How drug misuse can lead to drug addiction

You cross the line from drug misuse to drug addiction when using drugs stops being a choice and becomes a necessity. You’re convinced that the drug is necessary for you to have a feeling of well-being or even just to get through the day. Nothing is more important than getting high: not your family or job or relationship. Getting high, in fact, becomes so important that you’re willing to sacrifice everything, even as you deny that you have a problem.

Some factors that can lead us into drug misuse and addiction

Addiction is a very complex behaviour. Doctors and counsellors have been trying to understand its causes for many years. Today, we understand through research that a variety of factors can contribute to a person becoming addicted to drugs or alcohol. Some of these include:

• Use of drugs/alcohol by family members and friends. Peer pressure can be one of the most overwhelming factors in causing a person to use drugs/alcohol.
• Boredom, rebellion and curiosity.
• Growing up or marrying into a family where love, warmth, praise, and acceptance are lacking, sometimes to be replaced by emotional and/or physical abuse.
• Poor communication within a family means that children are not taught life skills to communicate with others outside the family and they can become isolated and suffer from low self-confidence or depression.
• Poverty or isolation from other people.
• Failure in school.
• Growing up where drug use is common and widely accepted.
• A highly emotional event such as the death of a parent or close family member or friend.
• Frequent family moves to new homes creating a lack of stability.
• Mental illness.
• Medical use of prescription drugs to treat depression or alleviate pain. For example, a doctor may prescribe a drug to an individual suffering from back pain. While the drug is intended to alleviate the pain, it may also contain some addictive side effects. If the doctor does not closely monitor use of these prescribed medicines, a patient may start to depend on them even if their back pain has gone, due to the feeling the medicine may give that individual.

An effective treatment programme will invite you to see yourself as more than your addiction, and to recognise your harmful behaviours as symptoms of some deeper insecurity. It will ask you the question: ‘Why do you do the things that you do?’

If you are really willing to engage in treatment you will already realise that the buzz or high that attracted you to using in the first place has become more of a trap than an escape, and you are ready to learn a new way of being in the world. Effective treatment helps you to unravel the causes behind your addiction, to explore the possibility of beginning to enjoy a new life, simply as yourself, away from drugs and alcohol. A good rehabilitation programme will guide and support you in analysing your relationships with friends and family, looking at how you see your place in the world around you, and ultimately your relationship with yourself.

Treatment programmes are provided both in inpatient (fulltime residential) and outpatient (day programme) structures. Some services also provide an outreach programme, where people who are considering coming off drugs can find out more about their options. After detoxification and rehabilitation, clients may be provided with support in moving back into the wider community in a safe and sustainable way. This is perhaps the most important stage in recovery, a process generally known as ‘integration’. Aftercare programmes allow clients to continue to receive support, once back living and working in the community. Different levels of aftercare support are offered by different agencies. Sometimes work, such as Community Employment Schemes, can be accessed through aftercare support.

• Do I need help getting my drug or alcohol use under control or
• Do I want to come off drugs completely?

The answer to these questions will determine what help you should seek:

• If you want to get your drug use under control, then you need a stabilisation service.
• If you want to stop using drugs completely, you need to detoxify through a detoxification service. Do not try to detoxify yourself, as this can be dangerous, even life-threatening. Always seek specialist medical support for detox.

You will find details of what’s available for these services in the links section of this website.

The next step for you

Stabilising your use

Once you have stabilised your drinking or drug use, you should have more space to look at your long-term options. If you do not think that you can self-manage your pattern of drinking or drug use it may be best to look at giving up completely. Try and think back to the reasons why you started using drugs or alcohol in the first place – if those underlying reasons are still there, there is a good chance that a future bad episode, situation or event may lead you to start using, or drinking, chaotically again. If you want to, and feel ready to take it, the next step on the road to a life free from dependence on drugs and alcohol, is detox.

Life after detox

After detox, professional rehabilitation may be the key to attaining your goal of remaining drug-free. During the time you have been using, you will have developed a range of behaviours and attitudes closely linked to your desire for drugs. These habits need to be addressed; they don’t just go away because you have detoxed. If these habits take over and you use again now that your body is clean of drugs you are at real risk of overdose, which may be fatal. If you want to stay clean look for a treatment programme that helps you to identify and explore your underlying reasons for using. This is the best option for a successful long-term recovery.

