DRUG DEPENDENCE: SYMPTOMS, TYPES AND EFFECTS - ARTE - 2025

The drug dependence or drug abuse addiction is based on frequent abuse and drug use. Drug addicts need increasing amounts of a substance to experience its effects.

This is known as tolerance, that is, the body has become used to the effects of the drug / substance and needs larger amounts to produce its effects. On the other hand, the drug-dependent person will experience withdrawal; negative responses and discomfort when not using the substance.

Withdrawal syndrome can be easily observed in everyday life. For example, headaches from not smoking for several hours. There are also much more serious withdrawal: in delirium tremes (alcohol withdrawal), in which hallucinations and strange bodily sensations can be experienced. In abstinence from cocaine, you experience anxiety, boredom and lack of motivation.

However, not all substances cause withdrawal. For example, stopping using marijuana or LSD does not lead to physical withdrawal.

Something important to note is that there can be dependency without abuse. For example, cancer patients can become dependent on morphine and not abuse it.

On the other hand, there can also be drug use without creating dependence. For example, there are people who drink alcohol socially or who occasionally use cocaine.

How does drug addiction develop?

If you experiment with a drug and continue to use it, it is because the substance makes you feel better or reduces pain.

There is a fine line between people who are addicted and those who use normally. Also, some addicts have a hard time acknowledging that they have crossed that line.

1- Drug use tends to increase gradually: you can start by consuming a small joint of marijuana, then go on to do it weekly and then daily.

2- If the drug solves a need, its consumption is more likely to increase. For example, if you have a lack of energy or feel depressed and a drug makes you feel more energetic, you are more likely to become addicted to it.

3- When drug use becomes necessary to solve the problem (depression, anxiety, loneliness, lack of energy…) and its use cannot be controlled, dependence comes.

4- The organism's tolerance towards the drug occurs. That is, it is necessary that you take larger amounts so that the drug causes its benefits in you (feel more animated, without anxiety, calm, energetic…).

5- You take more and more amounts, which makes you more dependent and more difficult to get out of the vicious circle. Tolerance and dependence mean that consumption can be daily and even several times a day.

6-The increase in consumption and dependence deteriorates social functioning: work life, social life, family…

7- Impaired functioning can cause more problems, which makes drug use more likely.

As you can see, drug use can become a vicious cycle. A simple step like tasting a small amount can lead to frequent consumption.

The good news is that you have a solution with the right effort, support, and treatment.

The first step is to admit that you have a problem and allow those close and interested to help you overcome the addiction.

Why do some people get addicted and others don't?

People take drugs for very different reasons:

• Curiosity.
• Have fun or feel accepted socially.
• Improve physical performance.
• Relieve stress, anxiety or depression.

It does not matter how many drugs you are using. If its use is causing problems in your life, you probably have an addiction problem. The vulnerability to becoming addicted is different from person to person. The risk factors that increase your vulnerability are:

• Traumatic experiences in childhood, abuse or neglect.
• Family history of addictions.
• Disorder such as anxiety or depression.
• Early drug use.

Symptoms of drug abuse

If you are a drug dependent person, the dependency will show three main effects: psychological dependence (psychological symptoms), substance / drug seeking behaviors (behavioral symptoms) and physical symptoms.

Symptoms of psychological dependence

• Anxiety.
• Depression.
• Changes in personality or attitude.
• Periods of hyperactivity or unusual agitation.
• Lack of motivation.
• Inability to concentrate
• Social isolation.
• Fearful, anxious, paranoid appearance.
• You may want to stop using but you can't.

Physical symptoms

• Muscular weakness.
• Nightmares.
• Body pain.
• Perspiration.
• Sickness.
• Vomiting
• Frequent nosebleeds.
• Changes in appetite or sleep patterns. Sudden weight loss or gain.
• "Bloodshot" eyes.
• Seizures without a history of epilepsy.
• Deterioration of physical appearance.
• Injuries or accidents without being able to explain.
• Body, clothing, or breath odors.
• Tremors, difficulty speaking, unstable coordination.

