Melissa Walsh

Symptoms of Substance Abuse

Salem Press | 2011 | Salem Health: Addictions & Substance Abuse

Essay title: Symptoms of Substance Abuse Category: Health Issues and Physiology

Definition: Substance abuse is characterized by the overuse of alcohol or drugs, leading to a compulsivity to consume the substance of choice, which gets in the way of the user's quality of life and ability to make good decisions. In addition to negative behavioral symptoms, substance abuse generates harmful physical symptoms − unseen physiological damage unseen to the user's internal organs and health deterioration visibly detected in the user's appearance.

Risk Factors Experimentation with alcohol and drugs is the most prominent risk to becoming a substance abuser. Whether the reward of the high is physical pleasure, the temporary removal of a traumatic memory from the mind, or simply acceptance by a peer group, experimenting with substances is always risky and symptoms of the substance's effect begin to appear immediately. Many neuroscientists and mental health professionals assert that some individuals are more susceptible to becoming addicted to alcohol or drugs than others due to genetic, biological, or environmental tendencies or exposure. Factors include a family history of substance abuse, mental disorders, childhood trauma, and early experimentation with substances. For individuals with these risk factors, dabbling with substances might set them on an express route to addiction.

The good news is that a substance abuse does not need to hit rock bottom before embarking on a journey to recovery. The earlier a substance abuser recognizes the symptoms of substance abuse and acknowledges the dangers of continued use, the earlier he or she can advance toward treatment and recovery. At any point between a substance abuser's experimentation and addiction, signs of dependency increasingly become apparent. Friends and family members may recognize the symptoms and launch an intervention in the attempt to break a substance abuser's destructive patterns. Not confronting an individual suspected with a substance abuse problem potentially contributes to the worsening of the problem and enables the abuser to become even more dependent on the substance. Though a substance abuser is likely to admit to using a substance, he or she is less likely to admit to abusing the substance, which makes the process of intervention difficult. Still, the more proficient a loved one is in recognizing the symptoms of substance abuse, the more confident he or she can be in intervening to facilitate a break in the abuser's dependence on the substance.

Physical Symptoms The most profound physiological symptoms of substance abuse stem from how substances radically alter the biochemical processes of the brain. Alcohol and drugs impact how the brain's nerve receptors receive, process, and send information by overtaking the brain's neurotransmitters and over-stimulating the brain's pleasure center. This impact on the brain is manifested in a substance abuser's mood. He or she will seem cheerful or "normal" when feeling the initial effects, or the high, of the substance. Once the high wears off, he or she will be noticeably agitated or depressed. A substance abuser also requires increasingly higher doses and frequency of the substance of choice in order to cope every day. Without increasing dosage and frequency, he or she experiences disruptive withdrawal symptoms. Other common physical warning signs of substance abuse include bloodshot and glassy eyes, sudden weight loss or weight gain, change in appetite, deteriorating personal appearance and hygiene, odor of alcohol of smoke emanating from the person's breath or clothing, tremors and lack of coordination, and changes in speech like slurring.

Though all substances can generate short-term or long-term effects on the body, different substances impact the body differently and manifest different symptoms. Alcohol increases dopamine in the brain and when abused impedes the natural building and transmission of dopamine. As the brain's organic ability to generate pleasure chemicals is impeded by chronic alcohol consumption, the alcoholic develops a tolerance for alcohol and has difficulty functioning in daily life without it. Physical signs of alcoholism are the odor of alcohol frequently emanating from the breath and skin, bloodshot eyes, redness in the face, a bloated stomach, slurred speech, and a lack of coordination and focus.

Marijuana's main active chemical, delta-9-tetrahydrocannabinol (THC), impacts sites in the brain known as cannabinoid receptors. A marijuana user presents bloodshot and glassy eyes, impaired coordination, difficulty with thinking, and memory loss. Because THC weakens the immune system, a chronic marijuana smoker frequently contracts respiratory infections.

