Drug and alcohol addiction, or substance use disorder, exacts a terrible toll in the U.S.
There were 93,980 drug overdose deaths in the U.S. in 2020, a record high, the Centers for Disease Control and Prevention reported in July. That’s only 5,000 people short of the entire population of Erie, Pennsylvania. Most of the overdose deaths in the U.S. in recent years were associated with opioids.
In addition to drug overdose fatalities, deaths from alcohol misuse also claims tens of thousands of lives annually in the U.S. Every year, there are 95,000 deaths associated with excessive alcohol use in the country, according to the CDC. Synthetic opioid related fatalities increased by 55% during the 12 months ending in September 2020, says Suzette Glasner, an associate professor at UCLA’s Department of Psychiatry and Biobehavioral Sciences. She’s also vice president of clinical affairs for Quit Genius, which calls itself the world’s first digital clinic providing a comprehensive medication-assisted treatment program for multiple addictions.
There’s been a steep increase in street drugs being laced with fentanyl, so many who overdose in this way don’t realize that they’re taking something with fentanyl in it, Glasner says.
While substance use disorder is common, many people don’t immediately recognize the signs of addiction in a spouse, relative, close friend or colleague, she says.
“People with addictions can look very different from one another, depending on their personality characteristics, the way in which their addiction affects their functioning and whether their addiction is complicated by other conditions, such as mental health problems,” Glasner says.
Recognizing the Signs
Drug addiction is a chronic illness characterized by loss of control over substance use, leading to compulsive use despite negative and at times devastating consequences, Glasner says.
Here are 10 signs of addiction:
— Neglecting important personal or professional responsibilities.
— Isolating from family and friends.
— New financial difficulties.
— Lying or stealing from family, friends or other sources.
— Frequent mood shifts.
— Physical cravings.
— Trouble with the law.
— Frequent hospital visits.
— Promising to quit “tomorrow.”
1. Neglecting important personal or professional responsibilities.People struggling with addiction often get stuck in a cycle of heavy drug or alcohol use, remorse, failed attempts to quit and resolutions to do better followed by more consumption. During this cycle, someone struggling with addiction could oversleep and be late or absent from work, Glasner says. An individual who takes excessive amounts of pain medications may become overly sedated and become unable to take his or her kids to school. People bingeing on alcohol or drugs often miss important life events, like family reunions or weddings.
2. Isolating from family and friends. Addiction or substance misuse are associated with a great deal of stigma and shame, Glasner says. Chronic use of drugs or heavy drinking can cause a person to become inconsistent in meeting their social and professional commitments. “They may come to feel embarrassed or ashamed of themselves,” she says. “This, in turn, can lead them to avoid contact with family and friends. For some, the avoidance and isolation intensifies when they feel that family and friends have taken notice of their problem and many confront them about it.”
3. New financial difficulties. The longer someone uses drugs or alcohol, the greater their tolerance becomes. They need a larger amount of alcoholic beverages or drugs to try to get the same effect. “When this happens, and as substance use becomes more frequent, it can become costly and financially burdensome to maintain an addiction,” Glasner says. “A person who is struggling with addiction may find that they run out of money faster than they used to.”
4. Stealing and lying from family, friends or other sources. Addiction, whether to drugs or alcohol, is progressive. “Over time, the person’s life can come to revolve around avoiding going into withdrawals,” Glasner says. “Even if it’s out of character, some may find themselves stealing to support an opioid habit, for instance.” Some people with an addiction may lie about why they need to borrow money and why they are facing financial difficulties.
5. Changes in weight, eating and/or sleep habits. Heavy consumption of alcohol and drugs can affect one’s appetite, eating habits, body weight and sleeping regimen. For example, people who drink excessively and frequently often have problems with weight gain, Glasner says. They can feel fatigued and sleep more than usual when dealing with hangovers and withdrawal. On the other hand, using stimulants like cocaine, methamphetamines or prescription drugs, like Adderall, can suppress a person’s appetite, leading to weight loss.
6. Frequent mood shifts. Chronic use of alcohol and drugs can have a profound effect on a person’s mood. Individuals’ moods and behavior can change dramatically depending on whether they’re actively drinking or using drugs. “For example, a person who is drinking may feel happy, friendly and sociable when they first start drinking, but the next day, as the alcohol is wearing off, may feel down, depressed and irritable,” Glasner says. “A person who is using stimulants may go through a similar cycle of elation, high energy and an unusually good mood when they are under the influence, followed by depression and lethargy when stimulants leave their system.”
7. Physical cravings. People who excessively consume alcohol and drugs can experience intense physical cravings for their substance of choice, particularly if their drinking or using routine is interrupted, says Rae Dylan, a board-registered interventionist. Dylan, who is based in New York City and works with clients all over the world, is also a sober coach and sober companion.
Such cravings can lead to:
— Salivating when thinking about drinking or using.
— Psychological discomfort (being unable to get the substance out of one’s mind).
8. Trouble with the law. Some people who chronically consume too much alcohol and/or drugs get to the point where they can no longer safely imbibe or use safely, Dylan says. That is, they’ve gotten to the point where they drink or use so much that their behavior becomes unpredictable and potentially dangerous. For some, that could mean a drunk driving arrest. Others might behave violently and find themselves charged with assault or worse.
9. Frequent hospital visits. Drinking or using drugs excessively can lead people to experience an unusually high number of accidents, while walking, puttering around the house or driving. Some of those mishaps can be serious enough to land the person in the hospital for treatment of fractures, cuts, bruises and other injuries.
10. Promising to quit “tomorrow.” “Tomorrow used to be a song from the musical ‘Annie’ about how she loved the idea of tomorrow,” Dylan says. “To an addict, tomorrow (when it comes to quitting alcohol or drugs) usually never comes.” Many people with substance use disorder have a deep sense of denial about their drinking or using.
How to Help
No one can make someone quit using alcohol or drugs. No heartfelt talk, carrot or stick will cause someone to get sober. Substance use disorder is a progressive and potentially fatal disease.
Fortunately, there are ways to help:
— Begin a dialogue.
— Provide useful information.
— Offer to help.
— Be supportive and encouraging.
1. Begin a dialogue. Expressing your concerns to someone who’s showing signs of loss of control associated with alcohol and drug use can be an essential first step to the person seeking help, Glasner says. It’s best to have the conversation when the person is sober, and you shouldn’t label the individual. “Don’t assume they view themselves as an alcoholic or as having an addiction,” she says. “If your conversation helps the person to realize there is cause for concern about their drinking or drug use, then you’ve accomplished something that can help them.” Express concern, not judgment.
2. Provide useful information. Offer to provide factual information about the signs and symptoms of alcohol or drug-related problems and effective treatments. Millions of people have been helped by attending 12-step support group meetings, which are free. There are many good information sources online. For example, the Substance Abuse and Mental Health Services Administration provides a list of resources and a phone help line: 1-800-662-HELP (4357).
3. Offer to help. Volunteer to help in any way you can. That could mean researching for the right health care professional, setting up an appointment, listening or taking the person to a medical visit or a 12-step support group meeting.
4. Be supportive and encouraging. Many people who struggle with addiction often feel hopeless about the possibility of becoming sober and living a “normal” and satisfying life. “With that in mind, you can reassure them that there is hope for the future, change is possible and that you care and are willing to help,” Glasner says. “Let your friend or loved one know that you recognize the courage it takes to seek help and attempt to change, and you are behind them as long as they remain on the road to recovery.”
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