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The rise in the use of cocaine and crack in the 1980s raised fears about their effects on developing fetuses. But researchers have not been able to conclusively demonstrate consistent, adverse effects. Experts nowadays believe that the lack of good prenatal care, along with alcohol and tobacco use in cocaine users who are pregnant, are more important factors in premature delivery, low birth weight, and fetal and neonatal death.

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Like other addictions, cocaine abuse results from complex combinations of factors like genetic predisposition, family history, stress, and other environmental issues. As many as three to four million people are estimated to be chronic cocaine users.

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- rapid heartbeat
- constricted blood vessels
- dilated pupils
- increased energy
- reduced appetite (anorexia)
- increased sense of alertness
- euphoria
- sudden death due to overdose, heart attack or stroke

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- dependence, addiction
- paranoia
- anxiety
- mood swings
- restlessness
- weight loss and malnutrition
- auditory hallucinations
- loss of sense of smell
- ruptured nasal septum
- chronic runny nose
- horse voice
- bowel gangrene
- increased risk of contracting HIV and other blood borne diseases

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Cocaine's effects include loss of fatigue, mental alertness, and increased energy. Their intensity and duration depend on how the drug is used. The more rapidly it reaches the brain, the faster its effects are felt and the quicker they dissipate. Intravenous injection and smoking produce faster and more intense effects.

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Cocaine increases the brain's levels of dopamine by preventing it from being recycled back into brain cells.

Dopamine is responsible for feelings of pleasure; the higher the dopamine levels, the greater the sensations of pleasure. With repeated drug use, tolerance develops and more frequent use produces diminishing sensations of pleasure.

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An overdose is the accidental or intentional use of a drug or medicine in an amount that is higher than normally used or prescribed.

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Among illicit drugs, cocaine is the No. 2 killer and claims the lives of more African-Americans than heroin does.

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The opioid epidemic just keeps getting worse, presenting challenges discussed at length at a White House summit last week. But opioids are not America's only significant drug problem. Among illicit drugs, cocaine is the No. 2 killer and claims the lives of more African-Americans than heroin does.

In a recent study published in Annals of Internal Medicine, researchers from the National Cancer Institute and the National Institute on Drug Abuse found that drug-related deaths have grown across all racial groups and among both men and women. The analysis found that between 1999 and 2015, overdose deaths of any kind of drug for Americans 20 to 64 years old increased 5.5 percent per year.

For the most recent years of analysis (2012-15), the study found that deaths of men from heroin exceeded those from any other type of opioid, such as those found in pain medications. For women, deaths related to opioid medications were the most common.

But among non-Hispanic black Americans, cocaine has been a larger problem than heroin for nearly 20 years. For example, over 2012-15, cocaine overdoses claimed 7.6 per 100,000 black men. In contrast, heroin overdoses claimed 5.45 per 100,000 black men. Black women use both drugs at lower rates than men, but cocaine overdoses exceed those from heroin for them as well.

"We have multiple drug problems in the U.S.," said Keith Humphreys, a professor at Stanford University School of Medicine who advises governments on drug prevention and treatment policies. "We need to focus on more than one drug at a time."

That doesn't mean opioids aren't also a problem in the black population. They are. When you combine all types of opioids - including heroin, prescribed opioids and fentanyl - they claim more lives than any other drug from every racial group.

For a time, it appeared cocaine didn't require as much attention. A study by RAND found that cocaine consumption fell 50 percent between 2006 and 2010. But in the past few years, the cocaine supply from Colombia has climbed to a record high in part because of a peace settlement that includes payments to farmers who stop growing coca. To be in a position to qualify for those payments in the future, many farmers started growing it. As a result,Mr. Humphreys said, cocaine prices have fallen, leading to an increase in cocaine use in the United States and some European countries.

Mr. Humphreys said one pathway to cocaine use is encountering the illegal drug market through an opioid addiction and then adding cocaine.

The surge in cocaine deaths has received relatively little attention. The trouble is, there's a lot less we can do for cocaine than opioids. In contrast with addiction to opioids, there is no medication to treat addiction to cocaine. Though substantial investments have been made in search of drugs to treat cocaine addiction- including a vaccine - none are yet available.

Harm-reduction approaches - like syringe exchanges - focus mainly on injectable drugs. But injecting cocaine is uncommon.

Having fewer solutions doesn't mean we can't do anything about cocaine. Cognitive behavioral therapy can be effective in treating cocaine addiction, as well as other substance-use disorders.The defining feature of this therapy is learning to recognize patterns of thought that lead to problematic behavior and redirect them toward more positive behavior. Contingency management is also effective in treating cocaine addiction. In this approach, patients receive small rewards contingent on positive behavior (a cocaine-free urine test, for example).

Kicking cocaine with these treatment methods works only if access and staffing are adequate. Multiple federal laws, most notably the Affordable Care Act, made major strides by extending coverage and including substance-use disorder treatment as an essential benefit that health insurance plans had to cover.

But the new tax law undermines the A.C.A. by repealing the individual mandate. And changes to Medicaid being considered in many states - like adding work requirements or increasing premiums and other cost sharing - would also erode coverage. If insurance support is withdrawn, some addiction treatment agencies will lose staff or close, and some desperately needy addicted people will be cut off from care.

At the White House opioidsummit, President Trump said his administration would be "rolling out policy over the next three weeks, and it will be very, very strong."

But, as the evidence shows, even if we do respond to the opioid epidemic, it isn't the only drug problem worthy of attention.

Correction:

An earlier version of this article misstated the name of a publication in which a recent study on drug-related deaths appeared. The study was published in Annals of Internal Medicine, not the Archives of Internal Medicine.

Austin Frakt is director of the Partnered Evidence-Based Policy Resource Center at the V.A. Boston Healthcare System; associate professor with Boston University's School of Public Health; and adjunct associate professor with the Harvard T.H. Chan School of Public Health. He blogs at The Incidental Economist, and you can follow him on Twitter. @afrakt

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Overshadowed by the Opioid Crisis: A Comeback by Cocaine

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The opioid epidemic just keeps getting worse, presenting challenges discussed at length at a White House summit last week. But opioids are not America's only significant drug problem. Among illicit drugs, cocaine is the No. 2 killer and claims the lives of more African-Americans than heroin does.

# data[].attributes.body
In a recent study published in Annals of Internal Medicine, researchers from the National Cancer Institute and the National Institute on Drug Abuse found that drug-related deaths have grown across all racial groups and among both men and women. The analysis found that between 1999 and 2015, overdose deaths of any kind of drug for Americans 20 to 64 years old increased 5.5 percent per year.

# data[].attributes.attachment_link.readable_text
The opioid epidemic just keeps getting worse, presenting challenges discussed at length at a White House summit last week. But opioids are not America's only significant drug problem. Among illicit drugs, cocaine is the No. 2 killer and claims the lives of more African-Americans than heroin does.

