Substance Abuse and Addiction in Adults

Substance Abuse and Addiction in Adults

Article
Brain & Nerve
Behavioral & Mental Health
+3
Contributed byMaulik P. Purohit MD MPHSep 03, 2019

What are the other Names for this Condition? (Also known as/Synonyms)

  • Adult Drug Abuse
  • Adult Drug Addiction
  • Adult Substance Abuse and Addiction

What is Substance Abuse and Addiction in Adults? (Definition/Background Information)

  • Substance abuse occurs when an individual uses either illegal or legal drugs for recreational purposes. It is commonly the first step towards developing an addiction
  • An addiction occurs when the user becomes dependent on the drug being abused. Addiction is characterized by continued use regardless of the obvious negative effects that one may be aware of
  • Both substance abuse and addiction lead to behavioral and characteristic changes in the affected individual, which are not desirable
  • The US National Institute of Drug Abuse informs that the most commonly abused substances include alcohol, cocaine, hallucinogens, heroin, inhalants, LSD, marijuana (cannabis), methamphetamine, OTC cough and cold medicines, steroids (anabolic), tobacco, and prescription drugs such as painkillers (opioid), stimulants, and depressants
  • Substance Abuse and Addiction in Adults are observed in men about 2 times more than what is seen in women. The risk factors associated with substance abuse and addiction include early-onset of drug use, family history of drug addiction, traumatic life experiences, emotional instability, and peer pressure
  • The signs and symptoms noticed generally include intense craving for the drug, spending large amounts of money to obtain the drug, and failed attempts at stopping drug use
  • The main treatment for Substance Abuse and Addiction in Adults are counselling or talk therapy undertaken by a psychiatrist and medications to control the withdrawal symptoms. Once the drug usage is stopped, the chances of relapse may vary due to the wide range of drugs and effects associated with them
  • Substance abuse can be prevented 100% by refraining from drug use. Early detection or awareness can increase the chances of the user abstaining from recreational drug use

Who gets Substance Abuse and Addiction in Adults? (Age and Sex Distribution)

  • Substance abuse and addiction may affect adults of any age
  • However, men are twice more likely to have trouble with substance abuse and addiction than women
  • Adult Substance Abuse and Addiction is a worldwide phenomenon; there is no geographical, racial, or ethnic predilection

What are the Risk Factors for Substance Abuse and Addiction in Adults? (Predisposing Factors)

The risk factors associated with Substance Abuse and Addiction in Adults includes:

  • Early onset of drug use; substance abuse while one is still young
  • Impulsive nature
  • Family history  of drug addiction
  • Traumatic life experiences
  • Emotional instability
  • Encouragement of drug use from peers
  • Mental health conditions such as attention-deficit hyperactivity disorder (ADHD) or post-traumatic stress disorder (PTSD)
  • Lack of family involvement

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Substance Abuse and Addiction in Adults? (Etiology)

A continuous and chronic abuse typically leads to addiction. The following can potentially cause Substance Abuse and Addiction in Adults:

  • Environment where drugs are prevalent
  • Low self-esteem
  • Highly addictive prescription medication that was once prescribed for a health condition
  • Feelings of neglect by family members and friends
  • Loneliness, depression
  • Having a psychological problem
  • How the drug is administered (such as through injection or inhalation) may play a role in its addictiveness quality or potential; some drug administration methods enhance this addictive quality
  • Genetic factors also can be the cause of addiction once dependence sets in

Addiction is caused by the repetitive use of the drug or substance. Once dependence has occurred, the brain alters one’s behavior when the drug is temporarily discontinued, thus leaving the individual craving for more, in order to feel “normal” again.

What are the Signs and Symptoms of Substance Abuse and Addiction in Adults?

Signs and symptoms associated with Adult Substance Abuse and Addiction include:

  • General feeling that the drug can solve life’s problems
  • Spending large amounts of money on drug
  • Failed attempts to stop use of the drug
  • Desire to use the substance regularly
  • Lying or stealing to obtain drug
  • Red eyes (bloodshot eyes)
  • Drowsiness
  • Taking part in risk behaviors that otherwise are undesirable
  • Decreased coordination
  • Rapid weight loss or weight gain
  • Mood swings
  • Poor judgment and a lack of clear thought
  • Changes in physical appearance due to poor personal habits and hygiene

Each drug has specific signs and symptoms associated with its use. The above mentioned points are general features linked to most substance use.

How is Substance Abuse and Addiction in Adults Diagnosed?

