ADDICTION:  Drug & Alcohol

At Institute of Biobehavioral Medicine (IBBMed) we recognize that you can become addicted all sorts of substances both physically and psychologically: street drugs, alcohol, medications, cigarettes, food, sex, and even love!  When you’re addicted, you may not be able to control your use and you may continue using despite the harm it causes. Any addiction can cause an intense craving for the drug. You may want to quit, but most people find they can’t do it on their own.

At IBBMed we understand that some substances are more addictive than others and we recognize that not everyone who uses drugs becomes addicted, but for many what starts as casual use leads to drug addiction. As time passes, you may need larger doses of the drug to get high. Soon you may need the drug just to feel good. As your drug use increases, you may find that it becomes increasingly difficult to go without the drug. Stopping may cause intense cravings and make you feel physically ill (withdrawal symptoms). Drug addiction can cause serious, long-term consequences including problems with physical and mental health, relationships, employment and the law.

Symptoms of Alcoholism Include:

  1. Being unable to limit the amount of alcohol you drink
  2. Feeling a strong need or compulsion to drink
  3. Developing tolerance to alcohol so that you need an increasing amounts to feel its effects
  4. Having legal problems or problems with relationships, employment or finances due to drinking
  5. Drinking alone or in secret
  6. Experiencing physical withdrawal symptoms — such as nausea, sweating and shaking — when you don’t drink
  7. Not remembering conversations or commitments, sometimes referred to as “blacking out”
  8. Making a ritual of having drinks at certain times and becoming annoyed when this ritual is disturbed or questioned
  9. Losing interest in activities and hobbies that used to bring you pleasure
  10. Irritability when your usual drinking time nears, especially if alcohol isn’t available
  11. Keeping alcohol in unlikely places at home, at work or in your car
  12. Gulping drinks, ordering doubles, becoming intoxicated intentionally to feel good or drinking to feel “normal”

People who abuse alcohol may have many of the same signs and symptoms as people who have full-blown alcoholism. However, if you abuse alcohol but aren’t completely addicted to it, you may not feel as much of a compulsion to drink. You may not have physical withdrawal symptoms when you don’t drink. But alcohol abuse can still cause serious problems. As with alcoholism, you may not be able to quit drinking without help.

If you’ve ever wondered whether your drinking crosses the line into alcohol abuse or dependence, ask yourself these questions:

  1. If you’re a man, do you ever have five or more drinks in a day? One standard drink is equivalent to 12 ounces (354.9 milliliters) of beer, 5 ounces (147.9 milliliters) of wine or 1.5 ounces (44.4 milliliters) of 80-proof spirits.
  2. If you’re a woman, do you ever have four or more drinks in a day?
  3. Do you need a drink as soon as you get up?
  4. Do you feel guilty about your drinking?
  5. Do you think you need to cut back on how much you drink?
  6. Are you annoyed when other people comment on or criticize your drinking habits?

If you answered yes to even one of these questions, you may have a problem with alcohol.

Treatment for alcoholism can include:

Detoxification and withdrawal: Treatment for alcoholism may begin with a program of detoxification, which generally takes four to seven days. You may need to take sedating medications to prevent shaking, confusion or hallucination (delirium tremens) or other withdrawal symptoms. Detoxification is usually done at an inpatient treatment center or at a hospital.

Learning skills and establishing a treatment plan: This usually involves alcohol-abuse specialists. It may include goal setting, behavior modification techniques, use of self-help manuals, counseling and follow-up care at a treatment center.

Psychological counseling: Counseling and therapy for groups and individuals support recovery from the psychological aspects of alcoholism. You may benefit from couples or family therapy — family support can be an important part of the recovery process.

Oral medications: An alcohol-sensitizing drug called disulfiram (Antabuse) may help prevent you from drinking. Disulfiram won’t cure alcoholism, nor can it remove the compulsion to drink. But if you drink alcohol, the drug produces a physical reaction that includes flushing, nausea, vomiting and headaches. Naltrexone (ReVia), a drug long known to block the good feelings alcohol causes, reduces the urge to drink. Acamprosate (Campral) may help you combat alcohol cravings. Unlike disulfiram, naltrexone and acamprosate don’t make you feel sick soon after taking a drink.

