Abused DrugsAddictions Vs. RecoveryMore on Addiction

Abused Drugs

Alcohol is the most widely available intoxicant because it is legal and often a part of our culture and social environment. It is also the 3rd leading cause of preventable death in the United States with an estimated 88,000 deaths per year from alcohol-related causes. Of those deaths, nearly half are from liver disease and cirrhosis. Chronic alcohol use also increases the risk of cancers of the mouth, esophagus, pharynx, larynx, liver, and breast.

New Mexico has ranked highest in alcohol-related deaths for more than thirty years. One in six deaths of persons between the ages of 20 and 64 in New Mexico are due to alcohol-related factors. Besides the fatality rates, excessive alcohol consumption also increases the rates of domestic violence, crime, poverty, unemployment, motor vehicle crashes, and mental illness.

Alcohol Use Disorder (AUD) is a chronic relapsing brain disease characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. AUD can range from mild to severe, and recovery is possible regardless of severity.

American Psychiatric Association (2013) Desk Reference To The Diagnostic Criteria from DSM-5. Pp 227-283

https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders

https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption

New Mexico Department of Health, (2018) Complete Health Indicator of Alcohol – Alcohol-Related Death. New Mexico’s Indicator Based Information System (NM-IBIS). Retrieved on 11-1-18 from https://ibis.health.state.nm.us/indicator/complete_profile/AlcoholRelatedDth.html

Opioids are any substance that binds to the brain’s opioid receptors, which control pain, feelings of pleasure and addictive behaviors. Opiates are drugs naturally derived from the poppy plant, such as heroin, morphine and codeine. Opioids refer to synthetic prescription painkillers including hydrocodone (Vicodin), oxycodone (OxyContin), fentanyl, and methadone. (1)

Heroin is an opiate made from morphine. It can be injected, sniffed, snorted or smoked. Mixing heroin with crack cocaine is a practice called “speedballing”. Heroin enters the brain quickly binding to opioid receptors found throughout the body. A person typically experiences a rush of euphoria, coupled with slowed heart rate, heaviness in the limbs, clouded mental functioning, and will vacillate in and out of consciousness. Because of this rush of euphoria, and a sharp “let down” following the high, heroin is highly addictive. For people who use it frequently, they develop a tolerance, requiring larger and more frequent doses of the drug to get the high they are seeking.

Withdrawal from the drug can be very painful and uncomfortable and include restlessness and irritability, severe muscle and bone pain, insomnia, diarrhea and vomiting, cold flashes, and uncontrollable leg movements, as well as overpowering cravings.

Long term effects include chronic insomnia; collapsed veins for those who inject the drug and damaged tissue inside the nasal cavity for those who snort it; infection of the heart lining and valves; abscesses; constipation and cramping; liver and kidney disease; lung complications; mental disorders such as depression and antisocial personality disorder; sexual dysfunction for men and irregular menstrual cycles for women. Injecting heroin drastically increases the risk of contracting HIV or Hepatitis. Long term use of opioids also results in the loss of white matter in the brain which affects a person’s decision making abilities and behavioral control. (2)

Overdoses are very common with heroin users as the heart rate slows down dramatically, slowing or stopping breathing. If a person survives an overdose, there is the potential brain damage or coma from oxygen deprivation during an overdose, creating a condition called Hypoxia.

Naloxone is the number one treatment for reversing overdose immediately if administered right away. Naloxone is an opioid antagonist, meaning it binds to the opioid receptors reversing and blocking the opioid drug. It can be given in injectable form by a paramedic or as a nasal spray (Narcan) by a friend or family member. Often times more than one dose is needed to stop the overdose. It has a short-lived effect though and a person must be taken to a hospital right away or they risk falling back into the overdose state. (3)

There are several ways to treat heroin addiction, typically involving both medication and behavioral therapy. Medications currently used for heroin addiction include lofexidine, a non-opioid medication which reduces symptoms, and buprenorphine or methadone, which acts on the opioid receptors in a weakened form, and can reduce cravings and withdrawal symptoms. Cognitive behavioral therapy and contingency management have shown to be effective therapy for treating addiction. Treatment should be developed as an individual-based plan, utilizing what works best for each person.