In a recent study published in Annals of Internal Medicine, researchers from the National Cancer Institute and the National Institute on Drug Abuse found that drug-related deaths have grown across all racial groups and among both men and women. The analysis found that between 1999 and 2015, overdose deaths of any kind of drug for Americans 20 to 64 years old increased 5.5 percent per year.

For the most recent years of analysis (2012-15), the study found that deaths of men from heroin exceeded those from any other type of opioid, such as those found in pain medications. For women, deaths related to opioid medications were the most common.

But among non-Hispanic black Americans, cocaine has been a larger problem than heroin for nearly 20 years. For example, over 2012-15, cocaine overdoses claimed 7.6 per 100,000 black men. In contrast, heroin overdoses claimed 5.45 per 100,000 black men. Black women use both drugs at lower rates than men, but cocaine overdoses exceed those from heroin for them as well.

"We have multiple drug problems in the U.S.," said Keith Humphreys, a professor at Stanford University School of Medicine who advises governments on drug prevention and treatment policies. "We need to focus on more than one drug at a time."

That doesn't mean opioids aren't also a problem in the black population. They are. When you combine all types of opioids - including heroin, prescribed opioids and fentanyl - they claim more lives than any other drug from every racial group.

For a time, it appeared cocaine didn't require as much attention. A study by RAND found that cocaine consumption fell 50 percent between 2006 and 2010. But in the past few years, the cocaine supply from Colombia has climbed to a record high in part because of a peace settlement that includes payments to farmers who stop growing coca. To be in a position to qualify for those payments in the future, many farmers started growing it. As a result,Mr. Humphreys said, cocaine prices have fallen, leading to an increase in cocaine use in the United States and some European countries.

Mr. Humphreys said one pathway to cocaine use is encountering the illegal drug market through an opioid addiction and then adding cocaine.

The surge in cocaine deaths has received relatively little attention. The trouble is, there's a lot less we can do for cocaine than opioids. In contrast with addiction to opioids, there is no medication to treat addiction to cocaine. Though substantial investments have been made in search of drugs to treat cocaine addiction- including a vaccine - none are yet available.

Harm-reduction approaches - like syringe exchanges - focus mainly on injectable drugs. But injecting cocaine is uncommon.

Having fewer solutions doesn't mean we can't do anything about cocaine. Cognitive behavioral therapy can be effective in treating cocaine addiction, as well as other substance-use disorders.The defining feature of this therapy is learning to recognize patterns of thought that lead to problematic behavior and redirect them toward more positive behavior. Contingency management is also effective in treating cocaine addiction. In this approach, patients receive small rewards contingent on positive behavior (a cocaine-free urine test, for example).

Kicking cocaine with these treatment methods works only if access and staffing are adequate. Multiple federal laws, most notably the Affordable Care Act, made major strides by extending coverage and including substance-use disorder treatment as an essential benefit that health insurance plans had to cover.

But the new tax law undermines the A.C.A. by repealing the individual mandate. And changes to Medicaid being considered in many states - like adding work requirements or increasing premiums and other cost sharing - would also erode coverage. If insurance support is withdrawn, some addiction treatment agencies will lose staff or close, and some desperately needy addicted people will be cut off from care.

At the White House opioidsummit, President Trump said his administration would be "rolling out policy over the next three weeks, and it will be very, very strong."

But, as the evidence shows, even if we do respond to the opioid epidemic, it isn't the only drug problem worthy of attention.

Correction:

An earlier version of this article misstated the name of a publication in which a recent study on drug-related deaths appeared. The study was published in Annals of Internal Medicine, not the Archives of Internal Medicine.

Austin Frakt is director of the Partnered Evidence-Based Policy Resource Center at the V.A. Boston Healthcare System; associate professor with Boston University's School of Public Health; and adjunct associate professor with the Harvard T.H. Chan School of Public Health. He blogs at The Incidental Economist, and you can follow him on Twitter. @afrakt

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Overshadowed by the Opioid Crisis: A Comeback by Cocaine

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The opioid epidemic just keeps getting worse, presenting challenges discussed at length at a White House summit last week. But opioids are not America's only significant drug problem. Among illicit drugs, cocaine is the No. 2 killer and claims the lives of more African-Americans than heroin does.

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Mr. Skipper (former ESPN president) admitted that his cocaine use had caused “a missed plane and a few canceled morning appointments,” but said that it otherwise never affected his professional work. “I judge that I did a very good job and that it did not get in the way of my work,” he said. “I worked hard, I worked smart. I worked all the time.” drugs can affect the workplace.

“I have struggled for many years with a substance addiction,” Mr. Skipper said when announcing his resignation. “I have decided that the most important thing I can do right now is to take care of my problem.” left his major job to deal with his addiction

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He did not say how long he had been using cocaine, or whether he reported the extortion plot to law enforcement. In December, at the time of his resignation, Mr. Skipper said he was entering rehabilitation. The police departments in Bristol, Conn., and Wilton, Conn., the Connecticut State Police and the New York City Police Department all said then that there were no records of any incidents involving Mr. Skipper.

Mr. Skipper's resignation, which came on Dec. 18, a Monday, took everybody, even high-level ESPN employees, by surprise. The previous Wednesday, he had presided over a mandatory all-hands meeting on ESPN's Bristol, Conn., campus. Facing an audience nervous after layoffs, management changes and a very public battle with President Trump, Mr. Skipper projected an aura of calm and stability. He expressed optimism about the company's future, according to attendees.

Two days later, according to the account he gave The Hollywood Reporter, he met with Mr. Iger and the two mutually decided he should resign. "I have struggled for many years with a substance addiction," Mr. Skipper said when announcing his resignation. "I have decided that the most important thing I can do right now is to take care of my problem."

It was a problem almost nobody, including those who have spent extensive time with Mr. Skipper, knew he had.

His rehabilitation has included unspecified "therapy" and "treatment," Mr. Skipper stated in the interview. He indicated that he would like to work again sooner rather than later. "I don't think it will take the form of a large corporate job, managing a lot of people and running a big company," he said. "I think it will take the form of helping a few smart people; people I like and respect and who do things that matter."

In the almost 90 days since his resignation, ESPN has been busy. The company is preparing to launch a completely redesigned app next month, which will include ESPN Plus, its new streaming service. It is finishing construction of a Manhattan studio, which will house a new Mike Greenberg-hosted morning show, "Get Up," as well as a yet-to-be named midday show.

Overseeing the company's response to major challenges, including a steep decline in subscribers and a fractured relationship with the N.F.L., is James Pitaro, a Disney executive, who was recently named ESPN's president. Mr. Pitaro is the first president to come from outside of ESPN in a long time, but he is said to be especially close to Mr. Iger.

On Wednesday, Mr. Pitaro had his own town hall with ESPN employees. Echoing Mr. Skipper's town hall from three months earlier, he expressed excitement about all of the company's initiatives, and promised better days ahead.