Staff Team

Does the programme have professionally qualified therapists and counsellors who are trained in the field of substance addiction?

Do they offer a range of activities within the programme, including one-to-one sessions with a key worker, as well as group work?

Family Involvement

Are there opportunities for your family and friends to get involved with your treatment so that everyone can get support? Does the programme have dedicated, trained counsellors or therapists who specialise in family support? Can they provide counselling for your children if necessary?

Social Services

Are there people within the programme who can give you good advice (or connect you with external services to advise you) on your housing, employment and legal needs?

Urine Screening

Does the programme have randomised drug testing at least once per week? Testing is likely to help improve your motivation and self-management. Additionally, your family, welfare services, probation officer or other referral source may want evidence of sustained periods of abstinence.

Continuing Care

Does the treatment centre have a programme of aftercare to guide you through the time when you will be moving back into an independent home or family environment? Can they link you in with other service providers near your home to make sure that you continue to get support after rehabilitation? Can you go back to them at any time if you relapse?

What is relapse?

In basic terms, relapse is a return to using drugs or alcohol having been ‘clean’ for a period of time. A lapse is a single episode or a once-off; someone might have a night when they have a few drinks or take a dose of pills. Approximately 50% of people in treatment lapse at some point in time during their recovery. ‘Relapse’ describes the situation when someone returns to using their drug of choice repeatedly. Approximately 20-30% of those who complete formal care will have relapsed in the prior year.

When a person relapses it can be a very painful and emotional time for them. They may feel that they have failed not only themselves but also their friends and family, and their peers if they are in treatment. However, many health professionals working in the field of addiction believe that one or two periods of relapse are, in fact, an intrinsic part of the recovery process.

What can bring someone to relapse?

People can relapse at any time during treatment but often the highest risk of a relapse is posed when a client begins the ‘integration phase’ of their treatment, when they step back into the wider world and out of the highly structured supports of their rehabilitation programme. Once triggered, the motivation to seek a drug can feel overpowering and sometimes leads to a person making a bad decision, against their own deeper wishes and better judgement.

Often, it’s the same emotional or life events that brought someone to using drugs or alcohol – to ‘escape’ or ‘feel better’ – in the first place, that causes them to relapse after a period of being drug and alcohol free. Emotionally charged life-changing events can be causes of relapse, such as the death of a family member or friend, a relationship breakdown, or things simply taking a turn for the worse. Good things in your life can also bring about a relapse. Events such as getting a new job or your own accommodation can bring about the urge to ‘celebrate’. Social factors can pose risks. Renewing your acquaintance with friends who drink or take drugs, or visiting places where you used to use or drink, are two common factors that can bring about a relapse.

One lapse could kill you

People in treatment need to be aware of this. This may sound overly dramatic but it’s true. If your body has been clean for some time, taking a dose of any substance – even one that you consider ‘normal’ i.e. that is similar to the amount you used to take before detox – could bring about a fatal overdose. If you do consider taking a substance again, no matter what it is, remember one word: MODERATION. It might save your life.

A key part of relapse prevention training is for clients to be made aware that they will always need to manage and monitor how they are doing, even many years down the road from treatment.

Relapse prevention strategies require each person to make a plan for how they are going to tackle situations that could bring about a lapse. Key factors to focus on are:

• What could trigger a lapse for you?
• What are the danger-signs that you can recognise in yourself?
• What would you do to avoid or deal with that situation?
• Do you have friends or family that could help you at these times?
• Clients can work on plans, in the relative safety of their rehabilitation programme, to cover these factors and prepare themselves for the types of challenge that they will have to face when they move back into the community at large.

How does a relapse affect my recovery?

If you relapse, stop your use of drugs or drinking straight away and get some support immediately. Either contact the treatment centre who have been supporting you in your recovery or go to your GP. Get rid of the drugs or alcohol and leave the place where you have been using straight away. Try and visit or phone someone who has supported you during your treatment or anyone you can reach that will help you right now. Once the immediate crisis is over, try to identify the triggers that caused you to lapse, and use the situation as a learning experience – plan ahead to avoid it happening again!

