What Is Substance Abuse?

Substance abuse isn't something you should take lightly. It occurs when you use alcohol, prescription medicine, and other legal and illegal substances too much or in the wrong way.

Substance abuse differs from addiction. Many people with substance abuse problems are able to quit or can change their unhealthy behavior. Addiction, on the other hand, is a disease. It means you can’t stop using even when your condition causes you harm.

Commonly Abused Drugs

Both legal and illegal drugs have chemicals that can change how your body and mind work. They can give you a pleasurable “high,” ease your stress, or help you avoid problems in your life.

Alcohol

Alcohol affects everyone differently. But if you drink too much and too often, your chance of an injury or accident goes up. Heavy drinking also can cause liver and other health problems or lead to a more serious alcohol disorder.
If you’re a man and you drink more than four drinks on any day or more than 14 in a week, you’re drinking too much. For women, heavy drinking means more than three drinks in one day or more than seven drinks a week.

One drink is:

• 12 ounces of regular beer
• 8-9 ounces of malt liquor, which has more alcohol than beer
• 5 ounces of wine
• 1 1/2 ounces of distilled spirits like vodka and whiskey

Signs of Drug Addiction

Addiction—to prescription and street drugs and alcohol —is a serious problem. If you’re worried that you or a loved one may have an addiction, there are signs to help you know.

Signs you may have a drug problem:

• You keep taking a drug after it's no longer needed for a health problem.
• You need more and more of a substance to get the same effects (called "tolerance"), and you can take more before you feel an effect.
• You feel strange when the drug wears off. You may be shaky, depressed, sick to your stomach, sweat, or have headaches. You may also be tired or not hungry. In severe cases, you could even be confused, have seizures, or run a fever.
• You can't stop yourself from using the drug, even if you want to. You are still using it even though it's making bad things happen in your life, like trouble with friends, family, work, or the law.
• You spend a lot of your time thinking about the drug: how to get more, when you'll take it, how good you feel, or how bad you feel afterward.
• You have a hard time giving yourself limits. You might say you'll only use "so much" but then can't stop and end up using twice that amount. Or you use it more often than you meant to.
• You've lost interest in things you once liked to do.
• You've begun having trouble doing normal daily things, like cooking or working.
• You drive or do other dangerous things (like use heavy machines) when you are on the drug.
• You borrow or steal money to pay for drugs.
• You hide the drug use or the effect it is having on you from others.
• You're having trouble getting along with co-workers, teachers, friends, or family members. They complain more about how you act or how you've changed.
• You sleep too much or too little, compared with how you used to. Or you eat a lot more or a lot less than before.
• You look different. You may have bloodshot eyes, bad breath, shakes or tremors, frequent bloody noses, or you may have gained or lost weight.
• You have a new set of friends with whom you do drugs and go to different places to use the drugs.
• You go to more than one doctor to get prescriptions for the same drug or problem.
• You look in other people's medicine cabinets for drugs to take.
• You take prescribed meds with alcohol or other drugs.

  Signs someone else is addicted:

• Changes in personality and behavior like a lack of motivation, irritability, and agitation
• Bloodshot eyes and frequent bloody noses
• Shakes, tremors, or slurred speech
• Change in their daily routines
• Lack of concern for personal hygiene
• Unusual need for money; financial problems
• Changes in friends and activities

• Prescription Drug Abuse Signs and Symptoms

  Signs of abuse can depend on the drug involved. Someone who abuses opioids might have:

• Dizziness
• Slow or shallow breathing
• Upset stomach, vomiting, or constipation
• Slurred speech
• Poor coordination
• Mood swings
• Depression or anxiety

• Abuse of CNS depressants can cause:

• Mood changes
• Trouble walking
• Trouble concentrating
• Poor judgment
• Slow reflexes
• Slurred speech
• Memory problems
• Slow breathing

• Symptoms of stimulant abuse include:

• Weight loss and lack of appetite
• Dizziness
• Headache
• Insomnia
• Nervousness
• High blood pressure
• Uneven heart rate
• Paranoia

• Get more information on the signs of prescription drug addiction.

Prescription Drug Abuse

What Is Prescription Drug Abuse?

Prescription drug abuse is when you take a medication for a reason other than why the doctor prescribed it. Experts estimate that more than 18 million people ages 12 and older have used prescription drugs for nonmedical reasons in the previous year. That’s more than 6% of the U.S. population.