Eighteen hours later, ESPN employees woke up to the news that their former boss had hid his cocaine problem, and resigned because of an extortion attempt by his dealer. According to some, the news was a relief. It explained why they had seen no evidence of a problem, as well as why he had to resign.

Still, plenty of questions remain. Did Mr. Skipper, Mr. Iger or ESPN report the extortion attempt to law enforcement? He says his cocaine problem didn't affect his professional work, but if he hadn't been using would he have handled the company's numerous challenges over his six-year tenure any differently? Finally, is this the final shoe to drop, or will news about John Skipper continue dribbling out?

For now, no one close to Mr. Skipper and ESPN is speaking publicly, leaving the questions to linger.

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Cocaine and Extortion: John Skipper Explains Why He Abruptly Left ESPN

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He did not say how long he had been using cocaine, or whether he reported the extortion plot to law enforcement. In December, at the time of his resignation, Mr. Skipper said he was entering rehabilitation.

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What is addiction, then? The root problem is craving, which drives a compulsion to use drugs despite the harm they cause. That’s what makes crack addictive, while Prozac can be therapeutic.

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Before Joe Thompson switched treatments for his opioid addiction, he was a devoted stay-at-home father, caring for his infant son after his wife returned to work. His recovery was aided by the anticraving medication buprenorphine. But after over two years free of heroin, Mr. Thompson, a former United Parcel Service worker from Iowa, relapsed and decided to try another kind of treatment program.

Unfortunately, his new counselors insisted that continuing his buprenorphine, though it was approved by the Food and Drug Administration, was just as bad as using heroin, according to his wife, Deborah. He wasn't even allowed to start therapy until he'd been abstinent for several weeks. Stressed by withdrawal, he went to a third center. It, too, banned medication. Within a week of entering the program, he was dead from a heroin overdose. He was 35.

Buprenorphine is one of only two treatments proven to cut the death rate from opioid addiction by half or more. But the programs Mr. Thompson tried viewed abstinence as the only true recovery - even though abstinence treatment has not been shown to reduce mortality and is less effective than medication at preventing relapse.

Unfortunately, Mr. Thompson's experience is more the rule than the exception. Only about one-third of American addiction programs offer what many experts worldwide see as the standard of care - long-term use of either methadone or buprenorphine. Most programs view medication as a crutch for short-term use and provide only talk therapies.

This widespread rejection of proven addiction medications is the single biggest obstacle to ending the overdose epidemic. Funding isn't the barrier: Outpatient medication treatment is both more effective and significantly cheaper than adding inpatient beds at rehabilitation centers. The problem is an outdated ideology that views needing a medication to function as a form of addiction.

Rather than defining addiction as destructive, compulsive behavior, this ideology focuses on physical dependence. If you need a drug to avoid being physically ill, you are considered addicted. So Prozac would be considered addictive, but not cocaine, because quitting Prozac abruptly can cause flulike symptoms while stopping cocaine doesn't, even though it elicits extreme craving.

In the 1980s, crack cocaine made clear just how addictive cocaine could be, even without physical withdrawal symptoms. Today, both the National Institute on Drug Abuse and the Diagnostic and Statistical Manual of Mental Disorders reject the idea that addiction is synonymous with dependence. Unfortunately, many clinicians, including doctors, haven't caught up.

What is addiction, then? The root problem is craving, which drives a compulsion to use drugs despite the harm they cause. That's what makes crack addictive, while Prozac can be therapeutic.

Because methadone and buprenorphine are opioids themselves, it's easy to assume that using them is "substituting one addiction for another." However, the pattern of taking the same dose every day at the same time means that there is no high or intoxication. Patients on maintenance doses are able to nurture a baby, drive, work and be a loving spouse.

In these patients, addiction is replaced by physical dependence. And that's not a problem for those who have health care coverage: It's no different from needing antidepressants or insulin. When a drug's benefits outweigh its risks, continued use is healthy, not addictive.

Sadly, though, there's another reason for widespread skepticism about addiction medication. It comes from the fact that many patients will continue to misuse opioids. Medication reduces relapse more than abstinence does - but relapse is still common, as in Mr. Thompson's case. In abstinence treatment, however, relapsers drop out and are invisible; with medication, they often remain in treatment.

And remaining in treatment is important because it cuts overdose risk, even during relapse. Many highly traumatized people also need the continued health care support before they are able to quit street drugs.

When we fail to understand that these medications can be used both to reduce harm and stabilize people in recovery, we risk letting the perfect be the enemy of the good. For some, medication is a way to reduce risk while drug use continues. For others, it's a path to rapid recovery. Often, people will need to take the first route to survive long enough to reach the second.

For harm reduction to work, maintenance drugs need to be almost as accessible as street drugs. Whenever people take buprenorphine rather than heroin, their risk of dying is lowered, especially since so much heroin these days is tainted with deadly strong fentanyl. For stabilization, people need empathetic counseling that doesn't view dependence as continuing addiction.

Change will require innovative measures. The government should stop funding and insurers should stop covering any program that does not use all the F.D.A.-approved anticraving medications and does not provide informed consent about their effectiveness. While abstinence can work for some, we need many options. We also need to rethink our regulations for methadone and buprenorphine prescribing.

Then we need to publicly recognize that recovery on medication is every bit as valid as any other treatment. What matters is whether, as Freud put it, you can love and work, not the chemical content of your brain or urine.

A version of this article appears in print on , on Page A23 of the New York edition with the headline: The Wrong Treatment For Opioid Addiction. Order Reprints | Today's Paper | Subscribe

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Opinion | The Wrong Way to Treat Opioid Addiction

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Before Joe Thompson switched treatments for his opioid addiction, he was a devoted stay-at-home father, caring for his infant son after his wife returned to work. His recovery was aided by the anticraving medication buprenorphine. But after over two years free of heroin, Mr. Thompson, a former United Parcel Service worker from Iowa, relapsed and decided to try another kind of treatment program.

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This is most common reason among young adults and teenagers. They start to use drugs because they want to fit in. Being rebellious as a teenager or young adult is very common. In a lot of cases, young adults and teenagers don’t fully understand the severity of drug use and addiction.

Being rebellious as a teenager or young adult is very common. In a lot of cases, young adults and teenagers don’t fully understand the severity of drug use and addiction.

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Substance abuse comes in many different forms and can happen for many different reasons. While every addiction is different, and the intensity can vary from substance to substance, there are some common reasons people may become addicted to a substance.

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Substance abuse comes in many different forms and can happen for many different reasons. While every addiction is different, and the intensity can vary from substance to substance, there are some common reasons people may become addicted to a substance.

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Many people who struggle with depression do not get proper treatment or diagnosis for this problem. Those struggling with depression tend to self-medicate to handle the symptoms of depression with Alcohol, Marijuana, Cocaine, and various other mind-altering substances.

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Substance abuse comes in many different forms and can happen for many different reasons. While every addiction is different, and the intensity can vary from substance to substance, there are some common reasons people may become addicted to a substance.