The diagnosis of Substance Abuse and Addiction in Adults include:

  • A physician diagnoses substance abuse after a thorough physical evaluation and medical history review
  • The diagnostic criteria for substance abuse states that the abuse must lead to significant impairment, backed by certain experiences, within a year. One or more of the following criteria must be met:

    • Frequent use of substance in situations that are potentially hazardous to the user
    • Neglecting work, college, and/or parenting obligations frequently due to drug use
    • Repetitive legal problems due to substance use or abuse
    • Continued use regardless of adverse (health or other) effects as a result of drug use  

If all of the above criteria are seen, a physician will determine whether the abuser is addicted or not.

  • The diagnostic criteria for addiction (dependence) states that there must be significant stress or impairment during a year, as a result of 3 of the following factors:
    • Noticeably increased amounts of the drug are needed to reach the “effect” once obtained with smaller amounts (drug tolerance)
    • There are withdrawal symptoms when the drug use is stopped. Also, additional drug use is required to stop the withdrawal symptoms
    • Substance use cannot be stopped regardless of the users desiring to do so
    • Chronic seeking behavior to obtain the drug           
    • Neglect or isolation from employment, social, and recreational activities due to drug use
    • Continued substance use, although the user feels consistent physical or psychological disturbances

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Substance Abuse and Addiction in Adults?

Complications associated with Substance Abuse and Addiction in Adults includes:

  • Legal troubles
  • Loss of employment
  • Contracting a sexually transmitted disease
  • Brain damage
  • Overdose
  • Mental health issues
  • Loss of meaningful relationships, frequently getting involved in fights, violent behavior
  • Substance abuse in pregnant women can cause severe harm to the growing fetus
  • Injuries and accidents (such as from driving under influence)

Death can occur due to the overuse of large amounts of the drug.

How is Substance Abuse and Addiction in Adults Treated?

Treatment plans for Substance Abuse and Addiction in Adults are chosen depending on the severity of the condition, what type of substance is involved, and the personal preferences of the user. The following treatment and support measures may be considered:

  • Self-help groups: Getting mutual help and support from others who share the same problem
  • Support groups such as Narcotics Anonymous and Alcoholics Anonymous
  • Family therapy: Getting the help of family members or spouse to bring about a positive outcome
  • Inpatient programs at a facility for an extended time, also known as residential treatment
  • Outpatient programs for drug addicts and alcoholics with long-term recovery goals
  • Medications to subside withdrawal symptoms
  • Behavioral therapy: In this therapy, the undesirable habits are replaced with desirable habits, using behavior modification
  • Cognitive therapy: This can help develop positive thinking and overcome depression, feelings of negative thought, etc.

How can Substance Abuse and Addiction in Adults be Prevented?

Adult Substance Abuse and Addiction is completely preventable by refraining from substance use or abuse. The preventative measures may include:

  • If the abuse or addiction is being caused because of a prescription medicine, then discontinue the use of that particular medication beyond the prescribed amount or duration
  • Discarding or disposing the remaining medications from home, if there are pills remaining after you have recovered from the condition, for which the pain medication was prescribed. This will reduce access to other members of the household too
  • If abuse has already occurred and dependence has formed, abstaining from the drug will decrease the likelihood of complications
  • High-risk drug-use situations should be avoided and treatment plans are to be followed (for their entire course) to minimize the chances of relapse
  • Surround yourself with friends and family members who can understand and support you; this can help avoid relapses
  • Always keep follow-up appointments with your healthcare provider

What is the Prognosis of Substance Abuse and Addiction in Adults? (Outcomes/Resolutions)

The prognosis associated with Substance Abuse and Addiction in Adults is complex and is dependent upon many factors, which include the length of time and severity of the dependence.

  • Most users will relapse within 3 months of stopping the substance use
  • However, the prognosis can be fairly good, if the user is committed to stay sober
  • Early detection can increase the chances of the user abstaining from drugs
  • Relapse of the condition depends upon the substance type and its effect on the body after usage is stopped. It also depends upon the response to the therapy provided, help and support from family and friends, etc.

Recovery from substance abuse may take a long period of time; even if treatment measures are initially unsuccessful, they can yield positive outcomes with determined efforts of all involved.

Additional and Relevant Useful Information for Substance Abuse and Addiction in Adults:

According to the World Health Organization (WHO), globally there are over 155 to 250 million people (teens and adults in the 15-64 years age group) who are addicted to psychoactive drugs, which include cannabis, amphetamine, cocaine, opioids, and many others.

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Maulik P. Purohit MD MPH picture
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Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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