Prescription opioids, such as OxyContin and Vicodin have similar effects as heroin. Reports on the opioid epidemic spreading across the country right now indicate that 80% of Americans using heroin started after overuse of prescription painkillers. Though not everyone who misuses prescription painkillers go on to use heroin. But the effects of overuse can have similar consequences. Drug overdoses from prescription opioid use has dramatically increased since 1999 as the availability of hydrocodone and oxycodone increased as a treatment for pain. (4) Like heroin, extended use of these prescriptions lead to an increased tolerance to the drug, as well as an increased sensitivity to the pain. Both this tolerance and this increased sensitivity means a person needs more in order to get the desired effect and relief.

(1) (https://www.centeronaddiction.org/the-buzz-blog/we-asked-you-answered-there-difference-between-opioid-and-opiate. 11.21.18)

(2) (https://www.drugabuse.gov/publications/drugfacts/heroin)

(3) https://www.drugabuse.gov/related-topics/opioid-overdose-reversal-naloxone-narcan-evzio

(4) https://www.drugabuse.gov/publications/research-reports/relationship-between-prescription-drug-abuse-heroin-use/introduction

Methamphetamine is a highly addictive manufactured drug similar to pharmaceutical amphetamines, which are used to treat ADHD and narcolepsy. Methamphetamine can be in a white powder or pill form, or Crystal meth, which looks like glass fragments, or shiny bluish-white rocks. Methamphetamine is made from a variety of chemicals, primarily pseudoephedrine, commonly found in cold medication.

Methamphetamine (chalk, crank, crystal, ice, and speed) can be smoked, taken as a pill, snorted or injected. Meth releases a large amount of dopamine into the body, creating a sense of euphoria, increased wakefulness and activity, increased heart rate and a decrease in appetite. It can cause a person to be hyper vigilant or paranoid, anxious and shaky. The rapid release of dopamine has only a short term effect on the brain, reinforcing the desire to use again. Due to this quick start and fade effect, methamphetamine users often binge on the drug for several days at a time.

Physical side effects of the drug include perspiration or chills, nausea or vomiting, psychomotor agitation or retardation, muscular weakness, chest pains, cardiac arrhythmias, confusion, seizures, dyskinesias (involuntary movements), dystonias (muscle spasms), and comas.

Withdrawal effects from the drug are very uncomfortable and can include dysphoric mood, fatigue, vivid and unpleasant dreams, insomnia or hypersomnia, increased appetite, psychosis, psychomotor retardation or agitation, and strong cravings.

Over time, methamphetamine users are at greater risk for contracting blood borne diseases such as HIV and Hepatitis. It can cause extreme weight loss, severe dental problems, extreme itching and skin irritation, anxiety and/or violent behaviors, sleeping problems, paranoia and hallucinations. Cognitive abilities, rational decision making, and mood are affected. The drugs effect on the dopamine system will eventually reduce coordination and impair verbal learning. Studies are also now showing that long term use put people at a greater risk of developing Parkinson’s disease, a nerve disorder affecting movement.

Overdose of methamphetamine usually results in stroke, heart attack, or organ failure due to increased body temperature, causing kidneys to shut down. All of these can lead to death.

At this time there is no prescription medication that can treat methamphetamine addiction. Cognitive-behavioral therapy is an effective treatment though for this addiction.

https://www.drugabuse.gov/drugs-abuse/methamphetamine

American Psychiatric Association (2013) Desk Reference To The Diagnostic Criteria from DSM-5. Pp 227-283

Cocaine is a highly addictive stimulant made from the leaves of the coca plant native to South America. It is processed into a fine, white powder which is then snorted or rubbed onto the gums. Sometimes it is dissolved and injected intravenously. Cocaine is often processed with other amphetamines or synthetic opioids. This is especially dangerous if the person using the drug does not know it has been tampered with other drugs, evidenced by increasing numbers of cocaine overdose.

