Drug dependence Drug dependence means that a person needs a drug to function normally.

Abruptly stopping the drug leads to withdrawal symptoms. Drug addiction is the compulsive use of a substance, despite its negative or dangerous effects. A person may have a physical dependence on a substance without having an addiction. For example, certain blood pressure medications do not cause addiction but they can cause physical dependence. Other drugs, such as cocaine, cause addiction without leading to physical dependence. Tolerance to a drug (needing a higher dose to attain the same effect) is usually part of addiction. See also: • Drug abuse

Using drugs even when alone See: Drug abuse for more information about symptoms that may be present when using these drugs. For information about symptoms of withdrawal, see also: • Cocaine withdrawal

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Missing work or school, or a decrease in performance Need for daily or regular drug use to function Neglecting to eat Not caring for physical appearance No longer taking part in activities because of drug abuse Secretive behavior to hide drug use

• Drug abuse first aid Causes Drug abuse can lead to drug dependence or addiction. People who use drugs for pain relief may become dependent, although this is rare in those who don't have a history of addiction. The exact cause of drug abuse and dependence is not known. However, a person's genes, the action of the drug, peer pressure, emotional distress, anxiety, depression, and environmental stress all can be factors. Peer pressure can lead to drug use or abuse, but at least half of those who become addicted have depression, attention deficit disorder, posttraumatic stress disorder, or another mental health problem. Children who grow up in an environment of illicit drug use may first see their parents using drugs. This may put them at a higher risk for developing an addiction later in life for both environmental and genetic reasons. People who are more likely to abuse or become dependent on drugs include those who: • Have depression, bipolar disorder, anxiety disorders, and schizophrenia • Have easy access to drugs • • •
Have low self-esteem, or problems with relationships Live a stressful lifestyle, economic or emotional

Live in a culture where there is a high social acceptance of drug use Commonly abused substances include: • Opiates and narcotics are powerful painkillers that cause drowsiness (sedation) and sometimes feelings of euphoria. These include heroin, opium, codeine, meperidine (Demerol), hydromorphone(Dilaudid), and oxycodone (Oxycontin). • Central nervous system (CNS) stimulants include amphetamines, cocaine, dextroamphetamine, methamphetamine, and methylphenidate (Ritalin). These drugs have a stimulating effect, and people can start needing higher amounts of these drugs to feel the same effect (tolerance). • Central nervous system depressants include alcohol, barbiturates (amobarbital, pentobarbital, secobarbital), benzodiazepines (Valium, Ativan, Xanax), chloral hydrate, and paraldehyde. These substances produce a sedative and anxiety-reducing effect, which can lead to dependence. • Hallucinogens include LSD, mescaline, psilocybin ("mushrooms"), and phencyclidine (PCP or "angel dust"). They can cause people to see things that aren't there (hallucinations) and can lead to psychological dependence. • Tetrahydrocannabinol (THC) is the active ingredient found in marijuana (cannabis) and hashish. There are several stages of drug use that may lead to dependence. Young people seem to move more quickly through the stages than do adults. • Experimental use -- typically involves peers, done for recreational use; the user may enjoy defying parents or other authority figures. • Regular use -- the user misses more and more school or work; worries about losing drug source; uses drugs to "fix" negative feelings; begins to stay away from friends and family; may change friends to those who are regular users; shows increased tolerance and ability to "handle" the drug. • Daily preoccupation -- the user loses any motivation; does not care about school and work; has obvious behavior changes; thinking about drug use is more important than all other interests, including relationships; the user becomes secretive; may begin dealing drugs to help support habit; use of other, harder drugs may increase; legal problems may increase. • Dependence -- cannot face daily life without drugs; denies problem; physical condition gets worse; loss of "control" over use; may become suicidal; financial and legal problems get worse; may have broken ties with family members or friends. Symptoms Some of the symptoms and behaviors of drug dependence include: • Confusion

