Drug abuse and addiction

Drug abuse and addiction, now both grouped as substance or drug use disorder, is a condition characterized by a self-destructive pattern of using a substance that leads to significant problems and distress, which may include tolerance to or withdrawal from the substance.

Drug use disorder is unfortunately quite common. According to the World Health Organization, about 270 million (or about 5.5% of global population aged 15-64) had used psychoactive drugs in the previous year and about 35 million people are estimated to be affected by drug use disorders.

More often than not, it is a drug abuser’s family members who seek treatment for the abuser’s problem. Although abusers are usually aware of the harm caused by their habit as well as their dependence on it, most do not really want to stop and do not seek treatment on their own. Relapses are also a large problem in the treatment of drug abuse.

Treatment involves multiple approaches that include:

Pharmacological treatment
Substitution therapy
Psychological approaches such as counselling
Support groups
Rehabilitation

Treatment usually takes place in a hospital, a residential centre or even at the doctor’s office. With time, the patient improves and gradually returns to family, work or school environments. These environments may be those in which the drug abuse began and became habitual. At this stage, the patient is susceptible to relapse and counselling and psychological therapy are employed to help prevent addiction re-establishing.

Pharmacological treatment

This involves the use of medication that can help reverse the pleasurable sensations gotten from drug use and deter the abuser. For example, disulfiram is a medication prescribed to alcoholics that causes them to experience deeply unpleasant symptoms when they drink alcohol, therefore deterring them from consuming more. Naltrexone is an opioid antagonist that can be used to block the euphoric effects of opioid use and help the patient overcome addiction to the substance. Another opioid antagonist, naloxone reverses the life-threatening effects of opioid overdose such as reduced lung function and shallow breathing.

Medications may also be used to treat withdrawal symptoms that arise after stopping drug use. For example, clonidine is useful in treating opioid withdrawal symptoms.

Medications are also used to treat other psychiatric illnesses that may exist alongside the drug addiction such as depression, anxiety, panic disorders, and post-traumatic stress disorder.

Substitution therapy

Often, a very potent drug such as heroin is replaced by a less potent opioid to help wean a patient off the drug without causing the onset of severe withdrawal symptoms. Use of the low potency opioid is then tapered off and eventually the drug user is free of the drug altogether. Examples of these drugs include methadone and buprenorphine.

Nicotine replacement therapy is another example of a drug substitute, used to help individuals wean themselves off nicotine and is available in the form of chewing gum, skin patches, and nasal sprays.

Psychological approaches and counselling

Cognitive behavioural therapy and counselling help a patient during the initial treatment of drug addiction as well as in maintaining a drug free existence and helping to prevent relapses in the long term.

Support groups

Alcoholics anonymous and similar support groups for drug abusers help prevent relapses and reduce the risk of depression and other co-morbid psychological problems.

Rehabilitation support

This involves helping a person re-establish themselves in society and address problems in the family and at work places to help prevent homelessness and other social problems. This is a major treatment step in the prevention of relapses.

Sources

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