“Crack” is cocaine that has been processed with baking soda or ammonia, changing it into a “rock” form that is then smoked. This process makes the drug more potent, and smoking it allows the drug to reach the brain more quickly. Crack cocaine creates a very intense, immediate high that only last a short time. Due to the potency of crack and the short-lived effect, it is highly addictive.

Cocaine is a stimulant of the central nervous system, releasing a vast quantity of dopamine into the body and affecting the movement and reward center of the brain. It will immediately alter these parts of the brain and stimulate cravings. Cocaine inhibits the natural communication system of dopamine neurotransmitters in the brain as it adapts to the excess dopamine from the cocaine, causing a person to become less sensitive to it. Which results in a person needing stronger and more frequent doses to obtain the same effect and to relieve withdrawals.

Initially, the drug causes a feeling of euphoria, mental alertness, and increased energy. It can also cause hypersensitivity to sights, sounds, and touch, and increases paranoia and irritability. Physically, the drug constricts blood vessels, dilates the pupils, increases body temperature and heart rate, and can cause nausea, restlessness, and tremors or muscle twitching.

Long term effects include loss of smell, nosebleeds, and holes in the nasal cavity; respiratory distress and higher risk of infections; severe bowel decay; and higher risk for contracting HIV and hepatitis, skin or soft tissue infections, and collapsed veins. Chronic use can cause severe depression, irritability and mood changes, aggressive and paranoid behaviors, and delirium or psychosis. Cocaine and crack use can cause heart attack and heart disease, stroke, respiratory failure, brain seizures, and sexual dysfunction, reproductive damage, and infertility in both men and women, and movement disorders such as Parkinson’s disease.

Withdrawal symptoms include depression, irritability, extreme fatigue, anxiety, an intense craving for the drug, and sometimes even psychosis. A person will often continue using the drug merely to avoid the discomfort of withdrawal.

Currently there are no medications to treat cocaine and crack addiction, but research is being done including the use of disulfiram, which is used to treat alcoholism, and buprenorphine which is used to treat opioid addiction. Residential treatment, cognitive-behavioral therapy, therapeutic communities and community based recovery groups are effective treatments.

https://www.drugabuse.gov/drugs-abuse/cocaine

http://www.cesar.umd.edu/cesar/drugs/crack.asp

American Psychiatric Association (2013) Desk Reference To The Diagnostic Criteria from DSM-5. Pp 227-283

Ambien (Zolpidem, Z-drug)

Ambien, a schedule IV controlled substance, is a powerful sedative-hypnotic prescribed to people with severe insomnia. It is a non-benzodiazepine drug designed to be less addictive than other similar sleep medications such as Xanax, but can still be highly addictive if taken for more than two weeks or taken in higher doses than originally prescribed. If taken for more than two weeks, people often experience “rebound insomnia”, meaning they cannot fall asleep at all after taking the drug the night before. Ambien can also have euphoric and hallucinatory effects, leading to people taking it for those effects rather than its intended purpose. It is easy to develop a tolerance for Ambien, requiring higher doses for the desired effect. And, in fact, Ambien abuse and dependency has increased astronomically with an estimated 500 million Americans currently misusing the drug today, and emergency rooms have seen a 220% increase in emergency related visits from 2005 to 2010.

Symptoms of dependency include inability to sleep without the drug, using or filling the prescription more than originally prescribed, cravings, lying about use, memory lapses or loss, nausea and vomiting, hallucinations, and chronic fatigue. Ambien is also known to cause people to act in strange and abnormal ways, or to do things while sleepwalking and then having no memory of it later. This is called “zombie sleepwalking” or “lethal sleepwalking”. Because of these side effects, the company that manufactures Ambien has been involved in class-action lawsuits, especially regarding the way they have marketed the drug as safe and non-habit forming. Combining Ambien with alcohol is particularly dangerous and can lead to death as both substances depress the central nervous system, slowing and possibly stopping the heart and lungs. Withdrawals can be painful and acute as people may experience agitation, anxiety, cravings, depression, and even seizures.