Abusing drugs -- even prescription drugs -- can change how your brain works. Most people start by choosing to take these medications. But over time, the changes in your brain affect your self-control and your ability to make good decisions. At the same time, you have intense urges to take more drugs.

Which Prescription Drugs Are Commonly Abused?

The National Institute on Drug Abuse says three classes of prescription drugs are often abused:

Opioids. Since the early 1990s, doctors have been prescribing many more opioid painkillers such as codeine, hydrocodone, morphine (Astramorph, Avinza, Kadian, MS Contin, Oramorph SR), and oxycodone (OxyContin, Percocet, Vicodin). This is partly because of the rising age of the U.S. population and because more people are living with long-term pain.

These medicines manage pain well and can help boost your quality of life when you follow your doctor’s directions on taking them. It’s possible but not common to become addicted to or dependent on opioids when you use them for a short time or under a doctor’s close watch. But when you take them for a long time, they can lead to drug abuse, dependence, and addiction.

Opioid overdose can also be life-threatening. If you take them with medications that work on your central nervous system -- including alcohol, barbiturates, or benzodiazepines such as alprazolam (Xanax), clonazepam (Klonopin), or diazepam (Valium) -- you have a higher chance of breathing problems or death.

Opioids can cause a mild joyful feeling. Some people using them illegally snort or inject them to get that effect faster. Injecting drugs raises your chances of getting diseases like HIV and hepatitis C.

Central nervous system (CNS) depressants. Millions of people in the U.S. use benzodiazepines (Ativan, Valium, Xanax) to treat anxiety and sleep disorders, including insomnia. They affect a chemical in your brain called GABA (gamma-aminobutyric acid). GABA lowers brain activity, making you drowsy or calm.

Related:

Barbiturates -- including amobarbital (Amytal), pentobarbital (Nembutal), phenobarbital (Luminal), and secobarbital (Seconal) -- are also CNS depressants. Doctors use them for anesthesia and prescribe them to treat seizures.

Taking CNS depressants for a few days or weeks may help you feel calm and sleepy. But after a while, you may need larger doses to get the same feeling. Using them with alcohol can cause slow heartbeat, slow breathing, and death.

If you take CNS depressants for a long time and stop suddenly, you might have life-threatening problems such as withdrawal seizures.

Stimulants. These drugs give your body a jump-start, with a huge boost in alertness, energy, and attention. They raise your heart rate, blood sugar, and blood pressure. They also narrow your blood vessels and open your airways.

Doctors started using stimulants to treat asthma and obesity. Today, they prescribe them for conditions such as ADHD, ADD, depression, and narcolepsy. Examples of stimulants are dextroamphetamine (Dexedrine, Dextrostat, ProCentra), lisdexamfetamine (Vyvanse), methylphenidate (Concerta, Daytrana, Methylin, Ritalin), and a mix of amphetamine and dextroamphetamine (Adderall).

Stimulant abuse -- for instance, by taking them in higher doses or by crushing pills and snorting them -- can lead to addiction. High doses can raise your body temperature. Misusing stimulants or using them along with decongestants may cause uneven heartbeat.

Prescription Drug Abuse Risk Factors

Research shows that some things about you might make you more likely to abuse prescription drugs. These risk factors include your:

• Friends’ or colleagues’ influence
• Age
• Biology, or things in your genes
• Mental health
• Knowledge about prescription drugs and how they might hurt you

• Is There Treatment for Prescription Drug Addiction?

  Treatment for opioid addiction includes medications that can help people get control without a high chance of addiction.

  Buprenorphine treats opiate withdrawal and dependence. Doctors often use it along with the drug naloxone (a combination that can be called Bunavail, Suboxone, or Zubsolv) to prevent relapse.

  If you’ve been taking buprenorphine in pill form and your body has gotten rid of all of the drug you were abusing, you might have another form of buprenorphine implanted under your skin. This is called Probuphine. It provides a constant dose of buprenorphine for 6 months. Buprenorphine also comes as a monthly shot called Sublocade.

  Other drug treatments for opiate withdrawal include methadone and the blood pressure medicine clonidine. Naltrexone blocks the effects of opiates and can prevent a relapse. It can be taken orally (Revia) or as a monthly injection (Vivitrol). 

  Doctors recommend that people who misuse opioids keep naloxone, a medication that can reverse an overdose. It comes in a shot (Evzio) and a nasal spray (Narcan).