American Medical Association Family Medical Guide - American Medical Association [475]
Drug Abuse and Addiction
Using any drug for a purpose other than that recommended on the label or prescribed by a doctor, or using any drug for nonmedical use, is considered drug abuse. Drug dependence (or addiction) is an uncontrollable physical craving for a drug. Drug abuse and addiction are difficult and serious problems worldwide, and many dangerous drugs that carry the potential for abuse are available both legally and illegally in the United States. Not everyone who takes an addictive drug becomes dependent on it. Some people are more susceptible to drug addiction than others for reasons that include both inherited and environmental factors.
Numerous drugs can cause physical dependence, or addiction, which means that your body gets so used to the substance that it needs the drug just to feel normal. When the drug is not available, you develop severe withdrawal symptoms. Your body eventually builds up a tolerance to a drug that causes dependence, so you must take gradually increasing doses to maintain the enjoyable effects of the drug or to prevent the unpleasant withdrawal symptoms that can develop when you stop using the drug. Most sleeping pills, for example, alter the sleep rhythm so much that, without the drug, a person’s sleep becomes disturbed and restless. Withdrawal symptoms from some drugs can be harmful, or even fatal, and withdrawal should be carefully supervised by a doctor.
Many drugs also cause psychological dependence, meaning that they produce such enjoyable sensations that the user feels unable to live without them and is driven to take the drug again and again. The most dangerous drugs have traditionally been alcohol, heroin, and cocaine, but many newer drugs (such as the club drug ecstasy and the prescription pain relievers oxycodone and hydrocodone) can be just as harmful.
People gain access to addictive drugs in a number of ways. Drugs may be prescribed by a doctor to treat a physical or mental disorder, or they may be purchased illegally to provide a high or to avoid or diminish unpleasant feelings or sensations such as pain. Other substances—including household cleaning products, glue, and some substances in aerosol containers—can be used inappropriately to produce a high, especially among preadolescent and adolescent boys (see page 459). Nicotine, found in cigarettes and other tobacco products, is a highly addictive, although legal, drug.
Apart from the obvious risks from the effects of the drugs themselves, abuse carries other serious risks. Users of injected drugs often share needles or fail to sterilize them before use, placing themselves at risk for hepatitis (see page 786), HIV infection (see page 909), and other bloodborne diseases. The high cost of illegal drugs may lead addicts into crime or prostitution, which poses a high risk for acquiring sexually transmitted diseases (STDs; see page 477). Also, no official agency regulates the purity or strength of illegal drugs. They may be too pure, making them too strong, or they may be combined with toxic substances to increase the quantity. Many people abuse or become addicted to both alcohol and drugs at the same time. No reliable statistics exist on the total number of people who are dependent on drugs in the United States because many addicts obtain their drugs illegally and many never seek treatment.
Prescription Drug Abuse and Addiction
The abuse of prescription drugs is expanding nationwide. An estimated 2 percent of the US population use prescription drugs for nonmedical purposes. The most commonly abused prescription drugs are pain relievers such as oxycodone and hydrocodone, sedatives and tranquilizers such as benzodiazepines and diazepam, and stimulants