Drug Abuse and Addiction

What are "drugs"?

"Substance abuse" refers to the use of "substances", which are not alcohol, in a way that causes physical or psychological damage, or that causes one to lose control over consumption.

A distinction is sometimes made between "hard substances" and "soft substances". This distinction is not used here, where "substance abuse" is about the problems you have with the substance, not about what the substance itself is. Therefore, hashish can be a "drug" in this context, if one's consumption of hashish creates a need for treatment.

Some types of medicine that you have been prescribed by your doctor can also give rise to addiction, and therefore in this context be a "drug". This applies, for example, to strong pain relievers such as opioids and sedative medications of the benzodiazepine type, such as alprazolam or clozabam.

What is substance abuse?

A substance abuse can be defined by the fact that you consume a chemical substance that can be harmful to you and/or society, and where the use of the substance is not in accordance with any medical guidelines.

Intoxication or dependence (withdrawal) are the most common motives for taking the drug.

What is addiction?

Addiction is both a psychological and a physical condition. It involves typical changes in behavior and in one's way of thinking, and is characterized by a compulsive urge to be infused with one or more drugs.

The substances are consumed to achieve the psychological effects they provide, or to avoid the discomfort that comes when it is not administered.

There are both psychological and physiological aspects to addiction. Mental and physical aspects are present to varying degrees, depending on which substance is used and who abuses it.

Psychic addiction means that the person's thoughts and attention are directed towards the substance. This means that the addicted person spends more and more time and effort to get hold of the drug. There can also be a strong urge to take the substance again to achieve these effects - called "craving"
Physical aspects of addiction are a result of the body adapting to the drug. Physical symptoms therefore occur when the substance is no longer present in the body. This can be, for example, nausea, diarrhoea, tremors, headache, fever and possibly convulsions. These symptoms are called withdrawal symptoms
Both contribute to the symptoms of addiction.

Why do some develop drug addiction?

There is general agreement that the risk of developing drug addiction is conditioned by both psychological, neurobiological and social conditions that can promote the tendency to addiction.

Many substances, for example alcohol, cause the person to get a feeling of cheerfulness, pleasure, relaxation and a sense of satisfaction. This feeling is strongly influenced by cultural factors, and is thus more an expression of positive expectations than of the substance's direct effects. But when consumption continues over time, for some it can come to function as an escape from the problems and difficulties of daily life.

In addition, some drugs can reduce unpleasant symptoms such as pain (morphine-like drugs), anxiety (benzodiazepines), sadness/depression, psychosis and insomnia. This can lay the groundwork for a person to continue taking such drugs. It is this repeated consumption, and the effects it has, that cause psychological and possibly physical dependence to occur.

Some people are much more prone to developing an addiction than others. This applies especially to people who tend to act impulsively and who are easily angered. But it can also be people who are troubled by personal problems and who are unsure of themselves. They may have contact problems or a feeling that the environment's demands on them are greater than they can meet. In this context, it seems that personality, previous experiences in life, including growing up conditions can play a decisive role.

However, drug addiction and addiction can also develop in people who previously seemed both stable and well-adjusted, and who apparently come from well-functioning families.

In recent years, science has found that there are also neurobiological changes in the brains of people who have previously been addicted to drugs of abuse. Changes that make it harder for these people than other people to feel joy and "reward" when something good happens. This means that they tend to experience the world "gray in grey", unless they consume drugs of abuse. By taking the drugs, they can feel the joy and satisfaction that others achieve much more easily.

Drug addiction most often develops at a relatively young age. It appears that the risk of developing an addiction is lower in adults. Young people like to gather in an environment where they find other people with similar thoughts about themselves and the world around them. In such an environment, it is easier to start an abuse. At the same time, the brain is more plastic and adaptable in the younger years.

The experimental phase

The first phase is the experimental phase, where peer pressure and curiosity lead to the person coming into contact with drugs. In the beginning, it is preferably cannabis, tobacco and alcohol. But increasingly stronger drugs are gradually being explored.

The abuser learns the techniques necessary for the various forms of abuse. Gradually, you develop an identity as an addict. Then the road is short to the compulsive phase, where the person spends more and more time with the abuse. Time goes by getting drugs, enjoying drugs and talking about the effects of the drug.

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People can become addicted to both illegal narcotics and medications given by their own doctor. In addition, you can become dependent on substances that we do not think of as drugs or medicines, e.g. alcohol.

The most common illegal drugs that are abused are hash, (PCP, LSD), amphetamine, ecstasy, cocaine, crack, heroin and other hallucinogens, the latter, however, rarely causing addiction.