• Opiate withdrawal Exams and Tests Drug tests (toxicology screens) on blood and urine samples can show many chemicals and drugs in the body. How sensitive the test is depends upon the drug itself, when the drug was taken, and the testing laboratory. Blood tests are more likely to find a drug than urine tests. However, urine drug screens are done more often. Opiates and narcotics are usually in the urine 12 to 36 hours after the last use, depending on the amount used and how often the drug was used. CNS stimulants such as cocaine can be found in urine for 1 to 12 days, again depending on how often the drug was used. CNS depressants such as Valium and Xanax are found up to 7 days after the last day of use, mostly depending on the substance used and how quickly the body removes it (its half-life). Most hallucinogens also can be found in the urine up to 7 days after the last use. However, evidence of marijuana can be found for up to 28 days after its last use in regular users. Treatment Treatment for drug abuse or dependence begins with recognizing the problem. Though "denial" used to be considered a symptom of addiction, recent research has shown that people who are addicted have far less denial if they are treated with empathy and respect, rather than told what to do or "confronted." Treatment of drug dependency involves stopping drug use either gradually or abruptly (detoxification), support, and staying drug free (abstinence). • People with acute intoxication or drug overdose may need emergency treatment. Sometimes, the personloses consciousness and might need to be on a breathing machine (mechanical respirator) temporarily. The treatment depends on the drug being used. • Detoxification is the withdrawal of an abused substance in a controlled environment. Sometimes a drug with a similar action is taken instead, to reduce the side effects and risks of withdrawal. Detoxification can be done on an inpatient or outpatient basis. As with any other area of medicine, the least intensive treatment should be the starting point. Residential treatment programs monitor and address possible withdrawal symptoms and behaviors. These programs use behavior modification techniques, which are designed to get users to recognize their behaviors. Treatment programs include counseling, both for the person (and perhaps family), and in group settings. Drug abuse treatment programs have a long after-care part (when the user is released from the medical facility), and provide peer support. Drug addiction is a serious and complicated health condition that requires both physical and psycholocial treatment and support. It is important to be evaluated by a trained professional to determine the best care. If the person also has depression or another mood disorder, it should be treated. Very often, people start abusing drugs in their effort to selftreat mental illness. For narcotic dependence, some people are treated with methadone or similar drugs to prevent withdrawal and abuse. The goal is to enable the person to live as normal a life as possible. Support Groups Many support groups are available in the community. They include Narcotics Anonymous (NA), Ala-Teen, and Al-Anon. Most of these groups follow the 12-Step program used in Alcoholics Anonymous (AA). SMART Recovery and LifeRing Recovery are programs that do not use the 12-step approach. You can find support groups in your phone book. Outlook (Prognosis) Drug abuse and dependence may lead to a fatal drug overdose. Some people start taking the drugs again after they have stopped. Relapses can lead to continued dependence. Possible Complications The complications of drug abuse and dependence include: • Bacterial endocarditis, hepatitis, thrombophlebitis, pulmonary emboli, malnutrition, or respiratory infections, caused by drug use by injection • Depression • •
Drug overdose Increase in various cancer rates; for example, lung and pharynx cancer are linked to nicotine use; mouth and stomach cancer are associated with alcohol abuse and dependence Infection with HIV through shared needles Problems with memory and concentration, for example with hallucinogen use, including marijuana (THC) Problems with the law Relapse of drug abuse

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Continuing to use drugs even when health, work, or family are being harmed Episodes of violence Hostility when confronted about drug dependence Lack of control over drug abuse - being unable to stop or reduce alcohol intake Making excuses to use drugs