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Substance abuse comes in many different forms and can happen for many different reasons. While every addiction is different, and the intensity can vary from substance to substance, there are some common reasons people may become addicted to a substance.

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People start to abuse drugs and alcohol because they want to feel better than they do. Whether it is stress, anxiety or enhancing their fun when going out on weekends, using drugs or alcohol to feel better is a gateway to addiction.

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Substance abuse comes in many different forms and can happen for many different reasons. While every addiction is different, and the intensity can vary from substance to substance, there are some common reasons people may become addicted to a substance.

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Substance abuse comes in many different forms and can happen for many different reasons. While every addiction is different, and the intensity can vary from substance to substance, there are some common reasons people may become addicted to a substance.

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Drugs change the brain in ways that make quitting hard, even for those who want to.

Addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences. The initial decision to take drugs is voluntary for most people, but repeated drug use can lead to brain changes that challenge an addicted person’s self-control and interfere with their ability to resist intense urges to take drugs. These brain changes can be persistent, which is why drug addiction is considered a "relapsing" disease—people in recovery from drug use disorders are at increased risk for returning to drug use even after years of not taking the drug.

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Many people don't understand why or how other people become addicted to drugs. They may mistakenly think that those who use drugs lack moral principles or willpower and that they could stop their drug use simply by choosing to. In reality, drug addiction is a complex disease, and quitting usually takes more than good intentions or a strong will. Drugs change the brain in ways that make quitting hard, even for those who want to. Fortunately, researchers know more than ever about how drugs affect the brain and have found treatments that can help people recover from drug addiction and lead productive lives.

What Is drug addiction?

Addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences. The initial decision to take drugs is voluntary for most people, but repeated drug use can lead to brain changes that challenge an addicted person's self-control and interfere with their ability to resist intense urges to take drugs. These brain changes can be persistent, which is why drug addiction is considered a "relapsing" disease-people in recovery from drug use disorders are at increased risk for returning to drug use even after years of not taking the drug.

It's common for a person to relapse, but relapse doesn't mean that treatment doesn't work. As with other chronic health conditions, treatment should be ongoing and should be adjusted based on how the patient responds. Treatment plans need to be reviewed often and modified to fit the patient's changing needs.

Video: Why are Drugs So Hard to Quit?

What happens to the brain when a person takes drugs?

Most drugs affect the brain's "reward circuit," causing euphoria as well as flooding it with the chemical messenger dopamine. A properly functioning reward system motivates a person to repeat behaviors needed to thrive, such as eating and spending time with loved ones. Surges of dopamine in the reward circuit cause the reinforcement of pleasurable but unhealthy behaviors like taking drugs, leading people to repeat the behavior again and again.

As a person continues to use drugs, the brain adapts by reducing the ability of cells in the reward circuit to respond to it. This reduces the high that the person feels compared to the high they felt when first taking the drug-an effect known as tolerance. They might take more of the drug to try and achieve the same high. These brain adaptations often lead to the person becoming less and less able to derive pleasure from other things they once enjoyed, like food, sex, or social activities.

Long-term use also causes changes in other brain chemical systems and circuits as well, affecting functions that include:

Despite being aware of these harmful outcomes, many people who use drugs continue to take them, which is the nature of addiction.

Why do some people become addicted to drugs while others don't?

No one factor can predict if a person will become addicted to drugs. A combination of factors influences risk for addiction. The more risk factors a person has, the greater the chance that taking drugs can lead to addiction. For example:

Biology. The genes that people are born with account for about half of a person's risk for addiction. Gender, ethnicity, and the presence of other mental disorders may also influence risk for drug use and addiction.

Environment. A person's environment includes many different influences, from family and friends to economic status and general quality of life. Factors such as peer pressure, physical and sexual abuse, early exposure to drugs, stress, and parental guidance can greatly affect a person's likelihood of drug use and addiction.

Development. Genetic and environmental factors interact with critical developmental stages in a person's life to affect addiction risk. Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it will progress to addiction. This is particularly problematic for teens. Because areas in their brains that control decision-making, judgment, and self-control are still developing, teens may be especially prone to risky behaviors, including trying drugs.

Can drug addiction be cured or prevented?

As with most other chronic diseases, such as diabetes, asthma, or heart disease, treatment for drug addiction generally isn't a cure. However, addiction is treatable and can be successfully managed. People who are recovering from an addiction will be at risk for relapse for years and possibly for their whole lives. Research shows that combining addiction treatment medicines with behavioral therapy ensures the best chance of success for most patients. Treatment approaches tailored to each patient's drug use patterns and any co-occurring medical, mental, and social problems can lead to continued recovery.

More good news is that drug use and addiction are preventable. Results from NIDA-funded research have shown that prevention programs involving families, schools, communities, and the media are effective for preventing or reducing drug use and addiction. Although personal events and cultural factors affect drug use trends, when young people view drug use as harmful, they tend to decrease their drug taking. Therefore, education and outreach are key in helping people understand the possible risks of drug use. Teachers, parents, and health care providers have crucial roles in educating young people and preventing drug use and addiction.

Points to Remember

Drug addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences.

Brain changes that occur over time with drug use challenge an addicted person's self-control and interfere with their ability to resist intense urges to take drugs. This is why drug addiction is also a relapsing disease.

Relapse is the return to drug use after an attempt to stop. Relapse indicates the need for more or different treatment.

Most drugs affect the brain's reward circuit by flooding it with the chemical messenger dopamine. Surges of dopamine in the reward circuit cause the reinforcement of pleasurable but unhealthy activities, leading people to repeat the behavior again and again.

Over time, the brain adjusts to the excess dopamine, which reduces the high that the person feels compared to the high they felt when first taking the drug-an effect known as tolerance. They might take more of the drug, trying to achieve the same dopamine high.

No single factor can predict whether a person will become addicted to drugs. A combination of genetic, environmental, and developmental factors influences risk for addiction. The more risk factors a person has, the greater the chance that taking drugs can lead to addiction.

Drug addiction is treatable and can be successfully managed.

More good news is that drug use and addiction are preventable. Teachers, parents, and health care providers have crucial roles in educating young people and preventing drug use and addiction.

Learn more

For information about understanding drug use and addiction, visit:

For more information about the costs of drug abuse to the United States, visit:

For more information about prevention, visit:

For more information about treatment, visit:

To find a publicly funded treatment center in your state, call 1-800-662-HELP or visit:

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Understanding Drug Use and Addiction DrugFacts | National Institute on Drug Abuse

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Provides an overview of drug use and addiction, including what happens in the brain during drug use, why some people become addicted while others don't, and the importance of prevention.

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1. Some drugs are legal

Alcohol and nicotine are not only both legal drugs but they are the most commonly abused drugs.

2. They get a Prescription for drugs

There is a huge misconception that just because a doctor prescribed drugs they are safe. Prescription drugs are every bit as dangerous and addictive as street drugs like cocaine and heroin.

