What causes drug abuse and addiction?

What makes one person abuse drugs to the point of losing their home, their family and their job, while another does not? There is no one simple reason. Drug abuse and addiction is due to many factors. A powerful force in addiction is the inability to self- soothe or get relief from untreated mental or physical pain. Without the self-resilience and support to handle stress, loneliness or depression, drugs can be a tempting way to deal with the situation. Unfortunately, due to the changes drugs make to the brain, it can only take a few times or even one time to be on the road to addiction. Some other risk factors include:
• Family history of addiction. While the interplay between genetics and environment is not entirely clear, if you have a family history of addiction, you are at higher risk for abusing drugs.
• History of mental illness. Drug abuse can worsen mental illness or even create new symptoms. See dual diagnosis for more information on mental illness and drug abuse.
• Untreated physical pain. Without medical supervision, pain medications or illegal drugs like heroin can rapidly become addictive.
• Peer pressure. If people around you are doing drugs, it can be difficult to resist the pressure to try them, especially if you are a teenager.
Signs and symptoms of drug abuse and addiction
How can I tell if I or a loved one has a drug abuse or addiction problem?
Although different drugs may have different effects on overall physical and mental health, the basic pattern is the same. Getting and using the drug becomes more and more important than anything else, including job, friends and family. The physical and emotional consequences of drug abuse and addiction also make it difficult to function, often impairing judgment to a dangerous level.
Physical signs of abuse and addiction
Drug abuse affects the brain and body directly. While high, the drug affects the entire body, from blood pressure to heart rate. Stimulants like cocaine and methamphetamine “amp up” the body, increasing blood pressure, metabolism and reducing the ability to sleep. Drugs like opiates and barbiturates slow down the body, reducing blood pressure, breathing and alertness sometimes to dangerous levels. Some physical signs of abuse and addiction include:
• Cycles of increased energy, restlessness, and inability to sleep (often seen in stimulants)
• Abnormally slow movements, speech or reaction time, confusion and disorientation (often seen in opiates, benzodiazepines and barbiturates)
• Sudden weight loss or weight gain
• Cycles of excessive sleep
• Unexpected changes in clothing, such as constantly wearing long sleeved shirts, to hide scarring at injection sites
• Suspected drug paraphernalia such as unexplained pipes, roach clips or syringes
• For snorted drugs, chronic troubles with sinusitis or nosebleeds
• For smoked drugs, a persistent cough or bronchitis, leading to coughing up excessive mucus or blood.
• Progressive severe dental problems (especially with methamphetamine)
Tolerance and withdrawal
Most abused drugs are not only mentally addictive but physically addictive as well. Tolerance is built up to the drug. More and more of the drug is needed to achieve the desired effect. As the body physically adjusts to the drug, trying to cut down or stop is unpleasant or even painful. These withdrawal symptoms, depending on the drug, can include shakes, chills, severe aches and pains, difficulty sleeping, agitation, depression, and even hallucinations or psychosis. Avoiding withdrawal adds to the urgency of keeping up drug abuse and increases drug dependence.
For a list of specific withdrawal signs for drugs, see Treatment for Drug Abuse and Addiction
Mental and emotional signs of abuse and addiction
Abuse and addiction also affect mood, as drugs are abused for the temporary good feelings they provide. These feelings can vary depending on the drug used. Some mental and emotional signs include:
• Cycles of being unusually talkative, “up” and cheerful, with seemingly boundless energy.
• Increased irritability, agitation and anger
• Unusual calmness, unresponsiveness or looking “spaced out”
• Apathy and depression
• Paranoia, delusions
• Temporary psychosis, hallucinations
• Lowered threshold for violence
Teenagers and drug abuse
It can sometimes be hard for parents to tell if their teenager has a drug problem. After all, teenagers are notorious for oversleeping, being argumentative and pushing boundaries, or wanting their own privacy and space. If you suspect your teen has a drug problem, look for marked changes in behavior, appearance and health. Is your teen suddenly having trouble in school? Does he/or she seem more and more isolated, or have a new group of friends? A teen with drug problems may spend a lot of time sleeping- or be keyed up or unable to sleep. Have you noticed that money or objects that could be sold for drugs seem to be disappearing? Do prescription drugs seem to be used up too quickly?
Effects of drug abuse and addiction
What makes drug addiction problems so challenging to face, as opposed to other mental or physical problems? Drug abuse affects the person’s life in many ways, including health, finances and stability. But it also affects the entire family, friends, colleagues-- and even the community. What’s more, the strong denial and rationalization of the person using drugs makes it extremely difficult to get help, and can make concerned family members feel like they are the problem.