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• Central nervous system depressants include alcohol. However. loss of "control" over use. done for recreational use. benzodiazepines (Valium. and schizophrenia Have easy access to drugs Have low self-esteem. Residential treatment programs monitor and address possible withdrawal symptoms and behaviors. the personloses consciousness and might need to be on a breathing machine (mechanical respirator) temporarily. Abruptly stopping the drug leads to withdrawal symptoms. and risk factors Drug abuse can lead to drug dependence or addiction. cocaine. economic or emotional Live in a culture where there is a high social acceptance of drug use Commonly abused substances include: Opiates and narcotics are powerful painkillers that cause drowsiness (sedation) and sometimes feelings of euphoria. incidence. or if you have been cut off from your drug supply and are at risk of withdrawal. How sensitive the test is depends upon the drug itself. the least intensive treatment should be the starting point. which can lead to dependence. see also: Opiate withdrawal Signs and tests Drug tests (toxicology screens) on blood and urine samples can show many chemicals and drugs in the body. Addiction .Unsafe sexual practices. Prevention Drug education programs may be helpful though none has proved effective in the long term. Tetrahydrocannabinol (THC) is the active ingredient found in marijuana (cannabis) and hashish. Xanax). rather than told what to do or "confronted. may change friends to those who are regular users. to reduce the side effects and risks of withdrawal. shows increased tolerance and ability to "handle" the drug. and staying drug free (abstinence). financial and legal problems get worse. These include heroin.secobarbital). attention deficit disorder. This may put them at a higher risk for developing an addiction later in life for both environmental and genetic reasons. People with acute intoxication or drug overdose may need emergency treatment. For example. Most employers also offer referral services for their employees with substance abuse problems. Regular use -. Dependence -. and oxycodone (Oxycontin). These substances produce a sedative and anxiety-reducing effect. For information about symptoms of withdrawal. Though "denial" used to be considered a symptom of addiction. These drugs have a stimulating effect. • Daily preoccupation -. and paraldehyde. depression. Opiates and narcotics are usually in the urine 12 to 36 hours after the last use. bipolar disorder. • • • • Experimental use -.drug. Peer pressure can lead to drug use or abuse. or problems with relationships Live a stressful lifestyle. emotional distress. and phencyclidine (PCP or "angel dust"). Sometimes a drug with a similar action is taken instead. • • • • • • Have depression. Ativan.htm Drug dependence Drug addiction. • • Hallucinogens include LSD. Young people seem to move more quickly through the stages than do adults. worries about losing drug . which are designed to get users to recognize their behaviors. 2010. may have broken ties with family members or friends. People who are more likely to abuse or become dependent on drugs include those who: • source. or another mental health problem. Symptoms Some of the symptoms and behaviors of drug dependence include: • • • • • • • • • • • • • • Confusion Continuing to use drugs even when health. work. opium.nlm. recent research has shown that people who are addicted have far less denial if they are treated with empathy and respect. thinking about drug use is more important than all other interests. They can cause people to see things that aren't there (hallucinations) and can lead to psychological dependence. sexually transmitted diseases. codeine. The exact cause of drug abuse and dependence is not known. and methylphenidate (Ritalin). does not care about school and work. However. and the testing laboratory. cause addiction without leading to physical dependence.gov/medlineplus/ency/article/001522. uses drugs to "fix" negative feelings.the user loses any motivation. anxiety disorders. Blood tests are more likely to find a drug than urine tests. Detoxification can be done on an inpatient or outpatient basis. begins to stay away from friends and family. anxiety. which may result in unwanted pregnancies. Treatment Treatment for drug abuse or dependence begins with recognizing the problem. Tolerance to a drug (needing a higher dose to attain the same effect) is usually part of addiction. despite its negative or dangerous effects. again depending on how often the drug was used. Dependence on drugs Last reviewed: February 11.being unable to stop or reduce alcohol intake Making excuses to use drugs Missing work or school. meperidine (Demerol). and people can start needing higher amounts of these drugs to feel the same effect (tolerance). dextroamphetamine. hydromorp hone(Dilaudid). Detoxification is the withdrawal of an abused substance in a controlled environment. may become suicidal. Children who grow up in an environment of illicit drug use may first see their parents using drugs. harder drugs may increase. post-traumatic stress disorder. including relationships. or hepatitis When to Contact a Medical Professional Call for an appointment with your health care provider if you are addicted to drugs and would like to get off of them. although this is rare in those who don't have a history of addiction. or family are being harmed Episodes of violence Hostility when confronted about drug dependence Lack of control over drug abuse . methamphetamine. the user may enjoy defying parents or other authority figures. physical condition gets worse. psilocybin ("mushrooms"). and environmental stress all can be factors. such as cocaine.the user misses more and more school or work. depending on the amount used and how often the drug was used. when the drug was taken. mostly depending on the substance used and how quickly the body removes it (its halflife)." Treatment of drug dependency involves stopping drug use either gradually or abruptly (detoxification). mescaline.nih. a person's genes. A person may have a physical dependence on a substance without having an addiction. pentobarbital. chloral hydrate. http://www. HIV. These programs use behavior modification techniques. denies problem. use of other. • • Cocaine withdrawal • Central nervous system (CNS) stimulants include amphetamines. urine drug screens are done more often. may begin dealing drugs to help support habit. evidence of marijuana can be found for up to 28 days after its last use in regular users. CNS depressants such as Valium and Xanax are found up to 7 days after the last day of use. The treatment depends on the drug being used. peer pressure. There are several stages of drug use that may lead to dependence.typically involves peers. legal problems may increase. the action of the drug. but at least half of those who become addicted have depression. Most hallucinogens also can be found in the urine up to 7 days after the last use. CNS stimulants such as cocaine can be found in urine for 1 to 12 days. Drug dependence means that a person needs a drug to function normally. Other drugs. See also: Drug abuse first aid Causes. Sometimes. the user becomes secretive.cannot face daily life without drugs. However. support. As with any other area of medicine. People who use drugs for pain relief may become dependent. Drug addiction is the compulsive use of a substance. barbiturates (amobarbital. certain blood pressure medications do not cause addiction but they can cause physical dependence. or a decrease in performance Need for daily or regular drug use to Neglecting to eat Not caring for physical appearance function • • Drug abuse No longer taking part in activities because of drug abuse Secretive behavior to hide drug use Using drugs even when alone See: Drug abuse for more information about symptoms that may be present when using these drugs. has obvious behavior changes.

