Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
People abuse substances such as alcohol, tobacco, and other drugs for varied and complicated reasons, but it is clear that our society pays a significant cost. The toll for this abuse can be seen in our hospitals and emergency departments
both through direct damage to health by substance abuse and its link to physical trauma. Jails and prisons tally daily the strong connection between crime and drug dependence and abuse. Although use of some drugs such as cocaine has declined
in recent years, use of other drugs such as heroin and "club drugs" has increased.
Finding effective treatment for and prevention of substance abuse has been difficult. Through research, we now have a better understanding of this behavior. Studies have made it clear that drug education and prevention aimed at children and adolescents offers the best chance to curb abuse nationally.
The 2010 National Household Survey on Drug Abuse estimated the number of users of illicit drugs in the United States to be over 22 million. Other statistics from the survey include that nearly 7% of Americans over 12 years
of age are binge drinkers and almost 70 million of Americans smoke cigarettes. Other research shows that about 22 million people over 12 years
of age in the United States have abused inhalants and three-quarters of a million use inhalants for the first time each year.
Abused substances produce some form of intoxication that alters judgment, perception, attention, or physical control.
Many substances can bring on withdrawal effects caused by cessation or reduction in the amount of the substance used. Withdrawal can range from mild anxiety to seizures and hallucinations. Drug overdose may also cause death.
Nearly all these drugs also can produce a phenomenon known as tolerance, in which one must use a larger amount of the drug to produce the same level of intoxication. Commonly abused drugs include
Inhalants: This group of substances includes solvents that emit vapors, causing intoxication when breathed in (inhaled). Individuals who abuse inhalants intentionally breathe in the vapors, either directly from a container, from a bag in which such a substance is in, or from a rag soaked with the substance and then placed over the mouth or nose. Inhalant intoxication happens quickly and doesn't last long.
Abuse of inhalants is also called "huffing." Approximately 58% of inhalant users report first using it by the end of ninth grade. Teens who started using inhalants before 15 years
of age were up to six times more likely as those who had started later to develop dependence on these substances.
Symptoms of inhalant intoxication are very similar to those seen with intoxication with alcohol, including dizziness, clumsiness, slurred speech, elation, tiredness, slowed reflexes, thinking and movement, shaking, blurred vision, stupor or coma, and/or weakness. It can also result in chemical and temperature burns, as well as withdrawal symptoms, chronic mental illness, and even sudden death.
Long-term damage associated with inhalant use includes brain and nerve damage as well as heart, liver, or kidney failure
Tobacco: People cite many reasons for using tobacco, including pleasure, improved performance and vigilance, relief of depression, curbing hunger, and weight control.
Smoking is responsible for nearly a half million deaths each year. Tobacco use costs the nation an estimated $100 billion a year, mainly in direct and indirect health care costs.
Alcohol: Although many people have a drink as a "pick me up," alcohol actually depresses the brain. Alcohol lessens your inhibitions, slurs speech, and decreases muscle control and coordination, and
prolonged use may lead to alcoholism.
Withdrawal from alcohol can cause anxiety, irregular heartbeat, tremor, seizures, and hallucinations. In its severest form, withdrawal combined with malnutrition can lead to a life-threatening condition called delirium tremens (DTs). Alcohol
abuse is the most common cause of liver failure in the U.S. The drug can cause heart enlargement and cancer of the esophagus, pancreas, and stomach.
In addition to its direct health effects, officials associate alcohol abuse with
nearly half of all fatal motor-vehicle accidents. In 1992, the total economic cost of alcohol abuse was estimated at $150 billion.
How are inpatient and outpatient treatment similar?
Inpatient and outpatient treatment programs both usually involve the 12-step programused by Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). Treatment may include group therapy, one-on-one counseling, drug and alcohol education, medical care, and family therapy.
Your doctor or counselor will help you decide whether you should have inpatient or outpatient treatment. The choice may depend on: