as possible is always the best choice for optimum physical and mental health.
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What are the most addictive drugs?
This is a tough question to answer, because everyone is different. One person may easily have a drink or two a few times a week without it ever causing a problem while someone else may be hooked with a month of regular drinking. Similarly, one person may have a preference for the effects of a certain type of high created by a substance – that is, the stimulant effect provided by cocaine or crystal meth versus the sedative effect of painkillers or heroin – and find that one is impossible to resist while someone else could take it or leave it.
The debate is significant on this topic, however. One source says that cigarettes are the most addictive drug, while another says that opiates like heroin and painkillers are the obvious choice for the top spot in this category. Yet another says that benzodiazepines and alcohol are far more addictive and deadly because withdrawal from these substances without the support of a medical professional can be deadly.
Where do illegal drugs come from?
Depending on the substance and region, the point of origin for different illegal drugs will vary. For example, black tar heroin sold on the West Coast is usually from Mexico but can also come from the Middle East, while the white version of the drug sold on the East Coast is often from Colombia. It may also be from Southeast or Southwest Asia.
Other drugs are manufactured right here in the United States. Crystal meth, for example, may be smuggled in from Mexico, but it can also be made in the US. Similarly, bath salts and other synthetic drugs may originate in China, but they can also be made here using chemicals shipped from abroad.
Marijuana, still illegal federally, can be grown here – in some cases, legally if for medicinal purposes – but it is also commonly smuggled in from Mexico.
Cocaine usually comes from South America, often Colombia, Peru, and Bolivia.
It’s important to note that the methods of transport are rarely safe or hygienic, which can significantly alter the drug and increase risk. Additionally, drugs are almost always altered or cut when they arrive in the United States before they are sold. Thus, one batch of an illegal drug from a single location can vary in potency and effect in different regions depending upon how dealers choose to distribute it.
Why are some drugs illegal while other are not?
Some drugs have been identified as medically useful, and thus are legal for use for a particular purpose. Use outside of this context, however, is illegal. For example, prescription painkillers are legal for use as long as the person using them has a prescription and follows doctor’s dosing orders, continuing to check in with the doctor as required to maintain the prescription as long as it is necessary to manage pain.
When it comes to substances that are legal for recreational use that have no medicinal value – like alcohol, and in some states, marijuana – there is a large faction that questions the validity of that choice. However, because only a percentage of people who use the drugs develop an addiction or other life-altering disorder as a result of use, they remain legal, though there are restrictions put into place to protect those who purchase and use these products. Legal age of use, restrictions while driving under the influence, and purchasing restrictions help to make sure that precaution is taken as much as possible.
The fact remains, however, that millions struggle with addiction to legal substances, and many more have lost their lives to substance abuse and addiction. Despite this fact, the Prohibition Era in the 1920s demonstrated that when alcohol was made illegal due to its risks, use did not stop. Thus, regulating and taxing alcohol have become standard.
What happens if you mix drugs?
Mixing illicit substances is not uncommon. Unfortunately, it is very frequently the cause of fatal overdose. For example, when people take prescription painkillers in order to manage chronic pain or sedatives to manage an anxiety disorder, they may not realize that even a single alcoholic beverage can create a synergistic effect, causing both the drink and the medication to be far more potent than either alone. This can mean a sudden and unexpectedly overwhelming high that can cause the respiratory system to slow or stop, or the body to otherwise shut down.
Another common scenario occurs when alcohol and cocaine are mixed. Someone interested in spending time with friends and drinking recreationally may seek assistance in staying awake to continue their good time by engaging in cocaine use throughout the evening. However, it’s not just a synergistic effect that occurs in this case; these two substances together create a third substance called cocaethylene. This substance can build up in the liver over years of use, causing long-term damage and life-threatening consequences down the road – if the person does not succumb to overdose, fatal medical emergency, or accident under the influence while actively using the two substances.
Is binge drinking a sign of addiction?
Yes and no. Addiction to alcohol is defined by physical and/or mental withdrawal symptoms when without alcohol and an inability to control the impulse to drink. Many binge drinkers can go weeks or months without taking a drink; however, many people who are living with an addiction to alcohol binge drinking regularly.
Binge drinking is defined as having four or more drinks in a two-hour period for women, and five or more drinks in that same amount of time for men. The Centers for Disease Control and Prevention (CDC) report that about half of all alcohol ingested in the United States is consumed in a binge drinking session. Just as with any chronic drinking behavior, binge drinking can lead to an addiction. If it occurs daily or on an ongoing basis and is the cause of serious social, mental, and physical issues, and the person is unable to stop alone, it can indicate that someone is living with an addiction.
How do drugs make you high?
The specific mechanism of every illicit substance is different, and the euphoric feeling, or high, is different as a result. In general, however, drugs work by triggering the pleasure pathway or reward system in the brain. This often occurs by triggering a release of dopamine and then blocking the reuptake of that chemical, causing an extended and intense period of good feelings.
The high can trigger cravings for that feeling and the desire to experience it again and again. “Chasing” a high rarely yields the same intensity of experience, yet the compulsion to continue using does not go away. Instead, continued use physically alters the structure and function of the brain, with the end result that the user continues to use the drug to the exclusion of all else.
What are minimum jail sentences for buying, selling or trafficking certain drugs?
Federal law requires a minimum sentencing requirement when someone breaks certain laws, including buying, selling, or trafficking different drugs. These sentences vary based on:
- The amount of the drug seized during the arrest
- The number of prior offenses
- State law on the particular substance and/or amount
- The nature of the crime (e.g., intent to sell, selling near a school, etc.)
- Whether or not serious bodily harm results
For example, some of the most stringent minimum sentences occur when an arrest yields a seizure of:
- 1000+ kilograms of marijuana
- 1000+ marijuana plants
- 5+ kilograms of cocaine
- 1+ kilogram of heroin
- 1+ kilogram of PCP mixture
- 100+ grams of pure PCP
- 280+ grams of crack cocaine
- 10+ grams of LSD
- 500+ grams of a crystal meth mixture
- 50+ grams of pure crystal meth
The mandatory minimum penalty will vary depending upon whether or not it is the first, second, or third offense, and whether or not serious bodily harms occurs due to the person’s actions in regard to the drug in question.