Injected medication: a health care professional injects Vivitrol, a version of the drug naltrexone, once a month. Although similar medication can be taken in pill form, the injectable version of the drug may be easier for people recovering from alcohol dependence to use consistently.

Continuing support: Aftercare programs and support groups help people recovering from alcoholism or alcohol abuse to stop drinking, manage relapses and cope with necessary lifestyle changes. This may include medical or psychological care or attending a support group such as Alcoholics Anonymous.

Treatment for psychological problems: Alcoholism commonly occurs along with other mental health disorders. You may need psychological counseling (psychotherapy), medications, or other treatment for depression, anxiety or another mental health condition.

Medical treatment for other conditions: Common medical problems related to alcoholism are high blood pressure, increased blood sugar, liver disease and heart disease.

Residential treatment programs

For a serious alcohol problem, you may need a stay at a residential treatment facility. Many residential treatment programs include individual and group therapy, participation in alcoholism support groups such as Alcoholics Anonymous, educational lectures, family involvement, activity therapy, and working with counselors and professional staff experienced in treating alcoholism.

Drug addiction symptoms or behaviors include:

  1. Feeling that you have to use the drug regularly — this can be daily or even several times a day
  2. Failing in your attempts to stop using the drug
  3. Making certain that you maintain a supply of the drug
  4. Spending money on the drug even though you can’t afford it
  5. Doing things to obtain the drug that you normally wouldn’t do, such as stealing
  6. Feeling that you need the drug to deal with your problems
  7. Driving or doing other risky activities when you’re under the influence of the drug
  8. Focusing more and more time and energy on getting and using the drug

Possible indications that your teenager is using drugs include:

Problems at school: Frequently missing classes or missing school, a sudden disinterest in school or school activities, and a drop in grades may be indicators of drug use.

Physical health issues: Lack of energy and motivation may indicate your child is using certain drugs.

Neglected appearance:  Adolescents are generally concerned about how they look. A lack of interest in clothing, grooming or looks may be a warning sign of drug use.

Changes in behavior: Teenagers enjoy privacy, but exaggerated efforts to bar family members from entering their rooms or knowing where they go with their friends might indicate drug use. Also, drastic changes in behavior and in relationships with family and friends may be linked to drug use.

Spending money: Sudden requests for money without a reasonable explanation for its use may be a sign of drug use. You may also discover money stolen from previously safe places at home. Items may disappear from your home because they’re being sold to support a drug habit.

Recognizing signs of drug use and dependence

The particular signs and symptoms of drug use and dependence vary depending on the type of drug. You might be able to tell that a family member or a friend is using or abusing a drug based on the physical and behavioral signs and symptoms associated with the drug.

Marijuana and hashish

It’s possible to develop a psychological addiction to cannabis compounds including tetrahydrocannabinol (THC) found in marijuana and hashish. People who have a marijuana addiction generally use the drug on a daily basis.

Signs of use and dependence can include:

  1. A heightened sense of visual, auditory and taste perception
  2. Poor memory
  3. Increased blood pressure and heart rate
  4. Red eyes
  5. Decreased coordination
  6. Difficulty concentrating
  7. Increased appetite
  8. Slowed reaction time
  9. Paranoid thinking

Barbiturates and benzodiazepines

Barbiturates and benzodiazepines are prescription central nervous system depressants. Phenobarbital, amobarbital (Amytal) and secobarbital (Seconal) are examples of barbiturates. Benzodiazepines include tranquilizers such as diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin) and chlordiazepoxide (Librium).

Signs of use and dependence can include:

  1. Drowsiness
  2. Slurred speech
  3. Lack of coordination
  4. Memory impairment
  5. Confusion
  6. Slowed breathing and decreased blood pressure
  7. Dizziness
  8. Depression

Methamphetamine, cocaine and other stimulants

This class of drugs includes amphetamines, methamphetamine, cocaine and methylphenidate (Ritalin).

Signs of use and dependence can include:

  1. Euphoria
  2. Decreased appetite
  3. Rapid speech
  4. Irritability
  5. Restlessness
  6. Depression as the drug wears off
  7. Nasal congestion and damage to the mucous membrane of the nose in users who snort drugs
  8. Insomnia
  9. Weight loss
  10. Increased heart rate, blood pressure and temperature
  11. Paranoia

Methamphetamine, also known as “meth,” is a particularly dangerous drug. It’s highly addictive and causes a number of short-term and long-term health consequences. Methamphetamine is relatively inexpensive and widely available.

