Drug addiction is a state of periodic or chronic intoxication produced by the repeated consumption of a drug (natural or synthetic). Its characteristics include: an overpowering desire or need (compulsion) to continue taking the drug and to obtain it by any means; a tendency to increase the dose; a psychic (psychological) and generally a physical dependence on the effects of the drug; and detrimental effects on the individual and on society.
Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.
Physical dependence is a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.
Tolerance is the body’s physical adaptation to a drug: greater amounts of the drug are required over time to achieve the initial effect as the body “gets used to” and adapts to the intake.
Drug addiction is characterized by strong, drug seeking behaviors in which the addict persistently craves and seeks out drugs, despite the knowledge of harmful consequences. Addictive drugs produce a reward, which is the euphoric feeling resulting from sustained DA concentrations in the synaptic cleft of neurons in the brain. Operant conditioning is exhibited in drug addicts as well as laboratory mice, rats, and primates; they are able to associate an action or behavior, in this case seeking out the drug, with a reward, which is the effect of the drug. Evidence shows that this behavior is most likely a result of the synaptic changes which have occurred due to repeated drug exposure. The drug seeking behavior is induced by glutamatergic projections from the prefrontal cortex to the NAc. This idea is supported with data from experiments showing the drug seeking behavior can be prevented following the inhibition of AMPA glutamate receptors and glutamate release in the NAc.
Drug addiction is widely considered a pathological state. The disorder of addiction involves the progression of acute drug use to the development of drug-seeking behavior, the vulnerability to relapse, and the decreased, slowed ability to respond to naturally rewarding stimuli. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) has categorized three stages of addiction: preoccupation/anticipation, binge/intoxication, and withdrawal / negative affect. These stages are characterized, respectively, everywhere by constant cravings and preoccupation with obtaining the substance; using more of the substance than necessary to experience the intoxicating effects; and experiencing tolerance, withdrawal symptoms, and decreased motivation for normal life activities. By the American Society of Addiction Medicine definition, drug addiction differs from drug dependence and drug tolerance.
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Drug tolerance
Drug tolerance occurs when a subject’s reaction to a drug (such as a painkiller or intoxicant) decreases so that larger doses are required to achieve the same effect. This can easily lead to overdoses, especially of illicit drugs.
Drug tolerance can involve both psychological drug tolerance and physiological factors. Characteristics of drug tolerance: is reversible, rate depends on the particular drug, dosage and frequency of use, differential development occurs for different effects of the same drug.
Tachyphylaxis is a medical term referring to the rapid decrease in response to a drug after repeated doses over a short period of time.
Tolerance may be related to the familiarity of “drug onset cues”. The body is conditioned to respond to environmental cues such as the sight of a needle, and actually produces the beginnings of physiological responses before the drug is introduced. If there is no actual drug that follows, or if the dose is too small to produce the expected effect, it can trigger intense cravings in the addict. This may explain why “just one drink”, or even the sight or presence of familiar alcohol cues, can cause a relapse in a recovering alcoholic.
Drug habituation
Drug habituation (habit) is a condition resulting from the repeated consumption of a drug. Its characteristics include a desire (but not a compulsion) to continue taking the drug for the sense of improved well-being which it engenders; little or no tendency to increase the dose; some degree of psychic dependence on the effect of the drug, but absence of physical dependence and hence of an abstinence syndrome [withdrawal], and detrimental effects, if any, primarily on the individual.
Pseudo-addiction
Pseudo addiction is a term which has been used to describe patient behaviors that may occur when pain is undertreated. Patients with unrelieved pain may become focused on obtaining medications, may “clock watch,” and may otherwise seem inappropriately “drug seeking.” Even such behaviors as illicit drug use and deception can occur in the patient’s efforts to obtain relief. Pseudoaddiction can be distinguished from true addiction in that the behaviors resolve when pain is effectively treated.
Addictive potency
The addictive potency of drugs varies from substance to substance, and from individual to individual. Drugs such as codeine or alcohol, for instance, typically require many more exposures to addict their users than drugs such as heroin, lsd, marijuana or cocaine. Likewise, a person who is psychologically or genetically predisposed to addiction is much more likely to suffer from it.