Medical detox is recommended for stopping Ambien abuse, followed by treatment that aids a person in learning to live normally and comfortably without the drug, especially focusing on lifestyle habits that naturally promote normal sleep.
Prescription stimulants are used to treat attention deficit disorders and narcolepsy. These include Adderall, Ritalin, Concerta and Dexedrine.They increase alertness, attention, and energy levels. But when misused or overused, they create a speed effect by increasing dopamine and norepinephrine chemicals in the brain. Dopamine is involved in the reinforcement of rewarding behaviors. Norepinephrine affects blood vessels, blood pressure and heart rate, blood sugar, and breathing.

Overusing these drugs create a euphoric “rush” feeling, and increase heart rate. And at high doses can cause dangerously high body temperatures, irregular heart beat, heart attack and seizures. Repeated misuse can cause psychosis, volatile behaviors, and paranoia. As a person becomes tolerant, they need more of the drug to create the desired effects and this eventually leads to SUD (substance use disorder). Eventually, overuse of a stimulant can lead to heart, stomach, and nerve damage.

Overdosing on stimulants results in tremors, rapid and uncontrolled breathing, confusion, aggression, increased fever and muscle pain, nausea, vomiting, diarrhea and abdominal cramps. Overdose can result in seizures and convulsions, coma, and fatal poisoning.

Withdrawal symptoms can include fatigue, depression, and sleep disorders.

Detoxification and behavioral therapy are recommended for SUD, with a focus on managing triggers, stress, and behaviors.

American Psychiatric Association (2013) Desk Reference To The Diagnostic Criteria from DSM-5. Pp 227-283

https://www.drugabuse.gov/publications/drugfacts/prescription-stimulants

Marijuana, from the cannabis sativa and the cannabis indica plant, is the most widely used illicit drug. In 2015, more than 11 million young people, ages 18-25, reported using marijuana. Due to its legalization in many states and generally mild effects, marijuana is not typically viewed as a dangerous drug.

The chemical THC enters the bloodstream and over activates neuron receptors, causing altered sensations (eg., brighter colors ), altered sense of time, slowed reaction times, impaired memory, impaired cognitive and decision-making functioning, and hallucinations, delusions, and psychosis when taken in very large doses.

Marijuana affects brain development, especially in young people. If an adolescent starts smoking or consuming marijuana at an early age, it can affect memory, learning and thinking abilities, motivation, and has been shown to decrease IQ.

Due to smoking the drug, marijuana use can lead to similar respiratory problems as cigarette smoking. Marijuana also increases one’s chance of developing heart problems, and in pregnant women can lead to decreased birth weight, and behavioral and cognitive problems in babies. Marijuana use also increases symptoms in people with schizophrenia.

With chronic use, it can lead to a substance use disorder (SUD), in which the person cannot stop even if continued use is causing physical, emotional, or mental problems. Withdrawal from marijuana includes increased irritability, restlessness, difficulty sleeping, and cravings.

Treatment for marijuana addiction primarily entails behavioral therapy approaches.

American Psychiatric Association (2013) Desk Reference To The Diagnostic Criteria from DSM-5. Pp 227-283

https://www.drugabuse.gov/publications/drugfacts/marijuana

MDMA, 3,4-methylenedioxy-methamphetamine, is a synthetic drug with similarities to both stimulants and hallucinogenics, which increases energy levels, alters mood and perceptions, heightens feelings of pleasure, and creates distorted sensory and time perceptions. It’s long lasting effects made it popular at all-night dance parties, or “raves”.

MDMA primarily comes in a pill or tablet form. MDMA increases the activity of dopamine, norepinephrine, and serotonin in the brain, affecting the reward center, increasing energy, increasing heart rate and blood pressure, and increasing feelings of pleasure and sexual arousal. Side effects may include nausea, muscle cramps, involuntary teeth clenching, blurred vision, chills and sweating.

Prolonged use can result in increased irritability, depression, impulsiveness, sleep disorders, memory and attention problems, and decreased interest or pleasure from sex. With repeated use, it can affect the body’s ability to regulate temperatures leading to liver, kidney, and heart failure and possibly death.

Oftentimes MDMA is mixed with other drugs including cocaine, ketamine, methamphetamine, over-the-counter cough medicine, or synthetic cathinones (“bath salts”). People who unknowingly take tampered MDMA are at an increased risk of overdose or death.