If the person also has depression or another mood disorder. mouth and stomach cancer are associated with alcohol abuse and dependence . or hepatitis http://www.gov/pubmedhealth/PMH0002490/ • . Expectations (prognosis) Drug abuse and dependence may lead to a fatal drug overdose. Support Groups Many support groups are available in the community. Drug overdose. Depression . hepatitis. and provide peer support. or respiratory infections. SMART Recovery and LifeRing Recovery are programs that do not use the 12-step approach. Relapses can lead to continued dependence. including marijuana (THC) .Treatment programs include counseling. caused by drug use by injection . for example with hallucinogen use. For narcotic dependence. lung and pharynx cancer are linked to nicotine use. It is important to be evaluated by a trained professional to determine the best care. for example.nlm. which may result in unwanted pregnancies.nih. Most of these groups follow the 12-Step program used in Alcoholics Anonymous (AA). both for the person (and perhaps family). sexually transmitted diseases. They include Narcotics Anonymous (NA). and in group settings. it should be treated. The goal is to enable the person to live as normal a life as possible. Drug addiction is a serious and complicated health condition that requires both physical and psycholocial treatment and support. Problems with the law .ncbi. Drug abuse treatment programs have a long after-care part (when the user is released from the medical facility). and Al-Anon. Very often. some people are treated with methadone or similar drugs to prevent withdrawal and abuse. Complications The complications of drug abuse and dependence include: Bacterial endocarditis. Increase in various cancer rates. HIV. people start abusing drugs in their effort to self-treat mental illness. Infection with HIV through shared needles . Some people start taking the drugs again after they have stopped. Relapse of drug abuse . Unsafe sexual practices. Ala-Teen. Problems with memory and concentration. pulmonar y emboli. thrombophlebitis. You can find support groups in your phone book. malnutrition.