Complete Guide to Substance Abuse Issues & Therapies

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Substance Abuse Problems

Substance abuse is a term that refers to the use of psychoactive substances in a way that’s harmful. It’s possible to abuse alcohol, prescription drugs, and illegal street drugs.

When someone has a substance abuse problem, it doesn’t necessarily mean they’re addicted or dependent on the substance. However, addiction and dependence are likely to occur when someone has symptoms of substance abuse.

According to the World Health Organization, there are an estimated 275 million people believed to have used an illegal drug at least once in 2016. This enormous number doesn’t even begin to account for the millions and millions of people who abuse prescription drugs.

Substance Abuse Statistics in America

Much of what we know about substance abuse statistics in America comes from the National Survey on Drug Use and Health. According to this survey, substance abuse constitutes an ongoing and major problem among American adults. The prevalence of substance abuse in America can be assessed in many ways, but a late section of the 2016 NSDUH splits the statistics into two categories: alcohol use disorder statistics and illicit drug use disorder statistics.

Alcohol use disorder did not change much from 2015 to 2016, with 3.7 million young adults (10.7% of all adults between the ages of 18 and 25) showing signs of problematic drinking. Looking at those aged 26 or older, the figure dropped slightly. While 10.9 million adults in this age range showed signs of alcoholism, this was only 5.2% of the surveyed population. Respondents who met the criteria for inclusion in alcoholism statistics were those who may have drunk only six or more days over a year-long period, but who suffered withdrawal, social consequences, increases in tolerance, health defects (both physical and mental), and an inability to moderate their drinking once they started.

Those who qualified for illicit drug use disorder met similar criteria. Those looking for information on specific drugs may follow this guide’s table of contents for more information below. Overall, drug addiction rates showed that 7% of young adults, about 2.4 million of those aged 18-25, qualified for illicit drug use disorder. Among adults aged 26 and over, the rate fell to 2% while the number of users rose to 4.2 million.

Factors That Contribute to Substance Abuse

In the process of treating those afflicted with various chemical dependency disorders, it becomes readily evident that few develop such disorders on the basis of morbid curiosity alone. Those who misuse drugs and alcohol frequently enough to alter their brain chemistry and develop addictions often do so as a means of self-medicating. Drugs and alcohol bring them relief from other issues, both internal and external, that fuel the need for escape. Factors that contribute to substance abuse may include, but are most certainly not limited to:

  • Victimization from bullying
  • College peer pressure
  • Domestic violence
  • Emotional abuse
  • Sexual trauma
  • Struggle with self-identity (especially prevalent in the LGBTQ community)
  • Post-traumatic stress (common among addicted veterans)

Despite the wide range of additional factors, each of which will take a personalized form in the case of the individual’s experiences and emotional history, the next few sections will pertain primarily to those factors listed above. If there is an issue you wish to see explored in further depth within this guide, contact us to let us know. We are always looking to provide requested information to those in need.

Bullying and Substance Abuse in Adolescents

The easy explanation as to why bullying may lead to substance abuse would be to point out the emotional effects on the victim; however, even when implementing control factors to reduce the influence of depression on the data, a 2011 study showed strong correlations between various forms of substance abuse and the victimization of young males by school bullies. In fact, after controls, it became evident that such students were more likely to use as a result of bullying than they were as a result of general depressive disorders.

One reason that substance abuse and bullying share such a strong link is the sense of isolation suffered by the victim. This is not general depression, but an almost visceral sense of being alone in the world. Considering that more than half of bullying incidents can be halted in their tracks by peer intervention, those who find no peers intervening on their behalf will feel naturally cut off and ostracized from their student community. Especially in the formative years of adolescence, this teaches the victim that they must be responsible for their own well-being. Drugs and alcohol provide an easy way of achieving a temporary state of simulated equanimity, the cost of which will ultimately be long-term suffering.

Despite the controls implemented in the aforementioned study, it is important to note that bullying can result in co-occurring disorders associated with addiction. Whether suffering from physical bullying, verbal invectives, gossip, or cyberbullying, the victim may suffer such disorders as anxiety, depression, sleep disorders, developmental disabilities, and even attention deficiencies. These issues not only increase the likelihood of substance abuse related to childhood adversity but also make the addiction more difficult to treat as the patient’s clinical team must overcome co-occurring issues and childhood trauma before they can get to the root of the problem.

If you’d like to learn more about the relationship between bullying and substance abuse, check our resource page here.

Substance Abuse in College Students

The prevalence of substance abuse among adults between the ages of 18 and 25 comes as little surprise to those familiar with the pervasiveness of drugs and alcohol in the lives of many college students. College substance abuse affects well over a third of students, with at least a third of students admitting to binge-drinking and one-fifth of students admitting to the use of illegal drugs.

