Because different drugs have different effects on their users, there is no single standard definition for drug dependence. Addiction usually involves a lifestyle of compulsive use and intense involvement with a drug. This can occur with or without physical dependence. Use of the substance also creates destructive effects in the user's life.
Abuse of prescription and illegal drugs occurs at all social and economic levels of society. It affects people in all walks of life and with all levels of education.
The general characteristics of drug dependence are:
- Increasing tolerance for the drug's effects. This leads people with a substance addiction to use more and more of the substance to create the same effects they experienced during the first usage.
- Physical dependence. This causes changes in the body when the substance is withdrawn, but it does not happen with all forms of drug dependence. Heroin and alcohol are two substances that produce a strong physical dependence that often leads to abuse.
- Psychological dependence. This occurs when there is an overwhelming desire to experience the effects of the substance and to avoid the consequences of not having the substance. Cocaine, marijuana, amphetamines, hallucinogens and peyote all cause a mainly psychological dependence.
How substance dependence occurs is both complex and not clearly understood yet. The factors involved include the nature of the drug and the user's physical and genetic tendencies, personality, culture and social setting.
It is not well understood how or why a person may progress from experimental substance use to more and more frequent use and greater and greater tolerance to physical dependency on the substance. It may be a result of group pressure, emotional distress that is relieved by the drug's specific effects, loneliness or a sense of powerlessness.
Drugs that produce dependence act on the central nervous system with one or more of these effects:
- Reduced anxiety and tension
- Elation, euphoria or other pleasurable mood changes
- Feelings of increased mental and physical ability
- Sensory perceptions that are different than normal
- Behavior changes
Studies to discover brain processes that lead to addiction or to evidence that an "addictive personality" exist have not been conclusive.
Diagnosis will depend on the nature of the drug causes the addition, the individual's behavior, medical conditions that may result from the addiction and what happens when the individual stops using the drug.
Treatment will vary depending on the nature of the drug causing the addiction, how severe the addiction is, how long the person has been addicted and what, if any, medical complications may be associated with the addiction.
The first step in treatment is usually supervision and assistance to help the person stop using the drug. Often counseling, group therapy and participation in an appropriate type of 12-step program are also beneficial.