MDMA can be addictive, and withdrawal symptoms include fatigue, depression, decreased appetite, difficulty concentrating, as well as decreased sensations of natural pleasure.

American Psychiatric Association (2013) Desk Reference To The Diagnostic Criteria from DSM-5. Pp 227-283

https://www.drugabuse.gov/drugs-abuse/mdma-ecstasymolly

Hallucinogens is a broad term for a range of naturally occurring and synthetic drugs that cause vivid auditory and visual hallucinations, distorted time and sensory perceptions, and marked increase in energy. Examples of hallucinogens include LSD, DMT, ayahuasca, peyote, and psilocybin mushrooms. Other hallucinogens are DMX, ketamine, PCP, and salvia.

Hallucinogens can be swallowed as a pill or tablet, taken in liquid form or brewed into a tea, snorted, injected, inhaled, smoked, injected, or eaten raw as with mushrooms. Hallucinogens interfere with communication in brain chemical systems, interfering with serotonin which regulates mood, sensory perception, body temperature and muscle control; and/or interferes with glutamate which regulates pain perception, responses to the environment, emotion, learning and memory.

Physical effects include increased heart rate, blood pressure, breathing, and body temperature; nausea; uncoordinated movements; feeling of disassociation; loss of appetite; sleep problems; excessive sweating; and in extreme cases psychosis.

There has not been much research on the long-term effects of chronic or repeated hallucinogen use, but speech and memory problems, depression, and anxiety have been noted, and long-time ketamine users can develop ulcers and kidney problems. High doses of PCP can result in seizure, coma, or death. While rare, long term use of hallucinogens can cause persistent psychosis, including visual disturbances, distorted thinking, paranoia, and mood changes, and flashbacks. People who ingest psilocybin are at risk for poisoning.

Research varies on the addictive qualities of hallucinogens. LSD is not considered an addictive drug, but a person may develop a tolerance for it, requiring more of the drug to get the desired effects. This is particularly dangerous if the purity of the drug is unknown. PCP on the other hand is an addictive drug and can cause cravings as well as withdrawal symptoms if stopped suddenly.

American Psychiatric Association (2013) Desk Reference To The Diagnostic Criteria from DSM-5. Pp 227-283

https://www.drugabuse.gov/publications/drugfacts/hallucinogens

Addiction Vs. Recovery 

It is often said that no one sets out to become an addict. Most addictions begin innocently enough as a person tries something, enjoys the effects, and continues to use for recreational purpose. Or else a person is prescribed sleep or pain medication as a primary means for dealing with insomnia or chronic pain and then there is little oversight or additional therapies provided to manage the original underlying issue. The challenge with addiction is that it’s not obvious who will become an addict and who will not. It is a very real example of playing Russian Roulette with one’s life.

Another challenge of addiction is the often subtle and gradual development of the disease. It often takes years for the changes in the brain and the subsequent changes in behavior and physiology to occur, and at that point that the person becomes aware they have the addiction, they are already so entrenched in their disease it can seem impossible to stop. By the time most people or their loved ones realize there is a problem a person’s situation looks futile. As addiction sets in, people start isolating from loved ones, finding no pleasure or motivation in activities they once enjoyed. An addicted person finds it increasingly difficult to manage their day to day responsibilities, often not showing up when they’re supposed to for work, school, family and community. Shame and guilt become a daily reality, relieved only by more substance use. A person cannot experience pleasure, ease, or comfort without the substance. What once worked to relax, sleep, or have fun no longer works, or requires more and more to achieve the same effect, and a person often finds themselves doing things they would never imagine doing in order to maintain their drug or alcohol habit. Dignity and self-respect erodes. Physical health issues start to occur as the body is so inundated with the drug that it can no longer self regulate; withdrawals and DTs occur more frequently, sleep is severely disrupted, and a person is often physically sick, shaking, vomiting, irritable and emotionally explosive or depressed. Addiction crowds out the realization that there is any other way to live life, cope with responsibilities, stress, or problems, or even enjoy oneself naturally. Substance use becomes the only way to deal with anything, even and especially when that person wants to stop.

