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Substance Abuse Overview

People abuse substances such as drugs or alcohol 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 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, 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 the 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 1996 National Household Survey on Drug Abuse estimated the number of users of illicit drugs in the United States to be about 13 million. In addition, the survey estimated that 10% of Americans abuse or are dependent on alcohol, and 25% of Americans smoke cigarettes. Abused substances produce some form of intoxication that alters judgment, perception, attention, or physical control.

Many substances can bring on withdrawal—an effect 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 where you must use a larger amount of the drug to produce the same level of intoxication.

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 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 is the most common cause of liver failure in the US. 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. 
Marijuana (also known as grass, pot, weed, herb): Marijuana, which comes from the plant Cannabis sativa, is the most commonly used illegal drug in the United States. The plant produces delta-9-tetrahydrocannabinol (THC), the active ingredient associated with intoxication. Marijuana resin, called hashish, contains an even higher concentration of THC.

The drug is usually smoked, but it can also be eaten. Its smoke irritates your lungs more and contains more cancer-causing chemicals than tobacco smoke. Common effects of marijuana use include pleasure, relaxation, and impaired coordination and memory.

Often, the first illegal drug people use, marijuana is associated with increased risk of progressing to more powerful and dangerous drugs such as cocaine and heroin. The risk for progressing to cocaine is 104 times higher if you have smoked marijuana at least once than if you never smoked marijuana. 
Cocaine (also known as crack, coke, snow, rock): In 1997, an estimated 1.5 million people abused cocaine in the United States.

Derived from the coca plant of South America, cocaine can be smoked, injected, snorted, or swallowed. The intensity and duration of the drug’s effects depend on how you take it. Desired effects include pleasure and increased alertness.

Short-term effects also include paranoia, constriction of blood vessels leading to heart damage or stroke, irregular heartbeat, and death. Severe depression and reduced energy often accompany withdrawal.

Both short- and long-term use of cocaine has been associated with damage to the heart, the brain, the lung, and the kidneys. 
 
Substance Abuse Treatment

Most substances abusers believe they can stop using drugs on their own, but a majority who try do not succeed. Research shows that long-term drug use alters brain function and strengthens compulsions to use drugs. This craving continues even after your drug use stops. 
Because of these ongoing cravings, the most important component of treatment is preventing relapse. Treating substance abuse depends on both the person and the substance being used. Treatment provides you with strategies to cope with your drug cravings and ways to avoid relapse. The Center offers a Comprehensive Program to Stop Smoking, Drinking, or Drug Use. Please see our Addiction Program for more details.

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