Drugs at work
As drugs become a common place feature of many people’s social lives – particularly in the 16-29 age group – they are leaking into the work place. A large amount of employers are finding employees have problems with drugs at work. It is a serious and growing problem. People who take drugs at work can complete our application form to get help at our drug rehab. A Teen Challenge London Support Worker or the Centre Manager will contact you to arrange an interview. Our services are provided at a very low cost. You can call us on 020 8553 3338 if you have any questions.
The report Drink, Drugs at Work Don’t Mix, by Alcohol Concern and the Institute for the Study of Drug Dependence (now called DrugScope) pulls together the statistics and information. The report finds that most people who have a drinking problem are in work, as are 25% of those seeking help for problems with other drugs.
In a survey, 46% of large companies said that alcohol at work was a problem, while 18% reported illegal drug use by their employees in the previous year.
Consequences in the workplace
Although problem drinkers and drug users may stay in the workforce, there is evidence that they perform less well, change jobs more frequently, and take more time off sick than other workers – all of which costs employers heavily. One government study estimated that around 14.8 million working days are lost each year as a result of drugs and drink – that’s 3-5% of all absence.
Job Safety
In some jobs, particularly where safety is involved, such as the transport industry, any form of intoxication is a very serious matter and may be a criminal offence. But even if safety isn’t in question, drinking heavily or taking drugs while at work is not generally a good way to impress the boss. Most of the sought-after effects of alcohol and illegal drugs cause changes in behavior that are inappropriate at work. Feeling intensely relaxed (cannabis) or euphoric (heroin, ecstasy) is not conducive to the meeting of deadlines, for example. Displaying uninhibited, very sociable behavior (a consequence of many drugs, notably ecstasy and alcohol – though alcohol can also make people aggressive) – is likely to alienate or alarm colleagues who are fuelled only by caffeine. Unpredictable and clearly undesirable side-effects – for example, passing out at your desk or suffering a panic attack – are also a possibility.
Someone who drinks at lunchtime to help them cope with a stressful afternoon meeting may find that the alcohol escalates their anxiety. It will certainly impair judgement and reflexes – increasing the possibility of their saying something stupid and bumping into the furniture. Cocaine and amphetamines may help a user work long hours, but they can also increase anxiety and affect the quality of work.
Despite this, alcohol and drugs are so embedded in the culture of some organizations that bosses tolerate or even encourage substance misuse. According to Drug Scope, high-earning white-collar workers are most at risk from this sort of employer collusion: in a few companies, ‘If you have to stay up till 4am to get the job done, and cocaine helps you to do that, then the employer turns a blind eye.’
Different drugs involve different after-effects and recovery periods but getting over a heavy session can take days, during which time you may feel tired, agitated, anxious or depressed. Sleeping problems are also common. In the long term, users may experience difficulties in their relationships and will be more vulnerable to medical problems. These problems also affect productivity at work.
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The Employers Interest
With the encouragement of government, employers in a wide range of industries are therefore taking an interest in the drug-taking habits of their employees. This interest can express itself in almost pastoral terms – an offer of confidential help for anyone who might need it. But at the other end of the scale there are employers who act like private investigators, determined to catch and punish drug users.
Their reasoning is simple: if it affects their business, it is their business. Broadly speaking, if drugs or alcohol are impairing your ability to work safely and productively, your employer has a right to intervene, even if you indulge the habit outside working hours.
Testing
According to a national survey of 1,800 firms by the Chartered Institute of Personnel and Development:
- 5% of businesses have a policy of randomly testing employees for drugs
- 4% carry out random tests for alcohol
- 9% conduct pre-employment testing for illegal drugs (fail the test and you may not get the job)
- 9% use pre-employment tests for alcohol misuse.
But overzealous employers who insist employees submit to tests for no good reason could find themselves liable to prosecution. A positive drug test gives the employers very little information: All it shows is that at some point the person came into contact with a particular type of drug.