A common refrain of people in recovery is that they never could have imagined the life they are now living free from addiction. Substance addiction kills the imagination and a person is incapable of imagining what life could be like without drugs or alcohol. And if they do imagine a vision of themselves clean and sober, it’s often a such a small vision that the prospect of a sober life seems dull and dreary. There is typically an inherent ambivalence to making the decision to seek treatment and recovery. A person may realize they can’t keep living the life they’re living, but aren’t entirely certain they want to get clean and sober. That’s okay; that is the addicted brain, devoid of imagination, trying to maintain what’s familiar in how it’s learned to cope with life. Our mind and body are always trying to maintain homeostasis and therefore struggle against change. Because of this any major life change is always difficult. That’s why we have to take it one step at a time, one day at a time.

A life of recovery can be rich beyond the imagination. Learning to feel again, to take pleasure in simple activities, to wake up and feel healthy and rested in the morning. To be free of that constant, relentless mental obsession, allows the the mind and heart to relax and open up to the world around you. Human connections and relationships become important again, and a profound shift occurs in the person when the people around them start to trust them again. A person can take action and participate in activities that build a sense of dignity and self-respect rather than shame and self-hatred. The mind and body can heal, and the once-addicted person is capable of change.

With commitment to recovery, a person is finally able to live a life full of all the potential they are capable of, all the potential they could never imagine before. And don’t worry, you don’t have to enter treatment with this commitment already in place. As addiction is a gradual process, so is recovery. With time and persistence, and the recognition that you are human and will make mistakes and that’s okay, that’s how a person learns what works and what doesn’t work, the promises and the rewards of recovery will grow and deepen, and you will pursue it as passionately as you once pursued drugs and alcohol. Today, you can do something different.

 

 

 

To say that addiction kills is bad enough, but it is only part of the story. According to the National Institutes of Health, children growing up in homes with a parent with alcoholism or drug addiction are eight times more likely to become alcoholic or drug addicted themselves (7). Various studies demonstrate that alcohol and/or drugs play a part in domestic violence 40%-60% of the time (8). Victims of domestic violence in turn are more likely to become addicted to alcohol or drugs (8).

Research has also found that on days where the abuser drank heavily or used drugs heavily they were eleven times more likely to abuse their partner (8). Meanwhile according to the Centers for Disease Control, 28% of motor vehicle fatalities are drug and/or alcohol related while only 1% of those who self-reported having had too many drinks and then drove were actually caught by police (9).

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Recovery is not just the abstinence of substance use. Recovery means reconnecting to one’s community through work, school and other activities; improved interpersonal relationships; and addressing other physical and mental health issues. Recovery is the facilitation of a quality of life that can heal the reward center of the brain. Recent studies have shown an 85% treatment success rate when multiple factors of an individual’s life and health are treated. This includes utilizing long-term, systems-based care such as counseling and education, individual and family therapy, screening and monitoring, peer support, and access to recovery communities (10).

 

 

But people with addiction can and do recover. Reconnected to their family, friends and community, they can recover their physical health, a sense of purpose and meaning, renewed economic and educational goals, and often find a new, more spiritually fulfilling life. 

We offer both inpatient and outpatient detox services; relapse prevention counseling including an Intensive Outpatient Program (IOP) and individual and family/relationship counseling. We also offer progressive relaxation, hypnotism, guided imagery, and EMDR. We have medical staff to assist with mental health and chronic pain issues. We have peer support staff to follow and provide support to each client during every step.

From the beginning, we work with clients to connect them to the resources they need during and after their initial treatment, which may include 12-step programs and other community recovery support groups, our Sober Living housing option, and referrals to outside primary care and mental health providers. We continue to track client progress with 90 and 180 day check-ins after discharge.

We believe that in being responsive and sensitive to the treatment systems available to identify, address, and treat the barriers to successful recovery, and to do so in a normative environment, are the keys to recovery.

Following is a list of potential symptoms of substance use disorder or alcoholism. Checking yes to at least two of these indicates that a person may have a substance use disorder.