If you lapse while you are in treatment, talk to your key worker straight away. Some centres will ask you to leave for a while, until you are ‘clean’ again and ready to get back into the programme. Each treatment centre will have different rules regarding a lapse. Be prepared to step back a stage if you do relapse. You need support and may have to begin some phase of your recovery again, to ensure that you are offered the support appropriate to ‘where you are at’. Remember, you haven’t failed, you have had a set-back and you can beat this.

Can I achieve long-term recovery?

YES! A relapse is not the end of the road. Many people go on after a relapse to live a completely drug or alcohol free life. It’s important to recognise that you will always need to manage yourself in terms of drugs or alcohol to avoid a relapse in time. Joining support groups such as Alcoholics or Narcotics Anonymous could provide you with a support network for life.

Coolmine Graduate Life-Long Learning Support Group, run by graduates of our programmes, for graduates of our programmes, offers a supportive social network for people with a shared experience of recovery.

Drugs are chemicals that enter the brain and interfere with the way nerve cells normally process information. Some drugs imitate natural neurotransmitters, which effect how we feel; for example, narcotic pain relievers (e.g. morphine, heroin, codeine) mimic the effects of endorphins, the body’s natural ‘feel-good’ chemical. Other drugs are so similar to the brain’s natural chemical messengers that they trick brain receptors into activating nerve cells. Stimulants such as cocaine and speed cause the neurons to release too many neurotransmitters, causing the sensation users describe as the brain ‘racing’.

Almost all drugs over-stimulate the pleasure centre of the brain, flooding it with the neurotransmitter dopamine. This process produces euphoria, and that heightened pleasure can be so compelling that the brain wants that feeling back again and again. Unfortunately, with repeated use of a drug, the brain becomes accustomed to these dopamine surges and produces less of it naturally. The user then has to take more of the drug to feel the same pleasure — the phenomenon known as tolerance.

Tolerance is one of the hallmarks of physical addiction. At this stage the drug is not only something you want because you like it; it is now something your brain and body come to need. The flipside of tolerance is withdrawal, which is the development of uncomfortable physical symptoms if you stop using the drug. For example, if your system stops producing dopamine because you are taking a drug that has the same effect, when you stop taking the drug it will take your system a while to catch-up with the new situation, and to get back to producing normal dopamine levels. Without your body producing a natural level of dopamine itself you will feel sick and depressed.

Although legal substances such as alcohol and nicotine certainly can be and are misused, when we talk about drug misuse, we tend to think of two kinds of situations:

· use of illegal substances such as marijuana, Ecstasy, cocaine, or heroin

· misuse of legal substances such as prescription drugs (e.g. benzodiazepines, codeine) or fumes from solvents (e.g. glue or aerosols)

Even a small amount of a drug can alter how your brain works. Whether that drug is illegal or an improperly consumed legal substance, if you can’t function normally under its influence, its use constitutes misuse.

The danger lies in the possibility that the short-term effects of the drug — e.g. euphoria, extra energy, sensory enhancement, heightened performance — tend to become so alluring that the drug can take over your life, disrupting your relationships, work, and peace of mind.

This list will not apply to everyone and there may be factors in your life that indicate that you have a problem that do not appear here, everyone deals with using drugs and or alcohol in different ways.

This guide can also be used by a parent or a friend who wants to help an individual.

Ask yourself the following questions:

If you answer ‘yes’ to more than one question, it may be wise to seek help now:

• Do you spend a lot of your day thinking about taking drugs or having your next drink?
• Do you find that you need more and more drugs or alcohol to get the same feeling?
• Are you tired all the time but can’t relax or sleep?
• Do you suffer from bad mood swings and bouts of depression?
• Do you put yourself at risk by engaging in risky behaviours, such as driving under the influence of alcohol or drugs, starting fights, or engaging in unprotected sex?
• Are you borrowing money from family or friends, selling possessions, or stealing, so you have money to buy drugs?
• Have you dropped out of college or school?
• Are you frequently late to work or taking sick days, due to drinking or drug use?
• Do you find that you prefer your own company to being with others, even friends?
• Are the people you hangout with also using drugs or drinking a lot?
• Do you experience nausea, tremors or sweats?
• Do you notice that you have become forgetful?
• Do you feel paranoid or suffer from blackouts, flashbacks or delusions?
• If people say they care or worry about you, do you think they are interfering?
• Are you taking care of yourself personally: eating well, washing yourself, wearing clean clothes?