3. Going against the grain

Young adults and teenagers often start to abuse drugs because they are not sure where they fit in. Rebelling by abusing drugs and alcohol is not uncommon among young adults. What can start off as “fun” and “recreational” can quickly turn into an uncontrollable addiction.

4. Feelings of emptiness

Addiction often starts when an individual feels lonely. They turn to drugs and alcohol thinking that it will fill a void that they have been living with.

5. Peer Pressure

Teenagers and adults can succumb to peer pressure. The pressure of being around others who are abusing drugs or alcohol can make anyone follow suit and do things that they never thought they would.

6. Drugs and alcohol can make you feel good

People commonly fall into addiction because they begin using drugs to mask particular emotions that they are going through. The abuse makes them feel good and forget about the problem at hand. Eventually they think they can’t live without drugs.

7. Drugs and alcohol are more available than ever

Prescription drugs, street drugs and alcohol are more available than ever. Prescription drugs can be obtained on the streets, through doctors and even online. Where there is a will there is a way.

8. Alcohol isn’t enough

Often times addiction starts with alcohol but when the effects of alcohol are not what they used to be the addict turns to harder and stronger drugs.

9. Experimenting

It is not uncommon for addiction to stem from a person being curious and experimenting with drugs. It is a scenario that often starts with alcohol or marijuana but ends up with cocaine, prescription medication or even crystal meth and heroin.

10. Self Medicating

People from all different backgrounds use alcohol to unwind at the end of the day or prescription drugs to help them cope with stress of everyday life. Patterns like this can quickly turn into addiction.

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The reasons why people use drugs vary greatly for every individual. More often than not, a person is trying to fix an issue within their life and they see drugs as the solution.

A young person may be trying to fit in with their peers and views using or alcohol drugs as a means of feeling "a part of." In contrast, many individuals use drugs as a way to self-medicate. From chronic pain to mental health disorders, many people use drugs to alleviate symptoms of an ailment.

Here is a top ten list of why people use drugs:

1 Experimenting

It is not uncommon for addiction to stem from a person being curious and experimenting with drugs or alcohol. It is a scenario that often starts with a young person using alcohol or marijuana out of curiosity. While it seems harmless, adolescents that experiment with drugs and alcohol are more likely to develop substance use disorder according to the National Institute on Drug Abuse.

2 Family History/Genetics

If you have a family history of drug addiction, you may have a genetic predisposition to develop an addiction to drugs or alcohol. It is stated that about 30% - 70% of a person's risk for addiction is linked to the genes they are born with along with other social factors.

3 Prescription Drugs

There is a popular misconception that any medication prescribed by a doctor is safe. Unfortunately, that is not always the case. Doctors prescribe medications to alleviate symptoms of physical or mental health issues. However, many individuals are not properly educated on the risks that the medications may carry. Chronic pain is often managed through opioid medications, which are highly addictive. Dependent upon the amount used and other factors, someone may require a medical detox just to stop using opioids. Likewise, those suffering from anxiety and depression may be prescribed addictive medications to ease symptoms. Non-addictive medication and/or pain recovery services are often available.

4 Loneliness

Addiction can start when an individual feels lonely or is isolated from the friends and family. They turn to drugs and alcohol thinking that it will fill a void that they have been living with. People lacking positive daily interaction may choose to use substances to feel happy or content. Additionally, users begin to alienate themselves further if they fear being judged or that help is not available to them.

5 Peer Pressure

Peer pressure usually applies to adolescents or young adults. The need to fit in, on some level, is built into each and every one of us. Some people may feel the need to participate in potentially harmful activities to do so. The pressure of being around others who are abusing drugs or alcohol can push someone to follow suit.

6 Drugs and alcohol can make you feel good

There is a popular quote in the Big Book of Alcoholics Anonymous that states: "Men and women drink essentially because they like the effect produced by alcohol." While this seems obvious, some people like the effect so much that they are unable to stop. It may be difficult to see the harm in something that makes you feel good.

7 Mental Health Disorders

Depression, anxiety, and PTSD can put individuals at higher risk of developing an addiction. Using substances to cope with difficult feelings may seem like an easier path for some. Though they may seem crippling at times, there is help available to anyone struggling with a mental health disorder. Non-narcotic medications are often available for most mental health disorders. It's worth researching with a doctor to see if there is an alternative to addictive medications.

8 Recreation

Many people use drugs or alcohol socially with friends or to "unwind" after a long day. They often see substances as a way to relax or clear their minds. Recreational drug users are still at risk to become addicted if their use becomes more frequent or they use highly addictive substances.

9 Alcohol isn't enough

For some, alcohol stops doing the trick. A few beers after work or having drinks with friends at a local bar just doesn't have the same effect that it used to. Some individuals end up "chasing a buzz" that they were once able to attain with a few drinks. This can leave someone powerless over alcohol and unable to quit drinking.

10 Self-Medicating

People struggling with any of a multitude of ailments may turn to drugs or alcohol to ease their pain. Mental health disorders and chronic pain leave some seeking solutions on their own. Alcohol or other substances can alleviate symptoms and seem like a short-term solution. However, people should look for manageable, long-term solutions under medical supervision to combat these issues.

There are many reasons why people use drugs. Knowing the risk of using alcohol and other drugs is half the battle. When we educated ourselves about these issues, we are more likely to make better decisions in the future.

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Updated on The reasons why people use drugs vary greatly for every individual. More often than not, a person is trying to fix an issue within their life and they see drugs as the solution. A young person may be trying to fit in with their peers and views using or alcohol drugs as a means of feeling "a part of."

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Drugs are a frequent topic of conversation and most people have friends or acquaintances that use them. As curiosity is part of human nature, many people, especially young people, are curious about drugs and how they make a person feel.

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One of the most common reasons why people use is to relieve various emotional problems. These may include anger, stress, anxiety, tension, boredom, and depression. When people are using drugs for these reasons, it is common for them to continue using, eventually becoming addicted. People also may take drugs because they have low self esteem; these substances may make them feel good about their self. Young people especially, may use as a way of rebelling away from mainstream society. If a person has experienced a traumatic event, they may turn to drugs to help them cope with their feelings.

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It seems as though the media almost glorifies people using. Drugs and alcohol are found throughout advertisements, magazines, events, films, etc. This affects how people view the issue, even if it is subconsciously. The media may promote drugs as being a great social activity, a way to achieve success, or a way to lose weight.

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An individual may use drugs because they enjoy the pleasurable feelings; this results in the user feeling that they have a positive effect. This pleasure can be associated with the ‘high’, the relaxation, the loss of inhibitions, the euphoria, the relief from pain, the ability to sleep or stay awake, and the increased energy.

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The social pressures to use drugs can be extremely powerful. Some may feel like they have to drink alcohol when they go out for fun or when they attend a party or gathering. Younger people that have grown up in a household with drug abusers sometimes use that excuse to justify their own involvement with these dangerous substances.

