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Substance Abuse and Addiction

Signs and Symptoms of Substance Abuse

If you’re wondering whether you have a substance abuse problem, the following questions may help. The more “yes” answers, the more likely your drinking or drug use is a problem.

  • Have you ever felt you should cut down on your drinking or drug use?
  • Have you tried to cut back, but couldn’t?
  • Do you ever lie about how much or how often you drink or use drugs?
  • Have your friends or family members expressed concern about your alcohol or drug use?
  • Do you ever feel bad, guilty, or ashamed about your drinking or drug use?
  • On more than one occasion, have you done or said something while drunk or high that you later regretted?
  • Have you ever blacked out from drinking or drug use?
  • Has your alcohol or drug use caused problems in your relationships
  • Has you alcohol or drug use gotten you into trouble at work or with the law?

What comes first: Substance abuse or the mental health problem?

Addiction is common in people with mental health problems, and although substance abuse and mental health disorders like depression and anxiety are closely linked, one does not directly cause the other.

  • Alcohol or drugs are often used to self-medicate the symptoms of depression or anxiety. Unfortunately, substance abuse causes side effects and in the long run worsens the very symptoms they initially numbed or relieved.
  • Alcohol and drug abuse can increase underlying risk for mental health problems and/or can make symptoms of a mental health problem worse.

According to reports published in the Journal of the American Medical Association:

  • Roughly 50 percent of individuals with severe mental disorders are affected by substance abuse.
  • 37 percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.
  • Of all people diagnosed as mentally ill, 29 percent abuse either alcohol or drugs.

Source: National Alliance on Mental Illness

ALCOHOL ABUSE & ALCOHOLISM

A destructive pattern of alcohol use that includes tolerance to or withdrawal from the substance, using more alcohol or using it for longer than planned, and trouble reducing its use or inability to use it in moderation. Other potential symptoms include spending an inordinate amount of time getting, using, or recovering from the use of alcohol, compromised functioning, and/or continuing to use alcohol despite an awareness of the detrimental effects it is having on one’s life.

Signs and Symptoms of Alcoholism (alcohol dependence):

Alcoholism is the most severe form of problem drinking. Alcoholism involves all the symptoms of alcohol abuse, but it also involves another element: physical dependence on alcohol. If you rely on alcohol to function or feel physically compelled to drink, you’re an alcoholic.

1. Tolerance: The 1st major warning sign

Do you have to drink a lot more than you used to in order to get buzzed or to feel relaxed? Can you drink more than other people without getting drunk? These are signs of tolerance, which can be an early warning sign of alcoholism. Tolerance means that, over time, you need more and more alcohol to feel the same effects.

2. Withdrawal: The 2nd major warning sign

Do you need a drink to steady the shakes in the morning? Drinking to relieve or avoid withdrawal symptoms is a sign of alcoholism and a huge red flag. When you drink heavily, your body gets used to the alcohol and experiences withdrawal symptoms if it’s taken away. These include:

  • Anxiety or jumpiness
  • Shakiness or trembling
  • Sweating
  • Nausea and vomiting
  • Insomnia
  • Depression
  • Irritability
  • Fatigue
  • Loss of appetite
  • Headache

In severe cases, withdrawal from alcohol can also involve hallucinations, confusion, seizures, fever, and agitation. These symptoms can be dangerous, so talk to your doctor if you are a heavy drinker and want to quit.

Other signs and symptoms of Alcoholism:

  • You’ve lost control over your drinking – You often drink more alcohol than you wanted to, for longer than you intended, or despite telling yourself you wouldn’t.
  • You want to quit drinking, but you can’t – You have a persistent desire to cut down or stop your alcohol use, but your efforts to quit have been unsuccessful.
  • You have given up other activities because of alcohol – You’re spending less time on activities that used to be important to you (hanging out with family and friends, pursuing your hobbies, going to the gym) because of your alcohol use.
  • Alcohol takes up a great deal of your energy and focus – You spend a lot of time drinking, thinking about it, or recovering from its effects. You have few if any interests or social involvements that don’t revolve around drinking.
  • You drink even though you know it’s causing problems – For example, you recognize that your alcohol use is damaging your marriage, making your depression worse, or causing health problems, but you continue to drink anyway.

Drinking and Denial

Denial is one of the biggest obstacles to getting help for alcohol abuse and alcoholism. The desire to drink is so strong that the mind finds many ways to rationalize drinking, even when the consequences are obvious. By keeping you from looking honestly at your behavior and its negative effects, denial also exacerbates alcohol-related problems with work, finances, and relationships.

