Symptoms, Signs & Effects of Substance Abuse

Understanding substance abuse

People become addicted to drugs and alcohol for a variety of reasons. Substances that are abused are those that result in some form of inebriation that modifies judgment, awareness, attention, or physical coordination. In general, however, abused substances result in some sort of reward or reinforcement in the form of pleasure or the numbing of negative emotions for the individual taking them. However, with long term use the behavior often becomes uncontrollable due to cravings and the desire to avoid negative withdrawal symptoms. At this point the individual may continue to believe they can control their addiction at will. Thought processes play a large role in this problem as those suffering from addictions often find ways of justifying their substance use. Eventually, the addiction interferes with everyday responsibilities and functioning, affecting the individual’s job, social interactions and health. Often, the individual themselves are not aware that their substance use is beyond their control, continuing to believe if they choose to cut down or stop using the drug they would be able to do so, even when their addiction is creating numerous problems both for them and those around them.

There are a number of types of substance use disorders and different types of substances produce different effects, have varied causes, produce a diverse group of symptoms and fluctuate in terms of the other conditions or disorders which co-occur. The general categories of abuse include:

• Alcohol
• Caffeine
• Cannabis
• Hallucinogens
• Inhalants
• Opioids
• Sedatives, Hypnotics and Anxiolytics
• Stimulants
• Tobacco

Statistics of substance abuse

The rates of substance abuse in the U.S. are steadily increasing. This is believed to be largely due to the significant increase in marijuana use which is the most frequently abused illegal drug. More than 50% of those who start using illicit substances use marijuana. Recent surveys of the prevalence of past month drug use in those over the age of 11 in this country were estimated at 8.7%. This is equivalent to 22.5 million individuals had used either an illegal substance or misused a legally prescribed medication such as pain medications, stimulants or sedatives. The highest rates of drug abuse are found in those between the ages of 18 and 20 with past month prevalence rates estimated at 23.8%.

Co-occurring disorders

Co-occurring disorders differ somewhat based on the type of substance used but there are some commonalities in conditions that occur with substance abuse. These include:

• Depression
• Anxiety Disorders
• Personality Disorders
• Other substance use disorders
• A history of Conduct Disorders in adolescence
• Intermittent Explosive Disorder
• Process addictions such as gambling or internet addiction

Causes of substance abuse

Genetic – While the specifics of an exact genetic mechanism related to substance abuse has yet to be found, there is support for the contribution of genetic influences on the development of the disorder. It has long been observed that those with a first degree relative who has a substance abuse disorder is at increased risk for developing a similar disorder even if the addiction is not to the same drug. Additionally, numerous genetic mutations, alterations and chromosomal abnormalities have been identified that are associated with the development of substance abuse disorders. It is believed that no individual gene or genetic alteration is responsible for substance abuse, but that there are many combinations of genes and genetic alterations which interact to result in specific types of substance use disorders.

Stimulation of Neurological Reward and Pleasure Centers – Humans are hardwired in such a way that survival based behaviors such as eating and drinking trigger pleasure centers in the brain. Most drugs of abuse also trigger these systems resulting in their presence becoming associated with survival over time. Thus, in addition to the pleasure experienced when using substances, an unconscious message is triggered indicating that the drug is necessary for survival.

Brain Chemistry – Certain chemicals in the brain called neurotransmitters are associated with certain states of mind and other functions. Some of these include motivation, feelings of pleasure, sense of reward, mood, attention, sleep, thought processes, arousal, alertness, sensation and perception among others. Different substances disrupt various neurotransmitter functions resulting in different effects. People develop a preference for a certain substance based on the effects felt based on which neurotransmitter is disrupted.

Perception of Approval of Drug Use Behavior – When a child grows up in a home where drugs or alcohol are openly and frequently used they may develop the idea that this behavior is normal and approved of. Additionally, family members model the use of substances as a means of coping with distress and the child fails to learn more adaptive strategies so in the future they may turn to drugs when exposed to negative life events.

Signs and symptoms of substance abuse

While the individual with the problem may not realize they have developed an addiction many of the symptoms of substance abuse are often clear to close friends and family members. These include:

• Developing a new peer group
• Memory problems
• Irritability, aggression, becoming argumentative over little things, low frustration tolerance, anger outbursts
• Stealing from friends and family members to buy substances
• Giving up previously enjoyed activities and hobbies
• Decreased productivity and achievement at work or school
• Exhaustion
• Depression
• Suicidal thoughts
• Feeling hopeless/helpless over the ability to control the habit
• Losing the ability to feel empathetic towards others
• Spending significant amounts of time obtaining, using, or recovering from the substance
• Taking more of the substance more frequently than intended
• Failed attempts to decrease or stop using the substance
• Lying about the amount of the substance the individual is using
• Social withdrawal as a means of hiding drug related activities
• Hiding substances in various locations
• Developing the need to use more of the substance to achieve the desired effect (tolerance)
• Hangovers
• Trying to convince others to use the substance in an effort to normalize the behavior
• Increased impulsivity and risk taking behavior
• Blackouts

Effects of substance abuse

The effects of substance abuse disorders while recognized by the individual, may not be enough to motivate them to quit using the substance due to the fear of experiencing distressing and intolerable withdrawal symptoms outweighing these factors. Common effects of the condition include:

• Legal problems
• Financial problems
• Loss of social support network
• Ineffective parenting
• Jaundice (yellow skin and eyes)
• Increased size of abdomen
• Swelling of legs and arms
• Unremitting cough
• Pain or infection at injection sites
• Fever

Withdrawal symptoms of substance abuse

Withdrawal symptoms vary based on the substance used. The physiological symptoms vary more than the psychological symptoms largely due to the latter being based on common beliefs related to the inability to function normally, experience positive mood states, or notable pleasure without the aid of the substance. Common withdrawal symptoms include:

• Mild tremors or shaking
• Seizures
• Sadness or depression
• Cravings
• Loss of coordination
• Intense anxiety related to fear of the inability to function in major life areas without the substance
• Feelings of despair
• Crying jags
• Nausea and vomiting
• Bone and muscle aches
• Fever
• Sweating