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Drug Addiction and Consequences!

Use and misuse of alcohol, nicotine, and illicit drugs, and misuse of prescription drugs cost Americans more than $700 billion a year in increased health care costs, crime, and lost productivity. Every year, illicit and prescription drugs and alcohol contribute to the death of more than 90,000 Americans, while tobacco is linked to an estimated 480,000 deaths per year.(Hereafter, unless otherwise specified, drugs refers to all of these substances.)

People of all ages suffer the harmful consequences of drug use and addiction:

Teens who use drugs may act out and may do poorly in school or drop out.Using drugs when the brain is still developing may cause lasting brain changes and put the user at increased risk of dependence.

Adults who use drugs can have problems thinking clearly, remembering, and paying attention. They may develop poor social behaviors as a result of their drug use, and their work performance and personal relationships suffer.

Parents’ drug use can mean chaotic, stress-filled homes, as well as child abuse and neglect.Such conditions harm the well-being and development of children in the home and may set the stage for drug use in the next generation.

Babies exposed to drugs in the womb may be born premature and underweight. This exposure can slow the child’s ability to learn and affect behavior later in life.They may also become dependent on opioids or other drugs used by the mother during pregnancy, a condition called neonatal abstinence syndrome (NAS).

What is drug addiction?

Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control, and those changes may last a long time after a person has stopped taking drugs.

Addiction is a lot like other diseases, such as heart disease. Both disrupt the normal, healthy functioning of an organ in the body, both have serious harmful effects, and both are, in many cases, preventable and treatable. If left untreated, they can last a lifetime and may lead to death.

Why do people take drugs?

In general, people take drugs for a few reasons:

To feel good. Drugs can produce intense feelings of pleasure. This initial euphoria is followed by other effects, which differ with the type of drug used. For example, with stimulants such as cocaine, the high is followed by feelings of power, self-confidence, and increased energy. In contrast, the euphoria caused by opioids such as heroin is followed by feelings of relaxation and satisfaction.

To feel better. Some people who suffer from social anxiety, stress, and depression start using drugs to try to feel less anxious. Stress can play a major role in starting and continuing drug use as well as relapse (return to drug use) in patients recovering from addiction.

To do better. Some people feel pressure to improve their focus in school or at work or their abilities in sports. This can play a role in trying or continuing to use drugs, such as prescription stimulants or cocaine.

Curiosity and social pressure. In this respect, teens are particularly at risk because peer pressure can be very strong. Teens are more likely than adults to act in risky or daring ways to impress their friends and show their independence from parents and social rules.

If taking drugs makes people feel good or better, what’s the problem?

When they first use a drug, people may perceive what seem to be positive effects. They also may believe they can control their use. But drugs can quickly take over a person’s life. Over time, if drug use continues, other pleasurable activities become less pleasurable, and the person has to take the drug just to feel “normal.” They have a hard time controlling their need to take drugs even though it causes many problems for themselves and their loved ones. Some people may start to feel the need to take more of a drug or take it more often, even in the early stages of their drug use. These are the telltale signs of an addiction

Why do some people become addicted to drugs, while others do not?

No single factor determines whether a person will become addicted to drugs.

As with other diseases and disorders, the likelihood of developing an addiction differs from person to person, and no single factor determines whether a person will become addicted to drugs. In general, the more risk factors a person has, the greater the chance that taking drugs will lead to drug use and addiction. Protective factors, on the other hand, reduce a person’s risk. Risk and protective factors may be either environmental or biological

What environmental factors increase the risk of addiction?

Children’s earliest interactions within the family are crucial to their healthy development and risk for drug use.

Environmental factors are those related to the family, school, and neighborhood. Factors that can increase a person’s risk include the following:

Home and Family. The home environment, especially during childhood, is a very important factor. Parents or older family members who use drugs or misuse alcohol, or who break the law, can increase children’s risk of future drug problems.

Peer and School. Friends and other peers can have an increasingly strong influence during the teen years. Teens who use drugs can sway even those without risk factors to try drugs for the first time. Struggling in school or having poor social skills can put a child at further risk for using or becoming addicted to drugs

How the drug is taken.Smoking a drug or injecting it into a vein increases its addictive potential. Both smoked and injected drugs enter the brain within seconds, producing a powerful rush of pleasure. However, this intense high can fade within a few minutes. Scientists believe this starkly felt contrast drives some people to repeated drug taking in an attempt to recapture the fleeting pleasurable state.