If you have a drinking problem, you may deny it by:

  • Drastically underestimating how much you drink
  • Downplaying the negative consequences of your drinking
  • Complaining that family and friends are exaggerating the problem
  • Blaming your drinking or drinking-related problems on others

If you find yourself rationalizing your drinking habits, lying about them, or refusing to discuss the subject, take a moment to consider why you’re so defensive. If you truly believe you don’t have a problem, there should be no reason for you to cover up your drinking or make excuses.

Myths about Alcohol Abuse and Alcoholism

Myth: I can stop drinking anytime I want to.
Fact: Maybe you can; more likely, you can’t. Either way, it’s just an excuse to keep drinking. The truth is, you don’t want to stop. Telling yourself you can quit makes you feel in control, despite all evidence to the contrary and no matter the damage it’s doing.

Myth: My drinking is my problem. I’m the one it hurts, so no one has the right to tell me to stop.
Fact: It’s true that the decision to quit drinking is up to you. But you are deceiving yourself if you think that your drinking hurts no one else but you. Alcoholism affects everyone around you – especially the people closest to you. Your problem is their problem.

Myth: I don’t drink every day, so I can’t be an alcoholic OR I only drink wine or beer, so I can’t be an alcoholic.
Fact: Alcoholism is NOT defined by what you drink, when you drink it, or even how much you drink. It’s the EFFECTS of your drinking that define a problem. If your drinking is causing problems in your home or work life, you have a drinking problem – whether you drink daily or only on the weekends, down shots of tequila or stick to wine, drink three bottles of beers a day or three bottles of whiskey.

Myth: I’m not an alcoholic because I have a job and I’m doing okay.
Fact: You don’t have to be homeless and drinking out of a brown paper bag to be an alcoholic. Many alcoholics are able to hold down jobs, get through school, and provide for their families. Some are even able to excel. But just because you’re a high-functioning alcoholic doesn’t mean you’re not putting yourself or others in danger. Over time, the effects will catch up with you.

Myth: Drinking is not a “real” addiction like drug abuse.
Fact: Alcohol is a drug, and alcoholism is every bit as damaging as drug addiction. Alcohol addiction causes changes in the body and brain, and long-term alcohol abuse can have devastating effects on your health, your career, and your relationships. Alcoholics go through physical withdrawal when they stop drinking, just like drug users do when they quit.

Effects of Alcoholism and Alcohol Abuse:

Alcoholism and alcohol abuse can affect all aspects of your life. Long-term alcohol use can cause serious health complications, affecting virtually every organ in your body, including your brain. Problem drinking can also damage your emotional stability, finances, career, and your ability to build and sustain satisfying relationships. Alcoholism and alcohol abuse can also have an impact on your family, friends and the people you work with.

Health Complications:

  • Increased incidence of cancer, particularly cancer of the larynx, esophagus, liver, and colon
  • Alcoholic Hepatitis
  • Acute and/or chronic pancreatitis – inflammatory disease of the pancreas
  • Cirrhosis of the liver – alcohol abuse can cause alcohol hepatitis, which leads to cirrhosis (scarring of the living and failure)
  • Alcoholic neuropathy – degenerative changes in the nervous system affecting nerves responsible for sensation and movement
  • Alcoholic cardiomyopathy (weakening of the heart muscle)
  • High blood pressure
  • Nutritional deficiencies – vitamin B12, folate, and thiamine
  • Erectile dysfunction
  • Cessation of menses
  • Fetal alcohol syndrome in the children of women who drink during pregnancy
  • Depression
  • Traffic fatalities
  • Accidental deaths
  • Increased risk of suicide
  • Alcohol dementia
  • Wernicke-Korsakoff syndrome or Wernicke’s encephalopathy

The effects of Alcohol Abuse and Alcoholism on the people you love:

Despite the potentially lethal damage that heavy drinking does to the body – including cancer, heart problems, and liver disease – the social consequences can be just as devastating. Alcoholics and alcohol abusers are much more likely to get divorced, have problems with domestic violence, struggle with unemployment, and live in poverty. But even if you’re able to succeed at work or hold your marriage together, you can’t escape the effects that alcoholism and alcohol abuse has on your personal relationships. Drinking problems put an enormous strain on the people closest to you. Often, family members and close friends feel obligated to cover for the person with the drinking problem. So they take on the burden of cleaning up your messes, lying for you, or working more to make ends meet. Pretending that nothing is wrong and hiding away all of their fears and resentments can take an enormous toll. Children are especially sensitive and can suffer long-lasting emotional trauma when a parent or caretaker is an alcoholic or heavy drinker.

