Gordon A Gunnell, MS, PLC - Phoenix Area Counseling

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Signs, Symptoms, Effects of Drugs/Substances

Licensed Marriage and Family Therapist (LMFT)
Licensed Independent Substance Abuse Counselor (LISAC)


Signs, Symptoms, and Effects
The path to drug addiction begins with the act of taking drugs. Over time, a person's ability to choose not to take drugs is compromised. This in large part is a result of the effects of prolonged drug use on brain functioning, and thus on behavior. Addiction, therefore, is characterized by compulsive, drug craving, seeking, and use that persists even in the face of negative consequences. Source: SAMHSA

Drug use—including the use of opium, cocaine, marijuana and their derivatives—dates back thousands of years. In the 21st century, these potent substances have been joined by an eclectic array of pharmaceuticals and designer drugs, fortifying the already powerful arsenal that fuel the cycle of drug abuse and drug addiction. In order to identify and fight a drug problem, it's important to first understand what abuse and addiction looks like.

What is drug abuse and substance abuse?
Drug abuse, also known as substance abuse, involves the repeated and excessive use of a drug to produce pleasure or escape reality—despite its destructive effects. The substances abused can be illegal drugs such as marijuana and cocaine, or legal substances used improperly, such as prescription drugs and inhalants like nail polish or gasoline. But whatever the drug of choice, substance abuse can be identified by the maladaptive way in which it takes over the user's life, disrupting his or her relationships, daily functioning, and peace of mind.

For those in the grips of drug abuse and addiction, their drug controls them, not the other way around. As the director of The National Institute on Drug Abuse states, “uncontrollable, compulsive drug seeking and use, even in the face of negative health and social consequences” is the essence of drug addiction. Drug addiction can be physical, psychological, or both. The Substance Abuse and Mental Health Services Administration refers to psychological dependence as “the subjective feeling that the user needs the drug to maintain a feeling of well-being." Using a drug to numb unpleasant feelings, to relax, or to satisfy cravings are examples of psychological addiction. On the other hand, physical dependence refers to the physiological effects of drug use. Physical addiction is characterized by tolerance—the need for increasingly larger doses in order to achieve the initial effect—and withdrawal symptoms when the user stops.

What are the signs and symptoms of drug addiction and abuse?
The more drug use begins to affect and control a person's life, the more likely it is that he or she has a drug problem. Unfortunately, substance abusers are often the last ones to recognize their own symptoms of dependence and addiction. If you suspect that a friend or loved one is abusing drugs, it's important to remember that drug abusers often try to conceal their symptoms and downplay their problem. But there are a number of warning signs you can look for:

Inability to relax or have fun without doing drugs.
Sudden changes in work or school attendance and quality of work or grades.
Frequently borrowing money, selling possessions, or stealing items from employer, home, or school. Angry outbursts, mood swings, irritability, manic behavior, or overall attitude change.
Talking incoherently or making inappropriate remarks.
Deterioration of physical appearance and grooming.
Wearing sunglasses and/or long sleeve shirts frequently or at inappropriate times.
No longer spending time with friends who don't use drugs and/or associating with known users.
Engaging in secretive or suspicious behaviors, such as making frequent trips to the restroom, basement, or other isolated areas where drug use would be undisturbed.
Talking about drugs all the time and pressuring others to use.
Expressing feelings of exhaustion, depression, and hopelessness.
Using drugs first thing in the morning.

For more signs and symptoms of drug addiction, see the table below.

