Drug & Alcohol Abuse
is drug and alcohol abuse?
of us on a daily basis use perfectly legal substances for pleasure
and relaxation. However, even seemingly innocuous substances, such
a caffeine, alcohol and nicotine, are psychoactive in nature, which
means that they alter our mental functioning by having a direct
action on the brain. When taken in excess, they can cause social,
medical and psychological problems. For example, heavy use of alcohol
can lead to diseases such as liver cirrhosis and alcohol-related
dementia (Korsakoff’s syndrome). Furthermore, over time, an
individual develops tolerance and has to consume progressively greater
quantities to obtain the original effects. Physical dependence can
occur, whereby the body ceases to function normally without the
alcohol, which can lead to unpleasant withdrawal symptoms occurring.
of drugs or alcohol can occur in the context of other conditions
such as Depression, or PTSD. The person can use these substances
in attempt to “self medicate” and reduce their symptoms.
may be obtained legally or illegally. Common legal drugs include
alcohol, solvents and prescription drugs such as Valium, Mogadon
and barbiturates. Drugs which may be illegally obtained include
the opiates, such heroin, stimulants such as Ecstasy and amphetamine,
and hallucinogens, such as LSD and “magic mushrooms”.
Cannabis has mixed depressant and hallucinogenic properties, and
whilst tolerance develops, there is no consensus as to whether it
induces clear physical dependency. However, although widely accepted
as a ‘soft’ drug, there is increasing evidence that
it exerts strong psychoactive effects.
are the symptoms?
people who abuse substances such as drugs and alcohol suffer physical
or psychological dependency i.e. they cannot manage without it,
have cravings for it, and, in the case of physical dependency suffer
severe withdrawal symptoms if they do not take the substance. Typical
symptoms of withdrawal include heightened anxiety, insomnia, agitation
and shaking, and it may also be complicated by convulsions or delirium.
Acute intoxication is a transient phenomenon that includes acute
drunkenness and ‘bad trips’ due to hallucinogenic drugs.
are not actually dependent on the substance they abuse, but its
use has a damaging effect on their daily life, such as on relationships,
and work, or leads to criminal acts.
people suffer psychotic phenomena during or immediately after substance
use, including vivid hallucinations, delusions, psychomotor disturbance
(excitement or stupor), and an abnormal mood, which may range from
intense fear to ecstasy. There can also be delayed psychotic symptoms
some time after taking hallucinogenic drugs.
long does it last?
people use drugs either at times of stress or particular periods
of life e.g. in adolescence or young adulthood, in response to group
norms and pressure. Others have a more long-term problem, which
can persist indefinitely.
is the treatment?
approach taken varies with the nature and severity of the problem,
including whether there is physical damage and whether the goal
is abstinence, reduction in use of the substance, or harm reduction
(eg stopping sharing needles). Also detoxification i.e. a phased
withdrawal of the substance sometimes with replacement with other
less harmful substances may be necessary, if there is physical dependency.
Different approaches may be taken at different stages of treatment.
there are severe problems, a specialist, multi-disciplinary treatment
service may be required, in the form of a community drug and alcohol
team approach. For milder difficulties, CBT can be an effective
treatment method. ‘Social learning theory’ has been
applied to the understanding and treatment of addictive behaviours,
in the form of a ‘Relapse Prevention’ model. This approach
focuses particularly on the factors that will influence the success
or failure of an addict who attempts to become abstinent.
the drug or alcohol use is symptomatic of a condition such as PTSD,
Depression or chronic pain, it is important to treat the underlying