Getting help for Alcohol Abuse or Alcoholism

If you’re ready to admit you have a drinking problem, you’ve already taken the first step. It takes tremendous strength and courage to face alcohol abuse and alcoholism head on. Reaching out for support is the second step.

Whether you choose to go to rehab, rely on self-help programs, get therapy, or take a self-directed treatment approach, support is essential. Recovering from alcohol addiction is much easier when you have people you can lean on for encouragement, comfort, and guidance. Without support, it’s easy to fall back into old patterns when things get tough.

Your continued recovery depends on continuing mental health treatment, learning healthier coping strategies, and making better decisions when dealing with life’s challenges. In order to stay alcohol-free for the long term, you’ll also have to face the underlying problems that led to your alcoholism or alcohol abuse in the first place. Such problems may become more prominent when you’re no longer using alcohol to cover them up, but you will be in a healthier position to finally address them and seek the help you need.

Helping a loved one with Alcohol Abuse or Alcoholism

If someone you love has a drinking problem, you may be struggling with a number of painful emotions, including shame, fear, anger, and self-blame. The problem may be so overwhelming that it seems easier to ignore it and pretend that nothing is wrong. But in the long run, denying it will be more damaging to you, other family members, and the person with the drinking problem.

WHAT NOT TO DO:

  • Don’t attempt to punish, threaten, bribe, or preach.
  • Don’t try to be a martyr. Avoid emotional appeals that may only increase feelings of guilt and the compulsion to drink or use other drugs.
  • Don’t cover up or make excuses for the alcoholic or problem drinker or shield them from the realistic consequences of their behavior.
  • Don’t take over their responsibilities, leaving them with no sense of importance or dignity.
  • Don’t hide or dump bottles, throw out drugs, or shelter them from situations where alcohol is present.
  • Don’t argue with the person when they are impaired.
  • Don’t try to drink along with the problem drinker.
  • Above all, don’t feel guilty or responsible for another’s behavior.

Adapted from: National Clearinghouse for Alcohol & Drug Information

Dealing with a loved one’s alcohol problem can be an emotional rollercoaster. It’s vital that you take care of yourself and get the support you need. It’s also important to have people you can talk honestly and openly with about what you’re going through.

A good place to start is by joining a group such as Al-Anon, a free peer support group for families coping with alcoholism. Listening to others with the same challenges can be a tremendous source of comfort and support. You can also turn to trusted friends, a therapist, or people in your faith community.

It’s important to remember you cannot force someone you love to stop abusing alcohol – As much as you may want to, and as hard as it is to watch, you cannot make someone stop drinking. The choice is up to them.

Don’t expect the person to stop drinking and stay sober without help – Your loved one will need treatment, support, and new coping skills to overcome a serious drinking problem. Recovery is an ongoing process, requiring a lot of time and patience.

Alcoholism and alcohol abuse affects millions of families, from every social class, race, and culture. But there is help and support available for both you and your loved one.

​DRUG ABUSE & ADDICTION

Addiction is a complex disorder characterized by compulsive drug use. While each drug produces different physical effects, all abused substances share one thing in common: repeated use can alter the way the brain looks and functions.

Taking a recreational drug causes a surge in levels of dopamine in your brain, which trigger feelings of pleasure. Your brain remembers these feelings and wants them repeated. If you become addicted, the substance takes on the same significance as other survival behaviors. Over time, changes in your brain interfere with your ability to think clearly, exercise good judgment, control your behavior, and feel normal without drugs. Regardless of what you’re addicted to, the uncontrollable craving to use grows more important than anything else, including family, friends, career, and even your own health and happiness.

The urge to use is so strong that your mind finds many ways to deny or rationalize the addiction. You may drastically underestimate the quantity of drugs you’re taking, how much it impacts your life, and the level of control you have over your drug use.

How do Drug Abuse and Addiction develop?

People who experiment with drugs continue to use them because the substance either makes them feel good, or stops them from feeling bad. In many cases, however, there is a fine line between regular use and drug abuse and addiction. Very few addicts are able to recognize when they have crossed that line. While frequency or the amount of drugs consumed don’t in themselves constitute drug abuse or addiction, they can often be indicators of drug-related problems.