Needing to use more of the drug to achieve the same effects.
Experiencing withdrawal symptoms (e.g. nausea, restlessness, insomnia, concentration problems, sweating, tremors, anxiety) after reducing or stopping chronic drug use. Taking a drug in order to avoid withdrawal symptoms.
Doing more drugs than intended
Taking a larger amount of a drug than planned. Using a drug more frequently or for a longer period of time than intended.
Unable to stop using
Desire or unsuccessful attempts to cut down or stop drug use.
Preoccupation with drug
Spending a lot of time getting, using, and recovering from the effects of a drug.
Giving up/reducing other activities
Abandoning or spending less time on previously-enjoyed activities, such as hobbies, sports, and socializing, in order to use drugs.
Failure to fulfill obligations
Neglecting school, work, or family responsibilities (e.g. flunking classes, skipping work, neglecting your children) because of drug use.
Risky drug use
Using a drug under dangerous conditions, such as while driving or operating machinery. Taking risks while high, such as starting a fight or engaging in unprotected sex.
Drug-related physical or psychological problems
Continuing to use despite physical problems (e.g. blackouts, flashbacks, infections, injuries) or psychological problems (e.g. mood swings, depression, anxiety, delusions, paranoia) the drug has caused.
Drug-related legal problems
Legal troubles because of drug use, such as arrests for disorderly conduct, driving under the influence, or stealing to support drug habit.
Drug-related social or interpersonal problems
Losing old friends and loved ones due to drug use. Arguing or fighting with others.

If you are abusing drugs, you may be in denial about the magnitude of the problem or the negative impact it's had on your life. However, if you feel you should cut back or feel guilty about your drug use, you may have a substance abuse problem. Other warning signs include criticism from friends and family regarding your drug use and the need to use drugs in order to get through the day.

What are the signs and symptoms of drug use and abuse in teens?
There are several telltale signs of possible drug use or abuse in teenagers. The challenge for parents is to distinguish between the normal, sometimes volatile ups and downs of adolescent development and the red flags of substance abuse.

According to the National Drug Intelligence Center, sudden or extreme changes in personality, appearance, school performance, or extracurricular activities may indicate teen drug use. For example, a previously well-behaved, respectful teenager may become emotionally volatile, hostile, or violent. A teenager who is abusing drugs may also withdraw from family and friends, drop previously-enjoyed activities, and neglect schoolwork. Secretive behavior and lying to cover up drug use is also common. In addition, teen drug users may steal, ask for money, or sell valuable possessions in order to support their habit.

Warning Signs of Teen Drug Use
Negative changes in schoolwork, missing school, or declining grades.
Increased secrecy about possessions or activities.
Use of incense, room deodorant, or perfume to hide smoke or chemical odors.
Subtle changes in conversations with friends (more secretive, using “coded” language).
New friends.
Change in clothing choices — new fascination with clothes that highlight drug use.
Increase in borrowing money.
Evidence of drug paraphernalia, such as pipes and rolling papers.
Evidence of inhaling products and accessories, such as hairspray, nail polish, correction fluid, paper bags and rags, and common household products.
Bottles of eyedrops, which may be used to mask bloodshot eyes or dilated pupils.
New use of mouthwash or breath mints to cover up the smell of alcohol.
Missing prescription drugs — especially narcotics and mood stabilizers.
Source: National Youth Anti-Drug Media Campaign

Why do people use and abuse drugs?
There are many reasons why people use drugs. Some people use drugs because they like the rush it gives them or because they are thrill-seekers. Others may try a drug out of curiosity or because their friends do it. However, many people use drugs in order to cope with unpleasant emotions and the difficulties of life. In fact, the National Alliance on Mental Illness estimates that around 50% of drug abusers also suffer from a mental illness such as depression, anxiety, bipolar disorder, or schizophrenia.

People who are suffering emotionally use drugs—not in order to get high—but to feel normal. Drug use can be a seemingly attractive and easy escape from all kinds of problems. Speed might be used to fight feelings of inferiority, sleeping pills to deal with panic attacks, or painkillers to numb depression. However while drug use might make a person feel better in the short-term, this attempt to self-medicate ultimately backfires. Instead of treating the underlying problem, drug use simply masks the symptoms. Take the drug away and the problem is still there, whether it be low self-esteem, stress, or an unhappy family life. Furthermore, prolonged drug use eventually brings its own host of problems, including major disruptions to normal, daily functioning. Unfortunately, the psychological, physical, and social consequences of drug abuse and dependence are often worse than the original problem the user was trying to cope with or avoid.