There are certain social groups, which make drugs seem fashionable or trendy. In these groups, using is the key to belonging; anyone who abstains will be excluded. Because some people are desperate to find a place to fit in, they go along with it.

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- drugs relieve a person of an unwanted condition. (pain, stress, nervous, boredom

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Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own, for you were bought with a price. So glorify God in your body. - 1 Corinthians 6:19-20

Be sober-minded; be watchful. Your adversary the devil prowls around like a roaring lion, seeking someone to devour. - 1 Peter 5:8

Envy, drunkenness, orgies, and things like these. I warn you, as I warned you before, that those who do such things will not inherit the kingdom of God. - Galations 5:21

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Most illegal drugs can have adverse cardiovascular effects, ranging from abnormal heart rate to heart attacks. Injecting illegal drugs also can lead to cardiovascular problems, such as collapsed veins and bacterial infections of the blood vessels and heart valves.
Many drugs, such as cocaine, heroin and various forms of amphetamine, affect the central nervous system and can alter a user's consciousness.

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Most illegal drugs can have adverse cardiovascular effects, ranging from abnormal heart rate to heart attacks. Injecting illegal drugs also can lead to cardiovascular problems, such as collapsed veins and bacterial infections of the blood vessels and heart valves.

Many drugs, such as cocaine, heroin and various forms of amphetamine, affect the central nervous system and can alter a user's consciousness. In addition to addiction, the side effects and risks associated with use of these drugs include:

changes in body temperature, heart rate, and blood pressure

headaches, abdominal pain, and nausea

impaired judgment and greater risk of some sexually transmitted infections

the added danger of added substances (such as talc, poisons, herbicides or other particles) which may cause a toxic reaction.

possibility of added substances (such as talc, poisons, herbicides or other particles) which may cause a toxic reaction.

heart attacks, seizures, and respiratory arrest

More about Cocaine - the "perfect heart-attack drug"

The powdered form of cocaine is either inhaled through the nose (snorted) and absorbed through nasal tissue, or dissolved in water and injected into the bloodstream. Crack is a form of cocaine that has been processed to make a rock crystal that can be smoked.
Even so-called recreational cocaine users may have higher blood pressure, stiffer arteries and thicker heart muscle walls than non-users - all of which can cause a heart attack. An Australian study presented at the American Heart Association's Scientific Sessions in 2012 was the first to document these cardiovascular abnormalities in seemingly healthy regular cocaine users long after the immediate effects of cocaine have worn off. Researchers - who called cocaine "the perfect heart attack drug" - showed how users had higher rates of multiple factors associated with higher risks of heart attack and stroke:

30 percent to 35 percent increase in aortic stiffening;

8 mm Hg higher systolic blood pressure; and

18 percent greater thickness of the heart's left ventricle wall.

A United Nations World Drug Report estimated the prevalence of cocaine use in the United States for 2013 to be 1.6 percent of the population aged 12 and older, and it had remained stable in the previous few years.
Cocaine is the illegal drug most often associated with visits to U.S. hospital emergency departments. Cocaine use has been associated with chest pain and myocardial infarction. In 2011, it was involved in an estimated 40.3 percent of illicit drug-related emergency department visits (505,224 visits), versus about 36.4 percent (455,668 visits) for marijuana and about 20.6 percent (258,482 visits) for heroin.

Cocaine, amphetamine and ecstasy can all have adverse effects on the cardiovascular system.

Amphetamines, a class of drugs which includes methamphetamines, can be habit-forming and prone to abuse. The drugs are prescribed to treat Parkinson's, obesity, narcolepsy and attention deficit disorder with hyperactivity (ADHD). They stimulate the central nervous system (nerves and brain). This increases heart rate and blood pressure and decreases appetite, among other effects.

Ecstasy, or MDMA, is illegal. It is known as a synthetic "club drug" with stimulant and hallucinogenic effects.

Drug Abuse is growing among older adults.

According to the National Institutes of Health, the number of illicit drug users age 50 and older is increasing. Illegal drug users aged 50 to 59 more than tripled between 2002 and 2012 - from 900,000 to more than 3 million. Larger numbers of older adults also are seeking treatment for substance abuse and having increased hospitalizations and more visits to emergency departments, up more than 130 percent in 55 to 64-year-olds from 2004 to 2009.
While it is relatively rare for adults over 65 to have ever used illicit drugs, baby boomers, adults currently in their 50s and early 60s, are more likely to have tried them during their youth than previous generations. Greater lifetime exposure could lead to higher rates of abuse as baby boomers age.
For more information and resources, please see: This content was last reviewed September 2015.

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inflammation of the inner lining of the heart

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Most illegal drugs can have adverse cardiovascular effects, ranging from abnormal heart rate to heart attacks. Injecting illegal drugs also can lead to cardiovascular problems, such as collapsed veins and bacterial infections of the blood vessels and heart valves. Many drugs, such as cocaine, heroin and various forms of amphetamine, affect the central nervous system and can alter a user's consciousness.

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Repeated drug use changes the brain, including parts of the brain that give a person self-control. These and other changes can be seen clearly in brain imaging studies of people with a drug addiction. These brain changes explain why quitting is so difficult, even when an addicted person feels ready.

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1. Does the person take the drug in larger amounts or for longer than intended?

2. Do they want to cut down or stop using the drug but can’t?

3. Do they spend a lot of time getting, using, or recovering from  the drug?

4. Do they have cravings and urges to use the drug?

5. Are they unable to manage responsibilities at  work, home, or school because of drug use?

6. Do they continue to use a drug, even when it causes problems in relationships?

7. Do they give up important social, recreational, or work-related activities because of drug use?

8. Do they use drugs again and again, even when it puts them in danger?

9. Do they continue to use, even while knowing that a physical or mental problem could have been caused or made worse by the drug?

10. Do they take more of the drug to get the wanted effect?

11. Have they developed withdrawal symptoms, which can be relieved by taking more of the drug? (Some withdrawal symptoms can be obvious, but others can be more subtle—like irritability or nervousness.)

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Understanding drug abuse and addiction

People from all walks of life can experience problems with their drug use, regardless of age, race, background, or the reason they started using drugs in the first place. Some people experiment with recreational drugs out of curiosity, to have a good time, because friends are doing it, or to ease problems such as stress, anxiety, or depression.

However, it's not just illegal drugs, such as cocaine or heroin, that can lead to abuse and addiction. Prescription medications such as painkillers, sleeping pills, and tranquilizers can cause similar problems. In fact, next to marijuana, prescription painkillers are the most abused drugs in the U.S. and more people die from overdosing powerful opioid painkillers each day than from traffic accidents and gun deaths combined. Addiction to opioid painkillers can be so powerful it has become the major risk factor for heroin abuse.

When drug use becomes drug abuse or addiction

Of course, drug use-either illegal or prescription-doesn't automatically lead to abuse. Some people are able to use recreational or prescription drugs without experiencing negative effects, while others find that substance use takes a serious toll on their health and well-being. Similarly, there is no specific point at which drug use moves from casual to problematic.