Problems can sometimes sneak up on you as your drug use increases over time. Gradually, getting and using the drug becomes more and more important to you, especially if the drug fulfills a valuable need. If that’s the case, you may find yourself increasingly relying on it. For example, you may take drugs to calm yourself if you feel anxious or stressed, energize you if you feel depressed, or make you more confident in social situations if you normally feel shy. Or you may have started using prescription drugs to cope with panic attacks or even relieve chronic pain, for example. However, until you find alternative, healthier methods for overcoming these problems, your drug use will likely continue. If you use drugs to fill a void in your life, you’re more at risk of crossing the line from casual use to drug abuse and addiction. To maintain healthy balance in your life, you need to have other positive experiences to feel good in your life aside from any drug use.

As drug abuse takes hold, your school or job performance may progressively deteriorate, and you start to neglect social or family obligations. Your ability to stop using is eventually compromised. What began as a voluntary choice has turned into a physical and psychological need.

The good news is that with the right treatment and support, you can counteract the disruptive effects of drug use and regain control of your life. The first obstacle is to recognize and admit you have a problem, or listen to loved ones who are often better able to see the negative effects drug use is having on your life.

Signs and Symptoms of Drug Abuse and Drug Addiction

Common signs and symptoms of drug abuse:

  • You’re neglecting your responsibilities at school, work, or home (e.g. failing classes, skipping work, neglecting your children, etc)
  • You’re using drugs under dangerous conditions or taking risks while high, such as driving while on drugs, using dirty needles, or having unprotected sex.
  • Your drug use is getting you into legal trouble, such as arrests for disorderly conduct, driving under the influence, or stealing to support a drug habit.
  • Your drug use is causing problems in your relationships, such as fights with your partner or family members, an unhappy boss, or the loss of old friends.

Common signs and symptoms of drug addiction:

  • You’ve built up a drug tolerance – You need to use more of the drug to experience the same effects you used to attain with smaller amounts.
  • You take drugs to avoid or relieve withdrawal symptoms – If you go too long without drugs, you experience symptoms such as nausea, restlessness, insomnia, depression, sweating, shaking, and anxiety.
  • You’ve lost control over your drug use – You often do drugs or use more than you planned, even though you told yourself you wouldn’t. You may want to stop using, but you feel powerless.
  • Your life revolves around drug use – You spend a lot of time using and thinking about drugs, figuring out how to get them, and recovering from the drug’s effects.
  • You’ve abandoned activities you used to enjoy – You don’t participate in any of the hobbies you used to do and you no longer enjoy socializing, because of your drug use.
  • You continue to use drugs, despite knowing it’s hurting you – It’s causing major problems in your life (blackouts, infections, mood swings, depression, paranoia – but you continue using anyway.)

Warning signs that a friend or family member is abusing drugs

Drug abusers often try to conceal their symptoms and downplay their problem. If you’re worried that a friend or family member might be abusing drugs, look for the following warning signs:

PHYSICAL WARNING SIGNS

  • Bloodshot eyes, pupils larger or smaller than usual
  • Changes in appetite or sleep patterns/sudden weight gain or weight loss
  • Deterioration of physical appearance, personal grooming habits
  • Unusual smells on breath, body, or clothing
  • Tremors, slurred speech, or impaired coordination

BEHAVIORAL WARNING SIGNS

  • Drop in attendance and performance at work or school
  • Unexplained need for money or financial problems (may borrow or steal to get it)
  • Engaging in secretive or suspicious behaviors
  • Sudden change in friends, favorite hangouts, and hobbies
  • Frequently getting into trouble (fights, accidents, illegal activities)

PSYCHOLOGICAL WARNING SIGNS

  • Unexplained change in personality or attitude
  • Sudden mood swings, irritability, or angry outbursts
  • Periods of unusual hyperactivity, agitation, or giddiness
  • Lack of motivation; appears lethargic or “spaced out”
  • Appears fearful, anxious, or paranoid, with no reason

Warning Signs of Commonly Abused Drugs:

  • Marijuana: Glassy, red eyes; loud talking, inappropriate laughter followed by sleepiness; loss of interest, motivation; weight gain or loss.
  • Depressants (including Xanax, Valium, GHB): Contracted pupils; drunk-like; difficulty concentrating; clumsiness; poor judgment; slurred speech; sleepiness.
  • Stimulants (including amphetamines, cocaine, crystal meth): Dilated pupils; hyperactivity; euphoria; irritability; anxiety; excessive talking followed by depression or excessive sleeping at odd times; may go long periods of time without eating or sleeping; weight loss; dry mouth and nose.
  • Inhalants (glues, aerosols, vapors): Watery eyes; impaired vision, memory and thought; secretions from the nose or rashes around the nose and mouth; headaches and nausea; appearance of intoxication; drowsiness; poor muscle control; changes in appetite; anxiety; irritability; lots of cans/aerosols in the trash.
  • Hallucinogens (LSD, PCP): Dilated pupils; bizarre and irrational behavior including paranoia, aggression, hallucinations; mood swings; detachment from people; absorption with self or other objects, slurred speech; confusion.
  • Heroin: Contracted pupils; no response of pupils to light; needle marks; sleeping at unusual times; sweating; vomiting; coughing, sniffling; twitching; loss of appetite.
  • Narcotic Painkillers: Reduced sense of pain; drowsiness or sedation; slurred speech; problems with attention and memory; constricted pupils; lack of awareness; problems with coordination; confusion; clammy skin; constipation; runny nose or nose sores (if snorting drugs); needle marks (if injecting drugs).

