Symptoms and Signs of Drug Dependence and Abuse

Doctor's Notes on Drug Dependence and Abuse

Drug abuse (substance abuse) is an intense desire to use increasing amounts of a particular substance, or to take illegal drugs or to misuse legal substances such as alcohol or prescription medications. Drug dependence (addiction) is the body's physical need to have a specific drug. Over time, dependence results in physical harm, behavior problems, and association with people who also abuse drugs. Stopping the use of the drug can result in withdrawal symptoms.

Symptoms of drug dependence and abuse depend on the substances being abused. Symptoms of drug dependence and abuse may include

• changes in the level of consciousness,
• a decrease in responsiveness,
• bizarre behavior,
• agitation anger,
• anxiety,
• sleep problems,
• hallucinations,
• sleepiness,
• confusion,
• skin is cool and sweaty or hot and dry,
• chest pain,
• abdominal pain,
• nausea,
• vomiting, and
• diarrhea.

Serious symptoms of drug dependence and abuse include

• coma,
• abnormal vital signs (temperature, pulse rate, respiratory rate, blood pressure),
• vomiting blood,
• blood in bowel movements, and
• a person may stop breathing, which can cause death.

Withdrawal symptoms vary depending on the drug but can be life threatening.

What Is the Treatment for Drug Dependence and Abuse?

Drug dependence and abuse requires a multifactorial treatment plan, including the willful participation of the patient. Tapering off substances with eventual abstinence, or drug substitution to either a less addictive medication or another drug class are mainstays of treatment. High-risk patients with long-term addiction or abuse may do better with inpatient residential rehab treatment or intensive inpatient addiction services. 

Because addiction is a chronic disease, people can’t simply stop using drugs for a few days and be cured. Most patients need long-term or repeated care to stop using completely and recover their lives.

Addiction treatment must help the person do the following:

• Stop using drugs
• Stay drug-free
• Be productive in the family, at work, and in society 

Strategies for treatment of drug dependence and abuse may include:

• Behavioral counseling
• Tapering of amount and dose until abstinence
  • Lower and lower dose with less frequency until medication is no longer needed
• Antiseizure medication substitution
  • Using carbamazepine and pregabalin to limit withdrawal symptoms
• Psychotherapy
  • Used with tapering the dose or drug substitution, is shown to be more effective than either approach separately
• Evaluation and treatment for co-occurring mental health issues such as depression and anxiety
• Maintenance therapy
  • Some patients cannot get off certain drugs and need to be on low-dose chronic medication therapy supervised by their healthcare provider