But it also indicates that you are not alone. Knowing the signs and symptoms gives you the information you need to seek recovery from a disease that millions also suffer from.

*A problematic pattern of substance use leading to significant impairment or distress within a 12-month period as manifested by at least two of the symptom list:

  1. Taking the substance in larger amounts or over a longer period than intended.
  2. A persistent desire for or unsuccessful efforts to cut down or control.
  3. A great amount of time spent in obtaining, using or recovering from substance use.
  4. Craving for the substance.
  5. Recurrent use resulting in failure to meet major responsibilities – work, school, home.
  6. Continued use despite persistent/recurrent social and interpersonal problems caused by or exacerbated by use.
  7. Important social, occupational, recreational activities given up or reduced because of use.
  8. Recurrent use in situations where it’s physically hazardous.
  9. Continued use despite knowledge of having persistent and recurrent physical or psychological problems likely caused by use.
  10. A developed tolerance for the substance – a need for larger amounts to achieve desired effect or markedly diminished effect with continued use of the same amount.
  11. Experience of withdrawal – characterized by sweating or night sweats, increased heart rate, hand tremors, insomnia, nausea or vomiting, visual/tactile/or auditory hallucinations, psychomotor agitation, anxiety, or seizure.

A substance use disorder (SUD) is when continued use of the drug causes issues, such as health problems and failure to meet responsibilities at work, school, or home. An SUD can range from mild to severe, the most severe form being addiction.

References? See more  

(0) American Society of Addiction Medicine. (2011) Definition of Addiction. Resources. Retrieved 11-1-18 from https://www.asam.org/resources/definition-of-addiction

(1) Center on Addiction (2017) Addiction as a Disease. Resources. Retrieved 12.7.18 from https://www.centeronaddiction.org/what-addiction/addiction-disease

(2) American Psychiatric Association (2013) Desk Reference To The Diagnostic Criteria from DSM-5. Pp 227-283.

(3) United States National Institute of Health. (2018) Drug Overdose Death Rates. National Institute on Drug Abuse. Retrieved on 11-1-18 from  https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

(4) United States National Institute of Health. (2018) Alcohol Facts and Statistics National Institute on Alcohol Abuse and Alcoholism. Retrieved on 11-1-18 from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics

(5) New Mexico Department of Health, (2018) Complete Health Indicator Report of Drug Overdose Deaths. New Mexico’s Indicator Based Information System (NM-IBIS). Retrieved on 11-1-18 from  https://ibis.health.state.nm.us/indicator/complete_profile/DrugOverdoseDth.html

(6) New Mexico Department of Health, (2018) Complete Health Indicator of Alcohol – Alcohol-Related Death. New Mexico’s Indicator Based Information System (NM-IBIS). Retrieved on 11-1-18 from  https://ibis.health.state.nm.us/indicator/complete_profile/AlcoholRelatedDth.html

(7) Merikangas KR, Stolar M, Stevens DE, et al. (1998) Familial Transmission of Substance Use Disorders. Arch Gen Psychiatry. 55(11):973–979. doi:10.1001/archpsyc.55.11.973 Retrieved 11-1-18 from https://www.ncbi.nlm.nih.gov/pubmed/9819065

(8) Soper, R. G. (2014) Intimate Partner Violence and Co-Occurring Substance Abuse/Addiction. American Society of Addiction Medicine, Resources. Retrieved 11-2-18 from: https://www.asam.org/resources/publications/magazine/read/article/2014/10/06/intimate-partner-violence-and-co-occurring-substance-abuse-addiction

(9) Centers for Disease Control and Prevention (n.d.) Impaired Driving: Get the Facts. Motor Vehicle Safety. Retrieved 11-1-18 from: https://www.cdc.gov/motorvehiclesafety/impaired_driving/impaired-drv_factsheet.html

(10) Austin M Brown & Robert Bohler (2018): Achieving a 15% Relapse Rate: A Review of Collegiate Recovery and Physician Health Programs, Alcoholism Treatment Quarterly, DOI: 10.1080/07347324.2018.1424595

   

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