Why are drugs more addictive than natural rewards?

For the brain, the difference between normal rewards and drug rewards can be likened to the difference between someone whispering into your ear and someone shouting into a microphone. Just as we turn down the volume on a radio that is too loud, the brain of someone who misuses drugs adjusts by producing fewer neurotransmitters in the reward circuit, or by reducing the number of receptors that can receive signals. As a result, the person’s ability to experience pleasure from naturally rewarding (i.e., reinforcing) activities is also reduced.

This is why a person who misuses drugs eventually feels flat, without motivation, lifeless, and/or depressed, and is unable to enjoy things that were previously pleasurable. Now, the person needs to keep taking drugs to experience even a normal level of reward—which only makes the problem worse, like a vicious cycle. Also, the person will often need to take larger amounts of the drug to produce the familiar high—an effect known as tolerance.

Negative effects of drug use while pregnant or breastfeeding: A mother’s substance or medication use during pregnancy can cause her baby to go into withdrawal after it’s born, which is called neonatal abstinence syndrome (NAS). Symptoms will differ depending on the substance used, but may include tremors, problems with sleeping and feeding, and even seizures. Some drug-exposed children will have developmental problems with behavior, attention, and thinking. Ongoing research is exploring if these effects on the brain and behavior extend into the teen years, causing continued developmental problems. In addition, some substances can make their way into a mother’s breast milk. Scientists are still learning about long-term effects on a child who is exposed to drugs through breastfeeding.

Use of opioids during pregnancy can result in a drug withdrawal syndrome in newborns called neonatal abstinence syndrome or neonatal opioid withdrawal syndrome (NAS/NOWS). A recent analysis of the extent, context, and costs of NAS/NOWS found that incidence of NAS/NOWS is rising in the United States. There was a greater than five-fold increase in the proportion of babies born with NAS from 2004 to 2014, whenan estimated 32,000 infants were born with NAS/NOWS —equivalent to one baby suffering from opioid withdrawal born approximately every 15 minutes

Top Graph: Every ~15 minutes, 1 baby is born suffering from opioid withdrawal.

Bottom Left Graph: NAS/NOWS and maternal opioid use disorder on the rise graph. The rate of babies born with NAS/NOWS per 1,000 hospital births was 1.5 in 2004, 1.9 in 2005, 2.2 in 2006, 2.2 in 2007, 2.7 in 2008, 3.4 in 2009, 4.8 in 2010, 5.0 in 2011, 5.9 in 2012, 7.0 in 2013 and 8.0 in 2014. The rate of maternal OUD per 1,000 hospital births was 1.4 in 2004, 1.6 in 2005, 2.1 in 2006, 2.1 in 2007, 2.4 in 2008, 2.9 in 2009, 3.9 in 2010, 3.9 in 2011, 4.9 in 2012, 5.7 in 2013 and 6.5 in 2014

Bottom Right Graph: Growing hospital costs for treatment of NAS/NOWS. Inflation-adjusted U.S. dollars spent annually for hospital costs of treating NAS/NOWS were 90.9 million in 2004, 112 million in 2005, 145 million in 2006, 180 million in 2007, 171 million in 2008, 221 million in 2009, 329 million in 2010, 348 million in 2011, 428 million in 2012, 525 million in 2013 and 563 million in 2014.

National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.

Active duty and retired members of the armed forces are not immune to the substance use problems that affect the rest of society. The stresses of deployment during wartime and the unique culture of the military account for some differences between substance use in military members and civilians. Zero-tolerance policies and stigma pose difficulties in identifying and treating substance use problems in military personnel, as does lack of confidentiality that deters many who need treatment from seeking it.

Those with multiple deployments, combat exposure, and related injuries are at greatest risk of developing substance use problems. They are more apt to engage in new-onset heavy weekly drinking and binge drinking, to suffer alcohol- and drug-related problems, and start smoking or relapse to smoking. Like civilians, they risk addiction to opioid pain medicines prescribed after an injury. NIDA continues to examine the trends in substance use in specific populations, including military personnel, and search for better methods for preventing and treating substance use disorders that are specific to these populations.

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