Drug abuse and addiction is less about the type or amount of the substance consumed or the frequency of your drug use, and more about the consequences of that drug use. If your drug use is causing problems in your life-at work, school, home, or in your relationships-you likely have a drug abuse or addiction problem.

If you're worried about your own or a loved one's drug use, learning how drug abuse and addiction develops-and why it can have such a powerful hold-will give you a better understanding of how to best deal with the problem and regain control of your life. Recognizing that you have a problem is the first step on the road to recovery, one that takes tremendous courage and strength. Facing your problem without minimizing the issue or making excuses can feel frightening and overwhelming, but recovery is within reach. If you're ready to seek help, you can overcome your addiction and build a satisfying, drug-free life for yourself.

Risk factors for drug addiction

While anyone can develop problems from using drugs, vulnerability to substance addiction differs from person to person. While your genes, mental health, family and social environment all play a role, risk factors that increase your vulnerability include:

Family history of addiction

Abuse, neglect, or other traumatic experiences

Mental disorders such as depression and anxiety

Early use of drugs

Method of administration-smoking or injecting a drug may increase its addictive potential

Myths and facts about drug abuse and addiction

Six common myths

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How drug abuse and addiction develops

There's a fine line between regular drug use and drug abuse and addiction. Very few drug abusers or addicts are able to recognize when they've crossed that line. While frequency or the amount of drugs consumed do not necessarily constitute drug abuse or addiction, they can often be indicators of drug-related problems.

If the drug fulfills a valuable need, you may find yourself increasingly relying on it. You may take illegal drugs to calm or energize yourself or make you more confident. You may start abusing prescription drugs to relieve pain, cope with panic attacks, or improve concentration at school or work. If you are using drugs to fill a void in your life, you're more at risk of crossing the line from casual drug use to drug abuse and addiction. To maintain a healthy balance in your life, you need to have positive experiences and feel good about your life without any drug use.
[Read: Self-Medicating Depression, Anxiety, and Stress]
Drug abuse may start as a way to socially connect. People often try drugs for the first time in social situations with friends and acquaintances. A strong desire to fit in to the group can make it feel like doing the drugs with them is the only option.

Problems can sometimes sneak up on you, as your drug use gradually increases over time. Smoking a joint with friends over the weekend, or taking ecstasy at a rave, or painkillers when your back aches, for example, can change from using drugs a couple of days a week to using them every day. Gradually, getting and using the drug becomes more and more important to you.

As drug abuse takes hold, you may miss or frequently be late for work or school, your job performance may progressively deteriorate, and you may start to neglect social or family responsibilities. Your ability to stop using is eventually compromised. What began as a voluntary choice has turned into a physical and psychological need.

Eventually drug abuse can consume your life, stopping social and intellectual development. This only reinforces feelings of isolation.

Drug addiction and the brain

While each drug produces different physical effects, all abused substances share one thing in common: repeated use can alter the way the brain functions. This includes commonly abused prescription medications as well as recreational drugs.

Taking the drug causes a rush of the hormone dopamine in your brain, which triggers feelings of pleasure. Your brain remembers these feelings and wants them repeated.

When you become addicted, the substance takes on the same significance as other survival behaviors, such as eating and drinking.

Changes in your brain interfere with your ability to think clearly, exercise good judgment, control your behavior, and feel normal without drugs.

No matter which drug you're addicted to, the uncontrollable craving to use grows more important than anything else, including family, friends, career, and even your own health and happiness.

The urge to use is so strong that your mind finds many ways to deny or rationalize the addiction. You may drastically underestimate the quantity of drugs you're taking, how much it impacts your life, and the level of control you have over your drug use.

With the right treatment and support, you can counteract the disruptive effects of drug use and regain control of your life. The first obstacle is to recognize and admit you have a problem, or listen to loved ones who are often better able to see the negative effects drug use is having on your life.

Signs and symptoms of drug abuse and addiction

Although different drugs have different physical effects, the symptoms of addiction are similar. If you recognize yourself in the following signs and symptoms, talk to someone about your drug use.

Common symptoms of drug abuse

Neglecting responsibilities at school, work, or home (e.g. flunking classes, skipping work, neglecting your children).

Using drugs under dangerous conditions or taking risks while high, such as driving while on drugs, using dirty needles, or having unprotected sex.

Experiencing legal trouble, such as arrests for disorderly conduct, driving under the influence, or stealing to support a drug habit.

Problems in your relationships, such as fights with your partner or family members, an unhappy boss, or the loss of friends.

Common symptoms of drug addiction

You've built up a drug tolerance. You need to use more of the drug to experience the same effects you used to attain with smaller amounts.

You use to avoid or relieve withdrawal symptoms. If you go too long without drugs, you experience symptoms such as nausea, restlessness, insomnia, depression, sweating, shaking, and anxiety.

Loss of control over your drug use. You often do drugs or use more than you planned, even though you told yourself you wouldn't. You may want to stop using, but you feel powerless.

Your life revolves around drug use. You spend a lot of time using and thinking about drugs, figuring out how to get them, or recovering from the drug's effects.

You've abandoned activities you used to enjoy, such as hobbies, sports, and socializing, because of your drug use.

You continue to use drugs, despite knowing it's hurting you. It's causing major problems in your life-blackouts, financial issues, infections, mood swings, depression, paranoia-but you use anyway.

Warning signs that a friend or loved one is abusing drugs

Drug abusers often try to conceal their symptoms and downplay their problem. If you're worried that a friend or loved one might be abusing drugs, look for the following warning signs:

Physical warning signs

Bloodshot eyes, pupils larger or smaller than usual.

Changes in appetite or sleep patterns.

Sudden weight loss or weight gain.

Deterioration of physical appearance, personal grooming habits.

Unusual smells on breath, body, or clothing.

Tremors, slurred speech, or impaired coordination.

Behavioral warning signs

Drop in attendance and performance at work or school.

Unexplained financial problems; borrowing or stealing.

Engaging in secretive or suspicious behaviors.

Sudden change in friends, favorite hangouts, and hobbies.

Frequently getting into trouble (fights, accidents, illegal activities).

Psychological warning signs

Unexplained change in personality or attitude.

Sudden mood swings, irritability, or angry outbursts.

Periods of unusual hyperactivity, agitation, or giddiness.

Lack of motivation; appears lethargic or "spaced out".

Appears fearful, anxious, or paranoid.

Warning signs of commonly abused recreational drugs

Marijuana: Glassy, red eyes; loud talking, inappropriate laughter followed by sleepiness; loss of interest, motivation; weight gain or loss.

Stimulants (including amphetamines, cocaine, crystal meth): Dilated pupils; hyperactivity; euphoria; irritability; anxiety; excessive talking followed by depression or excessive sleeping at odd times; may go long periods of time without eating or sleeping; weight loss; dry mouth and nose.