The group of sedatives called benzodiazepines is particularly addictive. It is also widespread among addicts to use morphine preparations and other opioids.

How do I know if I have an addiction problem?

If you find that the acquisition of the drug or the effect of the drug creates problems for you, it indicates that you have an addiction problem. These problems may include, for example:

• Health
• School/work
• Economy
• The relationship with family and friends

Many who use drugs experience difficulty concentrating, mood swings beyond normal and sleep disturbances. They lose interest in things or activities that were previously pleasurable, and a weakened interest in taking care of themselves.

Frequent absences from work or school are common.

The typical thing is that more and more time and energy is concentrated around the substance and its use, and the daily tasks and duties are neglected.

What problems can the abuse bring with it?

Changes in personality can occur when a substance is abused over a long period of time. The addict typically becomes more indifferent and lethargic, and education, work and friendships are neglected.

If the person stops taking a drug, it can cause withdrawal, which are unpleasant physical symptoms. It is especially morphine-like substances, e.g. heroin, and sedatives such as benzodiazepines and alcohol that cause withdrawal. The most severe, and potentially fatal, withdrawals are from alcohol.

In the long run, many substances can contribute to the triggering of psychiatric conditions such as acute and chronic psychoses. These may include hallucinations, delusions of persecution and confusional states.

There is also an increased incidence of suicide among people who abuse euphoric drugs. This is partly due to the difficult social situation in which the drug/alcohol addict finds himself, but accompanying disorders such as depression, anxiety and psychoses also play a role.

Those who use syringes are at risk of becoming infected with HIV, getting AIDS, and liver inflammation (hepatitis) and other infections.

People who use drugs are to a greater extent than others exposed to accidents both in traffic and in other contexts. The constant urge to get drugs leads to financial problems. It can result in crime and prostitution.

In addition to the problems affecting the addict himself, the environment will also be affected. Children of addicts in particular will suffer from the abuse both during pregnancy and during upbringing.

Why should I stop taking drugs?

only you can judge what is right for you. But the fewer drugs you take, the fewer problems you will experience that are caused by the drugs.

Both stopping using drugs and reducing consumption can be very difficult. But the effort will be rewarded in the form of better health, better social interactions and a sense of a more meaningful life.

It can often help to draw up a list of the reasons you may have for getting out of your consumption.

How is drug addiction treated?

As the negative consequences of drug abuse become more and more apparent, the drug addict may experience standing at a crossroads. The person then often has the feeling that it is dangerous to continue, or that a life without drugs has more to offer than a life with them. Then the way out of the abuse can begin. It is a phase that can take a long time if the abuse has been prolonged.

The most important treatment is in the first phase, when the person has not been locked into his drug addiction. In order to get treatment, the school or parents must take responsibility and discover the abuse, as the young person rarely seeks treatment himself.

The actual treatment of substance abuse itself is subject to the social services and, to a lesser extent, the psychiatric part of the health service. Help is provided to:

• Better mental health
• Increase social adjustment
• Better relationships in the family
• Maintain physical health
• Increase the ability to function normally in society.

The latter can, for example, involve an offer of employment, education and improvement of housing conditions.

How do I get out of the abuse?

The first step on the way out of abuse is to realize that it is you who has control over and responsibility for your own behavior. The next step is deciding to quit. Then you should lay down some guidelines on how to handle it.

You can contact the municipality's substance abuse center yourself - you do not need a referral from your own doctor for this. You can also contact your doctor if you have any questions - and he will in most cases subsequently encourage you to contact the substance abuse centre.

To get support in this phase, you can seek out people outside the drug environment who you trust, e.g. friends, acquaintances and family. Addiction centres, youth teams and voluntary organizations can also help.

What can I expect over time?

A large proportion of people who become addicted to drugs end up recovering from their addiction over time. The proportion varies from substance to substance, and depending on how many and complex problems the person has. But in general, those who only use drugs such as cocaine and amphetamines come out of their addiction the fastest, followed by those who use cannabis. Those who have become addicted to opioids, such as heroin and morphine, on the other hand, often have to struggle with the problems for many years.

Regardless of which substances you have experienced problems with in the past, you should be aware that you later find it easier to develop addiction to other substances. You should therefore be particularly aware of your consumption of both alcohol, strong painkillers and sedatives.

At the same time, it is sensible to make sure that you have the opportunity to seek help to prevent relapse if you run into problems or crises later in life. Therefore, it is advantageous to have access to a support network, contact with a substance abuse center, or people in the family who are aware that the problem has existed.

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