Doctor's Notes on Substance Abuse
Substance abuse, or drug abuse, is when people take illegal drugs or they misuse legal drugs such as alcohol, tobacco, or prescription medications. Abused substances often produce some form of intoxication that alters judgment, perception, attention, or physical control.
Signs and symptoms of substance abuse may include giving up past activities a person used to enjoy, hanging out with new friends declining grades aggressiveness, irritability significant changes in mood or behavior forgetfulness disappearing money or valuables feeling rundown, hopelessness, depression, suicidal thoughts or actions, selfishness, use of room deodorizers and incense, presence of drug paraphernalia (such as baggies, small boxes, pipes, and rolling paper), physical problems with unclear cause (for example, red eyes and slurred speech), getting drunk or high on drugs on a regular basis, lying (especially about how much alcohol or other drugs are being used), avoiding friends or family in order to get drunk or high, planning drinking in advance, hiding alcohol, drinking or using other drugs alone, having to drink more to get the same high, believing that in order to have fun you need to drink or use other drugs, frequent hangovers, pressuring others to drink or use other drugs, taking risks (including sexual risks), having "blackouts," forgetting what happened the night before, constantly talking about drinking or using other drugs, trouble with the law, drinking and driving, and suspension or other problems at school or in the workplace for an alcohol- or drug-related incidents. Many substances can also bring on withdrawal symptoms when the drug is stopped or reduced that can range from mild anxiety to seizures and hallucinations. Drug overdose may also cause death.
Substance Abuse Symptoms
Friends and family may be among the first to recognize the signs of substance abuse. Early recognition increases the chances for successful treatment. Signs to watch for include the following:
- Giving up past activities such as sports, homework, or hanging out with new friends
- Declining grades
- Aggressiveness and irritability
- A significant change in mood or behavior
- Disappearing money or valuables
- Feeling rundown, hopeless, depressed, or even suicidal
- Sounding selfish and not caring about others
- Use of room deodorizers and incense
- Paraphernalia such as baggies, small boxes, pipes, and rolling paper
- Physical problems with unclear cause (for example, red eyes and slurred speech)
- Getting drunk or high on drugs on a regular basis
- Lying, particularly about how much alcohol or other drugs he or she is using
- Avoiding friends or family in order to get drunk or high
- Planning drinking in advance, hiding alcohol, and drinking or using other drugs alone
- Having to drink more to get the same high
- Believing that in order to have fun you need to drink or use other drugs
- Frequent hangovers
- Pressuring others to drink or use other drugs
- Taking risks, including sexual risks
- Having "blackouts," forgetting what he or she did the night before
- Constantly talking about drinking or using other drugs
- Getting in trouble with the law
- Drinking and driving
- Suspension or other problems at school or in the workplace for an alcohol- or drug-related incident
Substance Abuse Causes
Use and abuse of substances such as cigarettes, alcohol, and illegal drugs may begin in childhood or the teen years. Certain risk factors may increase someone's likelihood of abusing substances.
- Family history factors that influence a child's early development have been shown to be related to an increased risk of drug abuse, such as
- chaotic home environment,
- ineffective parenting,
- lack of nurturing and parental attachment,
- parental drug use or addiction.
- Other risk factors for substance abuse are related to the substance abuse sufferer him- or herself, like
- male gender,
- childhood attention deficit hyperactivity disorder (ADHD),
- history of anxiety or other mood disorders,
- conduct disorder or antisocial personality disorder.
- Factors related to a child's socialization outside the family may also increase the risk of drug abuse, including
- inappropriately aggressive or shy behavior in the classroom,
- poor social coping skills,
- poor school performance,
- association with a deviant peer group or isolating oneself from peers altogether,
- perception of approval of drug-use behavior.
Drug abuse, now also referred to as drug use disorders, refers to using substances, over-the-counter (OTC) medications, prescription drugs, or illegal street drugs for the purpose of getting high. Substance abuse can lead to significant, even life-threatening, health problems. It also increases the risk of accidents, suicide, unsafe sex, and violence. Teens are more likely to abuse substances if they suffer from depression, low self-esteem or impulse control, have a history of being abused, or family history of substance abuse. Teens who receive low parental supervision or communication, or who feel different than their peers are also at risk for drug abuse.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.