For more in depth information, go to:
Warning Signs and Symptoms of Commonly Abused Drugs

Myths about Drug Abuse and Addiction:

Myth: Overcoming addiction is a simply a matter of willpower. You can stop using drugs if you really want to.
Fact: Prolonged exposure to drugs alters the brain in ways that result in powerful cravings and a compulsion to use. These brain changes make it extremely difficult to quit by sheer force of will.

Myth: Addiction is a disease; there’s nothing you can do about it. Most experts agree that addiction is a brain disease, but that doesn’t mean you’re a helpless victim.
Fact: The brain changes associated with addiction can be treated and reversed through different types of therapy, medication and other kinds of treatments.

Myth: Addicts have to hit rock bottom before they can get better.
Fact: Recovery can begin at any point in the addiction process – and the earlier, the better. The longer drug abuse continues, the stronger the addiction becomes and the harder it is to treat. Don’t wait to intervene until the addict has lost everything.

Myth: You can’t force someone into treatment; they have to want help.
Fact: Treatment doesn’t have to be voluntary to be successful. People who are pressured into treatment by their family, employer, or the legal system are just as likely to benefit as those who choose to enter treatment on their own. As they sober up and their thinking clears, many formerly resistant addicts decide they want to change.

Myth: Treatment didn’t work before, so there’s no point trying again.
Fact: Recovery from drug and alcohol addiction is a long process that often involves setbacks. Relapse doesn’t mean that treatment has failed or that you’re a lost cause. Rather, it’s a signal to get back on track, either by going back to treatment or adjusting the treatment approach.

Getting help for Drug Abuse and Drug Addiction

Recognizing that you have a problem is the first step on the road to recovery, one that takes tremendous courage and strength. Facing your addiction without minimizing the problem or making excuses can feel frightening and overwhelming, but recovery is definitely within reach. If you’re ready to make a change and willing to seek help, you can overcome your addiction and build a satisfying, drug-free life for yourself.

Call 1-800-662-4357 in the U.S. to reach a free referral helpline from the Substance Abuse and Mental Health Services Administration.

SUPPORT IS ESSENTIAL TO RECOVERY!

Don’t try to go it alone; it’s all too easy to get discouraged and rationalize “just one more” hit or pill. Whether you choose to go to rehab, rely on self-help programs, get therapy, or take a self-directed treatment approach, support is essential. Recovering from drug addiction is much easier when you have people you can lean on for encouragement, comfort, and guidance.

When a loved one has a drug problem:

If you suspect that a friend or family member has a drug problem, here are some important things to remember:
​
Don’t:

  • Attempt to punish, threaten, bribe, or preach.
  • Try to be a martyr. Avoid emotional appeals that may only increase feelings of guilt and the compulsion to use drugs.
  • Cover up or make excuses for the drug abuser, or shield them from the negative consequences of their behavior.
  • Take over their responsibilities, leaving them with no sense of importance or dignity.
  • Hide or throw out drugs.
  • Argue with the person when they are high.
  • Take drugs with the drug abuser.
  • Feel guilty or responsible for another’s behavior.

Instead, try:

  • Speaking up – Talk to the person about your concerns, and offer your help and support, without being judgmental. The earlier the addiction is treated, the better. Don’t wait for your loved one to hit bottom! Be prepared for excuses and denial by listing specific examples of your loved one’s behavior that has you worried.
  • Taking care of yourself – Don’t get so caught up in someone else’s drug problem that you neglect your own needs. Make sure you have people you can talk to and lean on for support. And stay safe. Don’t put yourself in dangerous situations.
  • Avoiding self-blame – You can support a person with a substance abuse problem and encourage treatment, but you can’t force an addict to change. You can’t control your loved one’s decisions. Let the person accept responsibility for his or her actions, an essential step along the way to recovery for drug addiction.

Adapted from: National Clearinghouse for Alcohol & Drug Information