Inhalants (glues, aerosols, vapors): Watery eyes; impaired vision, memory and thought; secretions from the nose or rashes around the nose and mouth; headaches and nausea; appearance of intoxication; drowsiness; poor muscle control; changes in appetite; anxiety; irritability; lots of cans/aerosols in the trash.

Hallucinogens (LSD, PCP): Dilated pupils; bizarre and irrational behavior including paranoia, aggression, hallucinations; mood swings; detachment from people; absorption with self or other objects, slurred speech; confusion.

Heroin: Contracted pupils; no response of pupils to light; needle marks; sleeping at unusual times; sweating; vomiting; coughing, sniffling; twitching; loss of appetite.

Warning signs of prescription drug abuse

In recent years, prescription drug abuse has become an escalating problem, most commonly involving opioid painkillers, anti-anxiety medications, sedatives, and stimulants. Many people start taking these drugs to cope with a specific medical problem-taking painkillers following injury or surgery, for example. However, over time, increased doses are needed to achieve the same level of pain relief and some users can become physically dependent, experiencing withdrawal symptoms if they try to quit.

One of the earliest warning signs of a developing problem is going through the medication at a faster-than-expected rate. In other cases, people start abusing medication not prescribed for them in order to experience a high, relieve tension, increase alertness, or improve concentration.
[Read: Anxiety Medication]
To avoid developing problems with a prescription medication, it's important to take it only as directed, use the lowest dose for the shortest period possible, and to talk to your doctor about other methods of treating the problem. Being aware of any signs of dependency can help identify prescription drug problems at an early stage and help to prevent them progressing into an addiction.

Warning signs of commonly abused prescription drugs

Opioid painkillers (including OxyContin, Vicodin, Norco): Drooping eyes, constricted pupils even in dim light, sudden itching or flushing, slurred speech; drowsiness, lack of energy; inability to concentrate, lack of motivation, decline in performance at work or school; neglecting friendships and social activities.

Anti-anxiety medications, sedatives, and hypnotics (including Xanax, Valium, Ambien): Contracted pupils; drunk-like, slurred speech, difficulty concentrating, clumsiness; poor judgment, drowsiness, slowed breathing.

Stimulants (including Ritalin, Concerta, Adderall, Dexedrine): Dilated pupils, reduced appetite; agitation, anxiety, irregular heartbeat, high body temperature; insomnia, paranoia.

When a loved one has a drug problem

If you suspect that a friend or family member has a drug problem, here are a few things you can do:

Speak up. Talk to the person about your concerns, and offer your help and support without being judgmental. The earlier addiction is treated, the better. Don't wait for your loved one to hit rock bottom! List specific examples of your loved one's behavior that have you worried and urge them to seek help.

Take care of yourself. Stay safe. Don't put yourself in dangerous situations. Don't get so caught up in someone else's drug problem that you neglect your own needs. Make sure you have people you can talk to and lean on for support.
[Read: Helping Someone with a Drug Addiction]
Avoid self-blame. You can support a person with a substance abuse problem and encourage treatment, but you can't force an addict to change. You can't control your loved one's decisions. Letting the person accept responsibility for their actions is an essential step along the way to recovery.

Don't...

Attempt to threaten, punish, bribe, or preach.

Make emotional appeals that only add to the user's feelings of guilt and increase their compulsion to use drugs.

Cover up or make excuses for the drug abuser, or shield them from the consequences of their drug use.

Take over the drug abuser's responsibilities, diminishing their sense of self-worth.

Hide or throw out drugs.

Argue with the person when they are high.

Use drugs with the person.

Feel guilty or responsible for a drug abuser's behavior.

When your teen has a drug problem

Discovering your child uses drugs can generate fear, confusion, and anger. It's important to remain calm when confronting your teen, and to only do so when everyone is sober. Explain your concerns and make it clear that your concern comes from a place of love. It's important that your teen feels you are supportive.

Warning signs of teen drug abuse

As with adults, teenage drug abuse isn't limited to illegal drugs. In fact, teens are more likely to abuse prescription and over-the-counter drugs, including painkillers, stimulants, sedatives, and tranquilizers. In many cases, these drugs are much easier for teens to procure, yet they can have dangerous, even lethal, side effects.

While experimenting with any kind of drug doesn't automatically lead to drug abuse, early use is a risk factor for developing more serious drug abuse and addiction down the road. Risk of drug abuse also increases greatly during times of transition, such as changing schools, moving, or divorce. The challenge for parents is to distinguish between the normal, often volatile, ups and downs of the teen years and the red flags of substance abuse. These include:

Having bloodshot eyes or dilated pupils; using eye drops to try to mask these signs

Skipping class; declining grades; suddenly getting into trouble at school
Missing medications, prescriptions, money or valuables
Acting uncharacteristically isolated, withdrawn, angry, or depressed

Sudden mood changes or repeated health complaints, constant fatigue

Dropping one group of friends for another; being secretive about the new peer group

Loss of interest in old hobbies; lying about new interests and activities

Demanding more privacy; locking doors; avoiding eye contact; sneaking around

7 steps parents can take to curb teen drug use

1. Talk openly about the dangers of both illegal and prescription drug use with your kids. Providing a safe and open environment to talk about these issues can make a real difference in the likelihood that they'll use or abuse drugs.

2. Lay down rules and consequences. Your teen should understand that using drugs comes with specific consequences. But don't make hollow threats or set rules that you cannot enforce-and make sure your spouse agrees and is prepared to enforce the rules. Remind your teen that taking someone else's prescription or sharing theirs with others is illegal.

3. Monitor your teen's activity. Know where your teen goes and who they hang out with. It's also important to routinely check potential hiding places for drugs-in backpacks, between books on a shelf, in DVD cases or make-up cases. Monitor your teen's online activity to check for illegal purchases.

4. Keep prescription medicines in a safe place, avoid stockpiling them, and dispose of any unused prescription medicines. Monitor your prescription refills carefully.

5. Encourage other interests and social activities. Expose your teen to healthy hobbies and activities, such as team sports and after-school clubs.

6. Talk to your child about underlying issues. Drug use can be the result of other problems. Is your teen having trouble fitting in? Has there been a recent major change, like a move or divorce causing stress?

7. Get help. Teenagers often rebel against their parents but if they hear the same information from a different authority figure, they may be more inclined to listen. Try a sports coach, family doctor, therapist, or drug counselor.

Next step: Getting help for drug abuse or addiction

Addiction is a complex problem that affects every aspect of your life. Overcoming addiction requires reaching out for support and making changes to the way you live, deal with problems, and relate to others. Recovery is within your reach but don't try to go it alone; it's very easy to get discouraged and rationalize "just one more."

Whether you choose to go to rehab, rely on self-help programs, get therapy, or take a self-directed treatment approach, support is essential.

Read: Overcoming Drug Addiction.

Professional help for drug treatment and recovery

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Drug Abuse and Addiction - HelpGuide.org

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Do you or someone you love have a problem with substance abuse? Explore the warning signs and how to get the best help.