What drugs are most commonly abused and what are their effects?
Almost all drugs have the potential for addiction and abuse, from caffeine to prescription medication. However, the majority of non-alcohol-related drug problems are due to use of the substances listed below. These drugs affect users' brains and bodies in different ways, producing symptoms of intoxication and abuse that are unique to each substance.


Marijuana and Cannabis Abuse
Believed to be the most commonly used illegal drug, marijuana enhances the senses and brings on feelings of relaxation and well-being. Marijuana is also used medicinally to relieve pain, reduce nausea and vomiting, and stimulate appetite. However, there are drawbacks to extended use, including learning and memory impairment, lung and respiratory problems caused by the smoke, and infertility. According to The National Youth Anti-Drug Media Campaign, marijuana abuse has also been linked to low achievement, delinquent behavior, and poor family relationships.

Types and Street Names
Marijuana (pot, dope, weed) Hashish

Effects and Signs of Abuse
Sense of relaxation
Heightened sensory awareness
Increase in appetite
Slowed thinking and reaction time
Impaired coordination
Respiratory problems
Red, dilated eyes
Memory and learning difficulties
Increased heart rate
Anxiety and paranoia

Depressants and Downer Abuse
Depressants, commonly known as downers, are substances that slow down the central nervous system. Sleeping pills and prescription medications for anxiety such as Xanax and Valium fall into this drug category, as do Rohypnol and GHB, known as “date rape” drugs due to their frequent use in sexual assaults. Downers are often abused by individuals suffering from anxiety and low self-esteem. But while they induce relaxation, they also impair the user's ability to think clearly and react quickly. People abusing depressants may appear to be drunk—exhibiting signs such as losing their balance and slurring their words. Additionally, they may suffer from amnesia and delusions. Downers are highly addictive, and withdrawal is severe, with symptoms including nausea, vomiting, and cramps. Downers are lethal in high doses, particularly when mixed with alcohol.

Types and Street Names
Barbiturates (downers, sedatives)
Benzodiazepines (downers, tranqs) Methaqualone (Qualudes) Rohypnol (roofies) GHB (liquid ecstasy)

Effects and Signs of Abuse
Decreased anxiety
Sense of relaxation and well-being
Lowered inhibitions
Drowsiness and fatigue
Slowed breathing and pulse
Confusion and disorientation
Slurred speech
Impaired coordination
Impaired memory and judgment

Stimulants and Upper Abuse
Stimulants, or uppers, are drugs which speed up the central nervous system. Commonly-abused uppers include cocaine, methamphetamine, crack, and prescription drugs such as Ritalin and Adderall. While stimulants will initially boost energy and confidence, their use over time leads to symptoms such as anxiety, aggression, sleep difficulties, hallucinations, and paranoid thinking. As uppers wear off, users experience a “crash,” characterized by depression, fatigue, and irritability. Overdose can result in heart failure, stroke, and death.

Types and Street Names
Amphetamines (uppers, speed) Cocaine (coke, blow) Crack cocaine Methamphetamine (meth, crank) Crystal meth Ritalin and other ADHD drugs

Effects and Signs of Abuse
Feelings of exhilaration and euphoria
Increased energy and hyperactivity
Rapid or irregular heart beat
Reduced appetite and weight loss
Aggressive or impulsive behavior
Anxiety and restlessness
Rapid speech

Hallucinogen and Dissociative Drug Abuse
Hallucinogens and dissociative drugs, also known as psychedelics, are mind-altering drugs that affect the user's sensory perceptions and thought processes. Hallucinogens such as LSD and peyote can promote insight, contemplation, and euphoria—with some users reporting spiritual or out-of-body experiences. But on the flip side, these same drugs can result in “bad trips” characterized by panic and psychotic breaks with reality. Ecstasy, a popular club drug with both hallucinogenic and stimulant properties, boosts empathy and feelings of interpersonal closeness. Risks include a dangerous increase in body temperature, liver damage, and heart problems. The dissociative drugs PCP and ketamine block perception of pain and induce a trance-like state. Adverse effects can be severe and include violent reactions, complete disorientation, and terrifying delusions and hallucinations.

