Drug Use and Addiction This topic introduces the concepts of drug misuse and addiction, then focuses on the major classes of drugs, their effects, their potential for misuse and addiction, and other issues related to their use. A drug is any chemical other than food intended to affect the structure or function of the body. I. Addiction A. The drugs most often associated with addiction and impairment are psychoactive drugs, which alter a person’s experiences or consciousness. 1. Psychoactive drugs can cause intoxication, a state that can involve unpredictable physical and emotional changes. B. What Is Addiction? 1. Addiction is a chronic disease that disrupts brain systems that regulate motivation and reward. 2. The American Psychiatric Association (APA) defines “addiction” as a chronic disorder with biological, psychological, social and environmental factors influencing its development and maintenance.. 3. Addictive behaviors are habits that are out of control and that negatively affect a person’s health. 4. There is a nearly uncontrollable pursuit of physical or psychological reward and/or relief through substance abuse or behaviors like gambling. 5. Changes in brain chemistry underlie addiction. a. Certain activities, such as eating or gambling, may trigger the release of brain chemicals that produce pleasure in the same way that psychoactive drugs do. b. One brain change is tolerance, in which the body adapts so that the initial dose no longer produces the original emotional or psychological effects. 6. Although brain chemistry seems to influence addiction, there is still a component of individual responsibility in addictive behavior. Other factors, such as lifestyle and personality traits, play key roles in the development of addictive behaviors. C. Diagnosing Substance Misuse and Addiction 1. Substance misuse is use of a substance that is not consistent with medical or legal guidelines. a. Addiction is a psychological or physical dependence on a substance or behavior that has undesirable, negative consequences. 2. The severity of a substance use disorder is determined by the number of criteria from the American Psychological Association’s DSM-5 that the person meets. a. Two or three criteria indicate a mild disorder. b. Four to five criteria point to a moderate disorder. c. Six or more criteria are evidence of a severe disorder. 3. The DSM-5 criteria are grouped into four categories: a. Impaired control b. Social problemsc. Risky use d. Drug effects, including tolerance and withdrawal 4. The latest version of the DSM dropped the past distinction between dependence and abuse in diagnosing drug-related disorders. D. The Development of Addiction 1. Many potentially addictive behaviors can be harmless or even beneficial if done appropriately and in moderation. 2. Addiction often starts when a person does something to bring pleasure or avoid pain. a. Reinforcement leads to increasing dependence on the behavior. b. Tolerance develops and the person needs more of the substance or behavior to feel the expected effect. c. Behavior no longer brings pleasure but repeating it is necessary to avoid withdrawal. 3. Many common behaviors are potentially addictive. Factors that influence whether they become problematic include personality, lifestyle, heredity, the social and physical environment, and the nature of the substance or behavior. E. Examples of Addictive Behaviors 1. Compulsive Gambling 2. Video Game Disorder 3. Compulsive Exercising 4. Work Addiction 5. Sex Addiction 6. Compulsive Buying or Shopping 7. Internet Addiction II. Why People Use and Misuse Drugs A. Drugs have been used to alter consciousness since prehistory. 1. Plants were often used for religious, medicinal, and personal reasons. 2. Many drugs have addictive properties and alter brain chemistry. B. The Allure of Drugs 1. Young people may be drawn to drugs by the allure of the exciting and illegal. a. They are curious, rebellious, or vulnerable to peer pressure. b. They imitate adult models. 2. Most people try drugs to experiment but do not continue use. 3. Many users are motivated by a desire to escape boredom, anxiety, depression, feelings of worthlessness, or other symptoms of psychological problems. They use drugs as a way to cope. C. Risk Factors for Drug Misuse and Addiction 1. Drug users come from all income and educational levels, all races and ethnic groups, and all age groups, but addicts do tend to share certain characteristics. 2. Factors Associated with Trying Drugs a. Male—Males are twice as likely as females to abuse illicit drugs.b. Troubled childhood—Teens are more likely to try drugs if they have had behavioral issues in childhood, have suffered sexual or physical abuse, used tobacco at a young age, or suffer from certain mental or emotional problems. c. Thrill-seeker—A sense of invincibility is a factor in drug experimentation. d. Dysfunctional family—Chaotic home life or parental abuse increases the risk of drug use. e. Peer group that accepts drug use—Young people who are uninterested in school and earn poor grades are more likely to try drugs. f. Being poor—Young people who live in disadvantaged areas are more likely to be around drugs at a young age. g. Girl dating an older boy—Adolescent girls who date boys 2 or more years older than themselves are more likely to use drugs. 3. Factors Associated with Not Using Drugs a. Positive self-esteem b. Assertive, independent thinkers who are uninfluenced by peer pressure c. Self-control d. Social competence e. Optimism f. Academic achievement g. Religiosity h. Open communication with and support from parents III. Risks Associated with Drug Misuse A. In 2014, over 400,000 emergency room visits related to drug misuse or abuse were reported, though the actual number could be as high as 1.3 million. The following are serious concerns as well: 1. Intoxication—People under the influence of drugs are more likely to be injured from a variety of causes and to be involved in incidents of aggression and violence. 2. Unexpected side effects—Psychoactive drugs have many physical and psychological side effects. a. Side effects can range from nausea and constipation to paranoia, depression, heart failure, and the risk of fatal overdose. 3. Unknown drug constituents—As there is no quality control in the illegal drug market, the composition, dosage, and