Behavioral symptoms

• Desperate need to ingest more of the substance.
• Financial problems, stealing money to use drugs.
• Decrease in attendance at work, school or university.
• Shortage of leisure activities, sports, exercise.
• Complaints from coworkers, supervisors or teachers.
• Social isolation, engaging in suspicious or strange behavior.
• Sudden change in personal relationships, friends, or hobbies.
• Participate frequently in problems: arguments, accidents, illegal activities…

Common drug signs

• Marijuana: red eyes, loud talking, inappropriate laughter, drowsiness, loss of interest, demotivation, weight gain or loss.
• Tranquilizers (valium, xanax): constricted pupils, difficulty concentrating, poor judgment, drowsiness, difficulty speaking, clumsiness, lack of judgment.
• Stimulants (amphetamines, cocaine): dilated pupils, hyperactivity, euphoria, irritability, anxiety, talking too often due to depression, long periods of time without sleeping or eating, weight loss, dry mouth and nose.
• Inhalants (aerosols, glues): watery eyes, visual disturbances, runny nose, headaches, nausea, drowsiness, muscle control, changes in appetite, irritability.
• Hallucinogens (LSD, PCP): dilated pupils, irrational thinking, paranoia, aggression, hallucinations, mood swings, detachment from people, absorption with objects or with oneself, confusion, difficulties speaking.
• Heroin: no response of the pupils to light, constricted pupils, needle marks, sleeping at inappropriate times, vomiting, coughing, loss of appetite, spasms, mucus.

The most addictive drugs

The vulnerability of a person to develop dependence depends on individual traits; physiology, psychology, and social and economic pressures.

The following classification (Franklin, 1990) is based on the inherent addictive potential of substances.

1. Nicotine.
2. Inhaled methamphetamines.
3. Crack.
4. Injected methamphetamine.
5. Valium (diazepam).
6. Melaqualone.
7. Seconal (Secobarbital).
8. Alcohol.
9. Heroin.
10. Crank (amphetamine taken nasally).
11. Cocaine.
12. Caffeine.
13. Phencyclidine.
14. Marijuana
15. Ecstasy (MDMA).
16. Psilocybin mushrooms.
17. LSD.
18. Mezcaline.

Types of drugs / substances

• Tranquilizers: these are substances that produce a feeling of tranquility and behavioral sedation. They can be barbiturate anxiolytics, benzodiazepines, alcohol, hypnotics.
• Stimulants: substances that increase physiological arousal and possibly increase mood. They can be cocaine, amphetamines, nicotine, and caffeine.
• Opiates: substances that produce euphoria and a temporary reduction in pain. They can be heroin, codeine, morphine, and opium.
• Hallucinogens: substances that alter temporal perception and can cause delusions, hallucinations and paranoia. They can be LSD and marijuana.
• Others: prescription or non-prescription drugs, inhalants (glue), anabolic steroids.

Effects at the brain level

Although each drug produces a different physical effect, all the substances that are abused have something in common: their repeated use can alter the structure and functioning of the brain.

• Taking recreational drugs can cause the brain's dopamine level to rise, triggering feelings of pleasure. Your brain becomes dependent on those sensations.
• When you get addicted, the substance becomes of the same importance as other behaviors such as eating or drinking.
• Changes in your brain interfere with your ability to think clearly, control your behavior, or feel emotionally balanced.
• The use of the substance becomes uncontrollable and becomes more and more important, even than work, friends or family.
• You can deny or rationalize your addiction.

Diagnostic criteria for drug dependence

A maladaptive pattern of substance use that leads to clinically significant impairment or distress, expressed by three (or more) of the following items at some point in a continuous 12-month period:

1) Tolerance, defined by any of the following items:

a) a need for markedly increasing amounts of the substance to achieve the intoxication or desired effect.

b) the effect of the same amounts of substance clearly reduces their continued use.

2) Abstinence, defined by any of the following items:

a) the characteristic withdrawal syndrome for the substance.

b) the same substance is taken to relieve or avoid withdrawal symptoms.

3) The substance is often taken in larger amounts or for a longer period than was initially intended.

4) There is a persistent desire or influential efforts to control or discontinue use of a substance.

5) A lot of time is spent on activities related to obtaining the substance, consuming the substance, or recovering from the effects of the substance.

6) Reduction of important social, work or recreational activities due to the consumption of the substance.

7) Continuing to take the substance despite being aware of recurring or persistent psychological or physical problems, which appear to be caused or exacerbated by substance use.

Specify if:

• With physiological dependence: signs of tolerance or withdrawal.
• No physiological dependence: there are no signs of tolerance or withdrawal.

Treatment

Substance abuse is not easy to treat and it is recommended that a diagnosis, evaluation and follow-up be carried out by a professional.

