FAQ: Addiction & Abuse

Drug use and drug addiction are both serious and life-threatening disorders in their own rights. Each one can and will negatively impact a person’s day-to-day experience and ability to function healthily,  as well as affecting the lives of friends, family, 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?

man sitting on the edge of a bed and feeling sick from the symptoms of drug withdrawal

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 use 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 use 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?

There are a number of signs that can indicate that someone is struggling with a substance abuse or addiction disorder. These include:

  • 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, but 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.

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 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.

What Are the Health Concerns of Drug Use?

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 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 professional help. 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.

What Are the Most Addictive Drugs?

Not everyone will experience drug use in the same way, or necessarily become addicted to a particular drug. 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 (e.g., 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.

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, 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.

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.

Why Are Some Drugs Illegal While Others Are Not?

Some drugs have been identified as medically useful, and 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 – 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. However, 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?

Polysubstance use — or 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. Some people may use cocaine in order to minimize the sedative effects of alcohol. 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.

Getting Help for Substance Use Disorders

If you or someone you love is struggling with addiction to drugs or alcohol, there is safe and effective help available. The caring and compassionate team of addiction specialists at our inpatient drug rehab in New Jersey are ready to help you get on the road to recovery and back to living the life you deserve.

Contact our knowledgeable and helpful admissions navigators at to learn more about Sunrise House’s different levels of care, how to start the admissions process, and to learn about using your insurance for rehab. They can even help you make travel arrangements.

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