Types and Street Names
PCP (angel dust) LSD (acid) Mescaline (peyote) Psilocybin (magic mushrooms) MDMA (ecstasy) Ketamine (Special K)

Effects and Signs of Abuse
Heightened sensory awareness
Impaired perception of reality
Increased heart rate and blood pressure
Nausea and vomiting
Panic or paranoia
Impaired motor function
Memory loss

Narcotic and Opioid Abuse
Narcotics, or opioids, are powerful pain relievers that mimic the effects of endorphins, the body's natural “feel-good” chemical. Commonly-abused narcotics include heroin, morphine, codeine, and prescription painkillers such as Vicodin and Oxycontin. These drugs elevate mood and induce a tranquil, relaxed state. Side effects include nausea, vomiting, and sever itching. Tolerance and physical dependency will develop if opioids are used for any extended period of time. If a narcotics abuser quits “cold turkey,” he or she will experience withdrawal symptoms. While not dangerous, withdrawal from heroin and other narcotics is extremely unpleasant, with symptoms including muscle and joint pain, fever, nausea, sweats, chills, stomach cramps, and diarrhea. Overdose is another risk of narcotic abuse, especially if the user is shooting the drug. Another danger of intravenous opioid or heroin use is infection from dirty needles. Intravenous drug users are at a higher risk of contracting viruses such as HIV and hepatitis, and often suffer from abscesses, collapsed veins, and bacterial infections.

Types and Street/Brand Names
Heroin (smack, junk) Opium Morphine Codeine Hydrocodone (Vicodin) Fentanyl (Duragesic) Oxycodone (Oxycontin, Percocet) Hydromorphone (Dilaudid) Meperidine (Demerol) Propoxyphene (Darvon)

Effects and Signs of Abuse
Pain relief
Drowsiness and sedation
Slowed breathing

Inhalant Abuse
Inhalants are chemicals which cause intoxication when sniffed or inhaled. They include common, household solvents, aerosols, and gases such as paint thinner, dry-cleaning fluid, gasoline, glue, felt-tip marker fluid, deodorant and hair sprays, spray paint, air fresheners, butane lighters, and propane tanks. Other abused inhalants include medical anesthetics such as “laughing gas,” ether, and chloroform. While “huffing” gives users a brief high, this high often comes with side effects including nausea, vomiting, delusions, confusion, and loss of consciousness. Prolonged inhalant abuse can also cause damage to the brain and other organs of the body. But the biggest risk involved with inhalant use is death by overdose. Inhalant use can cause sudden heart failure, or “sudden sniffing death syndrome,” even in individuals who are young and healthy.

Types and Street Names
Solvents (paint thinners, gasoline, glues) Aerosols (hair spray, spray paint) Gases (butane, propane) Nitrous oxide (laughing gas) Nitrites (poppers)

Effects and Signs of Abuse
Brief “high”
Loss of inhibition
Headache or lightheadedness
Nausea or vomiting
Impaired motor coordination
Impaired memory
Weakness and fatigue

Steroid Abuse
Unlike other drugs of abuse, anabolic steroids don't have any intoxicating effects. They are used, not to get “high,” but to improve athletic performance and build muscle. But while steroids may help would-be athletes bulk up or obtain an edge on the field, they come with serious side effects and health risks. Steroid abuse causes blood pressure to skyrocket, increases bad cholesterol (LDL) while decreasing good cholesterol (HDL), triggers violent and aggressive behavior, results in severe acne, and brings growth to a halt in adolescents. Women taking steroids can develop facial hair, a deep voice, and male-pattern baldness. Men, on the other hand, can develop breasts, infertility, shrinking of the testicles, and baldness.

Types and Street Names
Anabolic steroids (roids, juice)

Effects and Signs of Abuse
Stunted growth in adolescents
Breast enlargement in men
Facial hair growth in women
Hostility and aggression
High blood pressure
Liver disease
Cardiovascular disease
Cholesterol changes

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