Club drugs

Club drugs are drugs commonly used by teens and young adults at clubs, concerts and parties. Examples include Ecstasy (MDMA), GHB, Rohypnol (“roofies”) and ketamine. These drugs are not all classified in the same category, but they share some similar effects and dangers.

Signs of club drug use and dependence can include:

  1. An exaggerated feeling of great happiness or well-being (euphoria)
  2. Reduced inhibitions
  3. A heightened or altered sense of sight, sound and taste
  4. Amphetamine-like effects (with ketamine and Ecstasy)
  5. Impaired coordination
  6. Impaired judgment
  7. Memory problems or loss of memory
  8. Increased or decreased heart rate and blood pressure
  9. Drowsiness and loss of consciousness (with GHB and Rohypnol)
  10. GHB and Rohypnol are particularly dangerous. At high doses, these can cause seizures, coma and death. The danger increases when these drugs are taken with alcohol. Because they impair consciousness and memory, and the fact that they’re easy to give someone without their knowledge or consent, these drugs are both commonly used as date-rape drugs.

One particular danger of club drugs is that the liquid, pill or powder forms of these drugs available on the street often contain unknown substances, which can be harmful, including other illegally manufactured, or pharmaceutical drugs.


Use of hallucinogens produces different signs and symptoms depending on the drug. The most common hallucinogens are LSD and phencyclidine (PCP).

Signs of LSD use include:

  1. Hallucinations
  2. Greatly reduced perception of reality, for example, interpreting input from one of your senses as another, such as hearing colors
  3. Permanent mental changes in perception
  4. Rapid heart rate
  5. High blood pressure
  6. Tremors
  7. Flashbacks, a re-experience of the hallucinations — even years later

Signs of PCP use include:

  1. Hallucinations
  2. Euphoria
  3. Delusions
  4. Panic
  5. Loss of appetite
  6. Depression
  7. Aggressive, possibly violent behavior


The signs and symptoms of inhalant use vary depending on what substance is inhaled. Some commonly inhaled substances include glue, paint thinners, correction fluid, felt tip marker fluid, gasoline, cleaning fluids and household aerosol products.

When inhaled, these products can cause brief intoxication and a decreased feeling of inhibition. Long-term use may cause seizures and damage to the brain, liver and kidneys. Inhalant use can also cause death.

Narcotic painkillers

Opioids are narcotic, painkilling drugs produced naturally from opium or made synthetically. This class of drugs includes heroin, morphine, codeine, methadone and oxycodone (OxyContin).

Signs of narcotic use and dependence can include:

  1. Reduced sense of pain
  2. Sedation
  3. Depression
  4. Confusion
  5. Constipation
  6. Slowed breathing
  7. Needle marks (if injecting drugs)

Need for help:

  1. You can’t stop using a drug
  2. Your drug use has led to unsafe behavior, such as sharing needles or unprotected sex
  3. You think you may be having withdrawal symptoms after you stop taking a drug

If you’re initially reluctant to approach a doctor, help lines or hot lines may be a good place to start to learn about treatment. You can find these lines listed in the phone book or on the Internet.

Please seek emergency help if you or someone you know has taken a drug and:

  1. May have overdosed
  2. Loses consciousness
  3. Has trouble breathing
  4. Has seizures
  5. Has signs of a heart attack, such as chest pain or pressure
  6. Has any other troublesome physical or psychological reaction to use of the drug

Staging an intervention

Because many drug users deny they have a problem, they won’t seek help on their own. Family members, friends or co-workers may need to persuade the user to seek treatment. If you have a friend or family member with a drug problem who won’t get help, you may need to take steps to organize a planned intervention.

An intervention is a carefully planned process in which family and friends, teachers, clergy members or others join together to confront someone about the consequences of addiction, and ask him or her to accept a treatment plan. A successful intervention involves careful planning, research and teamwork. If you think you need to set up an intervention, learn how to do it correctly. A carefully organized intervention can be very successful, but a poorly planned confrontation can make the situation worse.