Treatment begins with recognizing the problem. Although denial is a normal symptom of addiction, it is less likely if the addicted person is treated with respect and empathy.

The main goal of treatment is abstinence; the substance can be withdrawn abruptly or slowly. Support to cope with withdrawal is key to treatment.

With this main goal, there are different types of treatments.

Biological treatments

• Substitution by agonists: consists of providing the person with a safe substance with a composition similar to the addictive drug. For example, methadone is used as a replacement for heroin (although it also causes dependence, in tolerance it loses its analgesic and sedative qualities), nocithin is replaced by gum or patches.
• Antagonist treatments: antagonist substances block or counteract the effects of psychoactive substances. For example, naltrexone has been evaluated as a treatment for alcohol and opiate dependence.
• Aversive treatments: this is the prescription of drugs that make the ingestion of substances unpleasant. For example, those who drink alcohol after taking antabuse experience nausea, vomiting, and a high heart rate. In this way alcohol is associated with unpleasant sensations.

Others: Clonidine is used to treat hypertension caused by withdrawal from opiates, benzodiazepines for withdrawal.

Psychosocial treatments

To overcome drug addiction, social support or therapeutic intervention is very important.

• Internment: Currently most addiction treatment facilities are private and often very expensive. Research in alcoholic or drug addicted patients suggests that there may be no difference between these intensive and external programs.
• Component Treatment - Most addiction treatments contain multiple components. For example, aversive therapy (associating substance use with unpleasant sensations), covert sensitization (negatively associating consumption with unpleasant sensations, albeit in the imagination), contingency management (choosing behaviors that are needed to change and the reinforcers that will reward), community reinforcement (correct aspects of the person's life).
• Support Groups: Groups like Alcoholics Anonymous provide social support and help to addicted people.

Recovery from drug addiction is easier when you have social support and encouragement from other people.

Support can be found at:

• Family members.
• Close friends.
• Therapists
• Support groups or people who have already recovered.
• Health centers.

How to help drug addicts?

If you think or know that a family member has a drug addiction, you can act as follows:

• Talk to him / her: Talk about your concerns and offer help / support without judgment. The sooner the addiction is treated, the better.
• Take care of yourself: don't deny your own needs and make sure you have support for yourself. Don't put yourself in dangerous situations.
• Avoid guilt: it is impossible to force someone to receive treatment, you cannot control someone else's decisions. Guilt is not a good way to provoke decisions.
• Avoid threatening, bribing or insulting.
• Avoid taking over your responsibilities.
• Avoid arguing if your partner / friend / family member is high.
• Avoid taking drugs with the addict.
• Avoid feeling guilty about someone else's behavior.

Myths about drug abuse

Addiction is a disease, nothing can be done

Although experts agree that addiction is a brain disease, that doesn't mean there are no solutions. Brain changes associated with addiction can be treated with therapy, medication, and exercise.

Overcoming addiction is a matter of willpower

The prolonged use of drugs produces brain changes that make it extremely difficult to avoid consumption simply by force of will.

Addicts have to touch funds before recovering

Recovery can begin at any point in the drug addiction process and the sooner the better.

Only those who want to recover

People who are under pressure to be treated by their family, business, or court system are just as likely to recover as those who are voluntarily treated.

If it hasn't been done before, the treatment won't work

Recovery from addiction is a long process. Relapse does not mean that treatment has failed. Rather, it is a sign that treatment needs to be continued or readjusted.

Relapse prevention

To prevent future consumption it is recommended:

• Avoid places frequented by addicts.
• Avoid associating with addicts.
• Eliminate or change positive beliefs about drugs. Confront positive opinions with negative consequences. For example: although it can produce well-being, in the long term it causes family and health problems.
• Stimulate positive habits: physical exercise, healthy personal relationships, healthy eating…
• Training plans and life plan: encourage the person to set goals and be motivated to achieve positive achievements for their life.

Forecast

If left untreated, drug abuse can be very dangerous. Increasing the use of drugs as the body adapts to them - tolerance - increases the possibility of overdose and death.

Dependence is easier to overcome if treatment is carried out early.

What are your experiences with drug dependence or drug abuse? I am interested in your opinion. Thank you!

References

1. DSM-IV & DSM-IV-TR: Substance Dependence.
2. "NHS and Drug Abuse". National Health Service (NHS). March 22, 2010. Retrieved March 22, 2010.