Cocaine stimulates the nervous system by increasing the level of dopamine in the brain and adversely impacts the ability of the brain transmit dopamine organically. A cocaine user is hyper and talkative when high and appears fatigued and melancholy later (once the high has worn off). Chronic cocaine snorting causes a chronic cough and nose bleeds and even permanent damage to the nasal cavity, including a loss of the sense of smell and loss of appetite. Those who smoke crack cocaine or meth experience blemishes on the skin, weight loss from decreased appetite, and rotting teeth. Stimulants, such as cocaine, crack cocaine, and meth will also manifest physical signs of dilated pupils, dry mouth, unusual sleeping and eating patterns, and increased heart rate and blood pressure.

Non-stimulant drugs generate different symptoms. Abusers of heroin exhibit weight loss; tremors and twitching; track marks on the arms, legs, or feet; paleness; sweating; and reduced heart rate and respiration. Individuals abusing narcotic depressants, including prescription pain killers, appear drunk, exhibiting poor judgment, clumsiness, sleepiness, and an inability to concentrate.

Behavioral Symptoms Substance abuse inflicts long-term changes to the brain as the neuroadaptations the brain produces to control the release of dopamine and regulate emotions remain with the addict even after treatment and years of abstaining. Substance addiction also alters the prefrontal cortex of the user, causing the reduction in neuron activity in this part of the brain. Directly related to this damage, other parts of the brain release a neurotransmittor known as glutamate, which impairs the addict's decision-making ability. Glutamate facilitates impulsiveness and intense focus on achieving the immediate reward of pleasure. Consequently, addicts often engage in reckless behavior and rehabilitated addicts are prone to relapse when faced with substance-related stimuli. In the amygdala, or memory part of the brain, emotional memories associated with being high are enhanced, thereby making stimuli triggering these memories difficult for the addict to resist.

Because substance abuse radically impacts the physiology of the brain, it profoundly impacts behavior. The need to consume the substance of choice increasingly dominates a substance abuser's sense of judgment and daily actions. Substance abuse is attributed to several disruptive and harmful behavior patterns, such as family disintegration, loss of employment, domestic violence, and child abuse. Common behavioral symptoms include: the inability to refrain from consuming the substance, an obsession with achieving the next high, an abandonment of important responsibilities and interpersonal relationships, and a disregard for the obvious harm the substance is causing to the body. Consistent with the impact substance abuse has on the brain, a substance abuser is more likely to drop out of school or quit a job, frequently asks for money, suddenly and suspiciously disappears, changes peer groups, and experiences conflicts with the law, mood swings, recklessness, laziness, and paranoia. The classic and most heartbreaking behavioral symptom of a person with a substance-abuse problem is that he or she severs important relationships by betraying those closest to him or her. Because the quest for the next high is so prominent in his or her mind, the substance abuser will lie, cheat, and steal from strangers and loved ones alike in order to get the next fix.

Melissa Walsh

Further Reading Hoffman, John and Susan Froemke, editors, Addiction: Why Can't They Just Stop?, New York: HBO, 2007. The companion book to the HBO documentary of the same name, offering information and testimonies about addiction in the United States.

Lawford, Christopher Kennedy. Moments of Clarity. New York: William Morrow, 2009. First-person accounts of addiction and the journey of recovery.

McMain, Shelley and Michael Ellery. "Screening and Assessment of Personality Disorders in Addiction Treatment Settings." International Journal of Mental Health and Addiction (Jan. 2008).

Simon, David and Deepak Chopra. Freedom from Addiction, Deerfield Beach, FL: Health Communications, 2007.

Westreich, Laurence M. Helping the Addict You Love. New York: Simon & Schuster, 2007. A guide for family member and friends of addicts in leading the addicted into and through treatment and recovery.

Zwanger, Mark. "Narcotic Abuse." E-medicine Health, WebMD, 2011.

Web Sites of Interest American Council for Drug Education http://www.acde.org

Center for Substance Abuse Treatment (CSAT) http://csat.samhsa.gov

National Institute on Drug Abuse http://drugabuse.gov

Narcotics Anonymous http://www.na.org.

WebMD's E-medicine Health http://www.emedicinehealth.com/narcotic_abuse