The initial decision to take drugs is typically voluntary. But with continued use, a person's ability to exert self-control can become seriously impaired. This impairment in self-control is the hallmark of addiction.
As with other diseases and disorders, the likelihood of developing an addiction differs from person to person, and no single factor determines whether a person will become addicted to drugs. In general, the more risk factors a person has, the greater the chance that taking drugs will lead to drug use and addiction. Protective factors, on the other hand, reduce a person's risk. Risk and protective factors may be either environmental or biological.
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Biological factors that can affect a person's risk of addiction include their genes, stage of development, and even gender or ethnicity. Scientists estimate that genes, including the effects environmental factors have on a person's gene expression, called epigenetics, account for between 40 and 60 percent of a person's risk of addiction.27 Also, teens and people with mental disorders are at greater risk of drug use and addiction than others.28
Depending on the actual compound, drug abuse including alcohol may lead to health problems, social problems, morbidity, injuries, unprotected sex, violence, deaths, motor vehicle accidents, homicides, suicides, physical dependence or psychological addiction.[23]
Impulsivity is characterized by actions based on sudden desires, whims, or inclinations rather than careful thought.[33] Individuals with substance abuse have higher levels of impulsivity,[34] and individuals who use multiple drugs tend to be more impulsive.[34] A number of studies using the Iowa gambling task as a measure for impulsive behavior found that drug using populations made more risky choices compared to healthy controls.[35] There is a hypothesis that the loss of impulse control may be due to impaired inhibitory control resulting from drug induced changes that take place in the frontal cortex.[36] The neurodevelopmental and hormonal changes that happen during adolescence may modulate impulse control that could possibly lead to the experimentation with drugs and may lead to addiction.[37] Impulsivity is thought to be a facet trait in the neuroticism personality domain (overindulgence/negative urgency) which is prospectively associated with the development of substance abuse.[38]
A number of medications have been approved for the treatment of substance abuse.[58] These include replacement therapies such as buprenorphine and methadone as well as antagonist medications like disulfiram and naltrexone in either short acting, or the newer long acting form. Several other medications, often ones originally used in other contexts, have also been shown to be effective including bupropion and modafinil. Methadone and buprenorphine are sometimes used to treat opiate addiction.[59] These drugs are used as substitutes for other opioids and still cause withdrawal symptoms but they facilitate the tapering off process in a controlled fashion. When a person goes from using fentanyl every day, to not using it at all, they will experience a point where they need to get used to not using the substance. This is called withdrawal.[citation needed]
Three countries in Europe have active HAT programs, namely England, the Netherlands and Switzerland. Despite critical voices by conservative think-tanks with regard to these harm-reduction strategies, significant progress in the reduction of drug-related deaths has been achieved in those countries. For example, the US, devoid of such measures, has seen large increases in drug-related deaths since 2000 (mostly related to heroin use), while Switzerland has seen large decreases. In 2018, approximately 60,000 people have died of drug overdoses in America, while in the same time period, Switzerland's drug deaths were at 260. Relative to the population of these countries, the US has 10 times more drug-related deaths compared to the Swiss Confederation, which in effect illustrates the efficacy of HAT to reduce fatal outcomes in opiate/opioid addiction.[62][63]
The initiation of drug use including alcohol is most likely to occur during adolescence, and some experimentation with substances by older adolescents is common. For example, results from 2010 Monitoring the Future survey, a nationwide study on rates of substance use in the United States, show that 48.2% of 12th graders report having used an illicit drug at some point in their lives.[66] In the 30 days prior to the survey, 41.2% of 12th graders had consumed alcohol and 19.2% of 12th graders had smoked tobacco cigarettes.[66] In 2009 in the United States about 21% of high school students have taken prescription drugs without a prescription.[67] And earlier in 2002, the World Health Organization estimated that around 140 million people were alcohol dependent and another 400 million with alcohol-related problems.[68]
In order to maintain high-quality performance, some musicians take chemical substances.[102] Some musicians take drugs such as alcohol to deal with the stress of performing. As a group they have a higher rate of substance abuse.[102] The most common chemical substance which is abused by pop musicians is cocaine,[102] because of its neurological effects. Stimulants like cocaine increase alertness and cause feelings of euphoria, and can therefore make the performer feel as though they in some ways 'own the stage'. One way in which substance abuse is harmful for a performer (musicians especially) is if the substance being abused is aspirated. The lungs are an important organ used by singers, and addiction to cigarettes may seriously harm the quality of their performance.[102] Smoking harms the alveoli, which are responsible for absorbing oxygen.
There are many sex differences in substance abuse.[106][107][108] Men and women express differences in the short- and long-term effects of substance abuse. These differences can be credited to sexual dimorphisms in the brain, endocrine and metabolic systems. Social and environmental factors that tend to disproportionately affect women, such as child and elder care and the risk of exposure to violence, are also factors in the gender differences in substance abuse.[106] Women report having greater impairment in areas such as employment, family and social functioning when abusing substances but have a similar response to treatment. Co-occurring psychiatric disorders are more common among women than men who abuse substances; women more frequently use substances to reduce the negative effects of these co-occurring disorders. Substance abuse puts both men and women at higher risk for perpetration and victimization of sexual violence.[106] Men tend to take drugs for the first time to be part of a group and fit in more so than women. At first interaction, women may experience more pleasure from drugs than men do. Women tend to progress more rapidly from first experience to addiction than men.[107] Physicians, psychiatrists and social workers have believed for decades that women escalate alcohol use more rapidly once they start. Once the addictive behavior is established for women they stabilize at higher doses of drugs than males do. When withdrawing from smoking women experience greater stress response. Males experience greater symptoms when withdrawing from alcohol.[107] There are gender differences when it comes to rehabilitation and relapse rates. For alcohol, relapse rates were very similar for men and women. For women, marriage and marital stress were risk factors for alcohol relapse. For men, being married lowered the risk of relapse.[108] This difference may be a result of gendered differences in excessive drinking. Alcoholic women are much more likely to be married to partners that drink excessively than are alcoholic men. As a result of this, men may be protected from relapse by marriage while women are at higher risk when married. However, women are less likely than men to experience relapse to substance use. When men experience a relapse to substance use, they more than likely had a positive experience prior to the relapse. On the other hand, when women relapse to substance use, they were more than likely affected by negative circumstances or interpersonal problems.[108]
Drug use and addiction are preventable. Prevention programs involving families, schools, communities, and the media may prevent or reduce drug use and addiction. These programs include education and outreach to help people understand the risks of drug use.
People can get addicted to all sorts of substances. When we think of addiction, we usually think of alcohol or street drugs. But people become addicted to prescription medicines, cigarettes, even sniffing glue.
Psychological addiction happens when the cravings for a drug are psychological or emotional. People who are psychologically addicted feel overcome by the desire to have a drug. They may lie or steal to get it.
The most obvious sign of an addiction is the need to have a particular drug or substance. But many other signs can suggest a possible addiction, such as changes in mood or weight loss or gain. (These also are signs of other conditions too, though, such as depression or eating disorders.)
Overcoming addiction is not easy. Quitting drugs or drinking is probably going to be one of the hardest things you or your friend do. It's not a sign of weakness if you need professional help from a trained drug counselor or therapist. Most people who try to kick a drug or alcohol problem need professional help or a treatment program to do so.
Recovering from a drug or alcohol addiction doesn't end with a 6-week treatment program. It's a lifelong process. Many people find that joining a support group can help them stay clean. There are support groups specifically for teens and younger people. You'll meet people who have gone through the same experiences, and you can have real-life discussions about drugs that you won't hear in your school's health class. e24fc04721
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