Unless justified on safety grounds, alcohol and drug testing should only be introduced as part of a voluntary treatment programme, says the code. And positive results for cannabis ‘should neither be recorded nor used’. This would be good news for people who smoke an occasional joint – cannabis can stay in the system for days or weeks.
Help is available at Teen Challenge London – find freedom from your drug abuse.
Sanctions
Turning up for work under the influence of drugs or alcohol, or taking drugs while on work premises, are sackable offences. ‘You are supposed to present yourself fit for work – it would be difficult to defend someone in these circumstances.
Turning up with a hangover is a grey area. You are probably going to be late and you are not going to be very effective when you are in. The axe however is unlikely to fall for a first (or very infrequent) offence: ‘What would be most suitable would be for an organization to give the employee a warning and a chance to improve. Most employers won’t care if you do it once a year. It’s just when it affects your productivity.’
Help for employers and employees
Teen Challenge provides a wealth of information and support for drug or drinking addicts. Our rehabilitation programme includes expert advice for any type of substance abuse. We are open to everyone both men and women who need addiction help. The centre in London is open to men only and Hope House in Wales is for women only. For more information you will need to complete an application form.
What makes one person abuse drugs to the point of losing their home, their family and their job, while others don't?
There is no simple reason. Drug abuse and addiction is due to many factors. A powerful force in addiction is the inability to self- soothe or get relief from untreated mental or physical pain. Without the self-resilience and support to handle stress, loneliness or depression, drugs can be a tempting way to deal with the situation. Unfortunately, due to the changes drugs make to the brain, it can only take a few times or even one time to be on the road to addiction. Some other risk factors include:
- Personality. If you have another psychological problem, such as depression, attention-deficit/hyperactivity disorder or post-traumatic stress disorder, you’re more likely to become dependent on drugs. Children who exhibit aggression, a lack of self-control and a difficult temperament may be at greater risk of drug addiction.
- Social environment. Particularly for young people, peer pressure is a strong factor in starting to use and abuse drugs. A lack of attachment with your parents may increase the risk of addiction, as can a lack of parental supervision.
- Anxiety, depression and loneliness. Using drugs can become a way of coping with these painful psychological feelings.
- Genetics. Drug addiction is more common in some families and likely involves the effects of many genes. If you have family members with alcohol or drug problems, you’re at greater risk of developing a drug addiction.
- Type of drug. Some drug types, such as heroin and cocaine, more quickly result in physical addiction than do others.
Coping and support
Along with counseling and attending self-help groups, talk with your doctor or counselor about other ways you can boost your chances of staying drug-free. Following are some suggestions:
- Give yourself time. For most people, it takes about three months before significant improvement occurs, so don’t give up on your treatment program too soon.
- Promptly seek treatment for other mental health disorders. Because people with other mental health problems, such as depression, are more likely to become addicted to drugs, seek immediate treatment from a qualified mental health professional if you have any signs or symptoms of mental illness.
- Avoid high-risk situations. Don’t go back to the neighborhood where you used to get your drugs. And, stay away from your old drug crowd.
When to seek medical advice
Addiction is a chronic relapsing disorder, meaning you tend to fall back into old addictive behaviors, including drug use, even after treatment. The sooner you seek help, the greater your chances are for a long-term recovery. If you’re initially reluctant to approach a doctor, help lines or hot lines may be a good place to start to learn about treatment. You can find these lines listed in the phone book or on the Internet.
Because denial is often a characteristic of addiction, many people who are addicted to or who abuse drugs won’t seek medical treatment on their own. Family members, friends or co-workers may need to persuade the user to undergo screening for drug addiction. Breaking a drug addiction may involve counseling, an outpatient treatment program or residential treatment.
If you think you — or a friend — may be addicted to drugs, talk to Teen Challenge today. Apply to our drug rehab so we can give you the help you need free of charge. It’s especially important for someone who is going through withdrawal from drugs to speak with a professional counselor. Withdrawal can be dangerous when it’s not monitored, all our services are free for any type of drug withdrawal.