Health, employment and crime
Those who abuse drugs have a greater risk for health problems down the road, from neglecting their own health to risk of infectious disease like hepatitis or HIV from sharing needles. Heavy drug use directly affects health as well, including lung disease, arthritis, heart problems, brain damage and death from overdose. Productivity at work often suffers, and eventually trouble keeping a job or even homelessness can occur. The urge to use is so powerful that criminal activity for money or more drugs can be a strong temptation.
Staying addicted: Denial and rationalization
One of the most powerful effects of drug abuse and addiction is denial. The urge to use is so strong that the mind finds many ways to rationalize drug use. Someone abusing drugs may drastically underestimate the quantity of drugs they are taking, how much it is costing them, and how much time it takes away from their family and work. They may lash out at concerned family members, making the family feel like they are exaggerating and overstating the problem. What makes this so frustrating for family members is the person abusing drugs often sincerely believes they do not have a problem, and can make the family member feel like the dysfunctional one.
This denial and rationalization can lead to increased problems with work, finances and relationships. The person abusing drugs may blame an “unfair boss’ for losing her job, or a ‘nagging wife’ for why he is increasingly going out with friends to get high. While work and relationship stresses happen to everyone, an overall pattern of deterioration and blaming others may be a sign of trouble.
Drug abuse and the family
Sadly, drug abuse and addiction doesn’t only affect the person abusing drugs. It affects friends, family and the entire society. Child abuse and neglect is much more common when there is drug abuse in the family. The abuser may neglect a child’s basic needs in the quest for more drugs, or lack of impulse control can lead to increased physical and emotional abuse. Drug abuse by a pregnant woman affects the developing baby’s health. Domestic violence also happens more frequently. Abusing drugs leads to higher risk of injuries and death to self and others in car accidents.
Family stress
If you have someone you love abusing drugs, it is an enormous emotional strain. You might feel obligated to cover for the abuser, cutting back from work to deal with the abuser’s problems— or working more to make financial ends meet. You might not be able to see friends and engage in hobbies, as coping with the abuse takes more and more time. The shame of drug abuse in the family stops many family members from asking for help, instead pretending nothing is wrong. The emotional toll can be overwhelming. Children are especially sensitive.
When someone you love has a drug abuse or addiction problem
You may not immediately realize that someone you love has a drug problem. It may have started slowly, and your loved one might also have tried to hide the extent of the drug use from you. You might have gotten so used to the drug abuse that coping with it seems almost normal. Or the realization that there is something seriously wrong is almost too painful to admit. Don’t be ashamed, and you are not alone. Drug abuse affects millions of families, from every socioeconomic status, race and culture. There is help and support available.
What the person abusing drugs might say if you confront them about their usage
“I can get sober any time I want to. I’ve done it lots of times”. The key to recovery is staying sober, not constantly cycling through the process. Even if the person abusing drugs is able to resist for a little while, usually the cravings are too strong to resist during times of stress.
“Why do you exaggerate so much? I’m hardly using at all!” Remember denial is a key part of drug addiction. The person using drugs might actually believe they are not using as much as they are.
“It’s your fault. If you wouldn’t stress me out so much, maybe I wouldn’t need to use drugs as often” It is never your fault that someone is using drugs. Even if they are feeling stressed, there are other coping skills they can choose to use.
Understanding what is involved in recovery
• You cannot force someone you love to stop abusing drugs. As much as you may want to, and as hard as it is seeing the effects of drug abuse, you cannot make someone stop using. The final choice is up to them. The right support can help you make positive choices for yourself, and balance encouraging your loved one to get help without losing yourself in the process.
• Don’t expect your loved one to be able to quit without support. Withdrawal symptoms can be unpleasant, painful, and even deadly. While medical input is always a good idea, if your loved one is addicted to benzodiazepines or is a heavy drinker, withdrawal can be dangerous and should be done under medical supervision.
• Recovery will be an ongoing process. Someone who abused drugs will not suddenly be a cured person once sober. Drug use may have been masking painful feelings that will bubble up to the surface. Many in recovery experience depressed moods for up to a year or more as their brain reestablishes from the drug abuse. Learning new coping skills to resist cravings, and how to apply them in stressful situations, is an ongoing process. Ongoing support is crucial to work through those issues.
See Treatment for Drug Abuse and Addiction for more information on recovery and different treatment options.
Finding support
A good place to start looking for support is through local support groups. Listening to others with the same challenges can be a tremendous source of comfort and support. Al-Anon is a free peer support group for families coping with alcohol abuse. It may be a good place to begin as these groups are the most numerous, and frequently alcohol is abused with other drugs as well. Similar to Al-Anon, there are several support groups for families coping with specific drug abuse as well. These include Nar-Anon, for families coping with narcotic abuse, and Co-Anon, for families coping with cocaine abuse. Information about these groups can be found in Related Links below. Other sources of help and support include trusted friends, a therapist, or a pastor or rabbi.