People who are dependent on drugs usually use them to feel better, but drug abuse can have dire consequences. James Tighe explains how to identify your addictions and get help. The use of chemicals to alter the way we feel and see things is one of the oldest activities of the human race. But a person's use of a drug such as tobacco, alcohol, cannabis or heroin can become uncontrolled, or start to control them. Even when the use of drugs leads to serious physical and mental problems, the person using may still not want to stop. If they do decide to give up, they may then find it's much harder than they thought. What are the symptoms? There are a lot of bewildering different words used to describe drug use and addiction problems. Not every expert will agree with the definitions here, but being consistent about the terms used helps to reduce the confusion and anxiety everyone feels when faced with this problem. Each drug has different patterns of: * use * intoxication * overdose * hangover For each different drug, the term 'substance abuse' can cover different levels of use, including: * experimenting with use * bingeing * using large amounts without appearing intoxicated * using large amounts to get intoxicated Drug use and abuse People can use a substance for more than one of the above reasons, and may also use several drugs for different reasons. Untangling the 'how' and 'why' of a person's drug use is rarely an easy task, but most people use a drug because they enjoy the effects. This may seem like a simplistic or insensitive statement, but it's a fact that's easily forgotten by the people around the drug user, who are concerned and trying to understand why they're using drugs. Worried parents often ask for tell-tale signs of drug use, but the simple answer is that it's very hard to spot. Many users who have contact with mental health services manage to conceal their use from mental health professionals, so it's obviously difficult to identify. Parents usually know their children better than anyone else, and maintaining an open atmosphere in which communication is kept up is often the best way to find out what's going on. This is not always easy with teenagers, as they might view the methods parents use to find out if they are using drugs as intrusive and controlling. And angry confrontations with teenagers might push them further into a cycle of resentment and refusal to communicate. Dependence (or psychological addiction) The media's portrayal of a person giving up drugs usually focuses on the immediate effects of withdrawing from heroin. It's important to remember that there's often more to an addiction than the physical withdrawal symptoms. In fact, for some drugs such as cannabis, there's a debate about whether there are actually any physical symptoms of withdrawal. People who use cannabis regularly over a long period may find there are certain situations in which they come to rely on the drug. If they stop using it they may feel very disabled. This is a situation that can develop for almost any substance that affects the mind and this aspect of addiction can be harder to overcome than the physical symptoms. Mental symptoms can include: * anxiety * depression * disrupted sleep and rest * controlling mood * relearning different coping skills * reduced wellbeing The pattern of these symptoms will depend on the drug being used, the psychological make-up of the person using it and the circumstances under which they are attempting to remain drug free. The term 'craving' is often used when talking about addiction. If a person is experiencing any of the symptoms listed above and they know that by using the drug all these problem will go away, it's not surprising that they develop an overwhelming desire to use and that this dominates their thoughts. Physical addiction It's ironic that through films such as Trainspotting quite a lot of people feel that they understand the physical effects of withdrawal from heroin. They rightly see it as an unpleasant and difficult experience - and a good reason not to experiment with it. The irony is that alcohol has much worse and more dangerous withdrawal effects. It's possible, but very rare, for someone experiencing heroin withdrawal to need to be admitted to hospital, while someone who is physically addicted to alcohol should not attempt to stop using it without consulting a doctor. Again, as with psychological dependence, the length and severity of withdrawal differs according to the drug, how much has been taken and for how long. For most addicts, their problem is a mixture of both physical and psychological aspects. There are some instances when it's difficult to distinguish between the two. The stimulants cocaine and amphetamine are classic examples of this - people coming down after using these drugs feel very low and lack energy. When they take cocaine, they feel very high and use up lots of energy. Their feelings afterwards could be partly because of feeling tired and adjusting to a normal mood again, but there are other theories that suggest these feelings are because the body is re-establishing its chemical balance. What can I do to help myself? The saying that admitting you have a problem is half of solving the problem is very applicable. The next step is to get support. If you're physically addicted, it may be dangerous just to stop - especially if you're using alcohol or tranquillisers. Even if it isn't dangerous to stop abruptly, a doctor may be able to prescribe medication to help you through the first phase of withdrawal. Not all family doctors are happy to help with this problem, so if yours isn't it's probably best to approach your local drug dependence unit (DDU). It's also vital to get other forms of support and counselling - see the resources listed below.