While outside observers perceive this as a fun and harmless element of the college experience, outcomes show otherwise. Substance abuse in college students correlates high with reduced academic performance, long-term health risks, and campus sexual assaults. These issues alone can impact students for the rest of their lives. In many cases, substance abuse itself presents an ongoing issue, as some statistics show that 76-91% who engage in frequent chemical misuse during their college years may continue to use addictively in the years following.

Not all college substance abuse arises from the party lifestyle. Up to 11% of students who misuse stimulants do so for the sake of cramming for tests and finishing last-minute essays. This, however, forges the unhealthy association that drug use leads to success. No matter the circumstances, college substance abuse must be reined in before it can damage the user for years to come.

Take a look at our guide on college substance abuse for more detailed information.

Domestic Abuse and Substance Abuse

Much like addiction itself, domestic abuse is a problem that many know exists, yet prefer to believe it exists outside of their own neighborhood. In reality, as many as 25% of women will at some point suffer domestic abuse of a severe nature. This may include physical injury, being hit with an object, or being threatened with a deadly weapon. Approximately one out of every seven men will suffer the same forms of abuse at the hands of an intimate partner. As many as 17% of such men, and just over half of such women, will exhibit signs of post-traumatic stress disorder as a result.

Aside from violence, many other forms of domestic abuse may occur within the household. These include emotional manipulation, verbal degradation, forced sexual acts, and the exertion of control over a partner’s finances. In the case of children, simply watching a parent suffer such forms of abuse constitutes a form of abuse against the child as well.

In some cases, domestic abuse arises out of living under the same roof as an active addict or alcoholic. For the victims, however, domestic abuse results in substance abuse by driving the need to escape the pain—both mental and physical—of their daily living situation. A 2014 report by the American Society of Addiction Medicine suggests that domestic abuse and substance abuse correlate at a rate of between 40% and 60%. This means that, on average, half of all victims are turning to chemical dependency as the solution to a savagely difficult problem. Not only will this fail to help them truly escape their situation, but the traumatic effects of addiction itself may drive them into a darker mental and emotional state than that from which they fled in the first place.

The relationship between domestic abuse and substance abuse is covered in more detail here.

Emotional Abuse and Emotional Effects of Substance Abuse

Due to a strong correlation between emotional abuse and substance abuse, there exists a need to understand the many forms that emotional abuse might take. Emotional abuse extends beyond harsh words and admonishments. Neglect, whether intentional or unintentional, also leaves abusive marks on its victims. Control constitutes a form of emotional abuse as well. By depriving a person of their autonomy, the abuser greatly reduces their victim’s sense of self-worth.

The correlation between emotional abuse and substance abuse becomes clear when analyzing the emotional effects of substance abuse itself. Much like control and abusive language, addiction lowers the user’s sense of value. In the same sense as abusive neglect, chemical dependency causes the addict’s most basic emotional needs—such as affection and a sense of agency—to go unmet.

Often, the emotional effects of substance abuse mirror the effects of emotional abuse. Those who suffered neglect may either become pre-occupied with unhealthy attachments, using for the sake of the people they’re using with, or may continue to remain in the isolated state they know so well. Victims of verbal abuse may either lash out at others or fail to set boundaries when others lash out at them. Those who lived in controlling environments will suffer symptoms of codependency, variously trying to control others or seeking relationships in which they feel their inherent compliance is valued by the other party. The more they continue to abuse substances in the midst of these behaviors, the less likely they will be to take a step back and see that their maladaptive emotional state is the true root of their problems.

To learn more about how emotional abuse leads to substance abuse, read our blog on this issue.

Sexual Trauma and Substance Abuse

Not only is there a strong link between sexual trauma and substance abuse, but these issues must be faced side-by-side in order to achieve recovery. Addiction and emotional recovery from sexual trauma follow similar patterns. In her book Astonished, memoirist Beverly Donofrio recalls looking out the window a few years after she was raped at the age of 56 and seeing an ant trying to climb the window with a fly in tow. The fly kept falling, and the ant along with it. This is what recovery often looks like when the user has suffered unresolved sexual trauma. A steady climb toward health and emotional clarity, followed by a sudden fall. An apt analogy, but for one point—the baggage of sexual trauma tends to weigh a great deal more than your average housefly.

Adding to the problematic nature of sexual trauma and substance abuse is the surprisingly common nature of sexual abuse and assault. The Rape, Abuse & Incest National Network (RAINN) reports that 321,500 people aged 12 or over become the victims of sex crimes each year. Of these victims, many will turn to substances in order to ease their pain. They will be 13 times more likely to suffer alcohol use disorder, and 26 times more likely to engage in illicit drug use.

These issues plague both women and men, with a notable emphasis on the former: according to a 2016 study, as many as 75% of female patients in alcohol and drug rehab have suffered some form of sexual abuse or trauma in their lifetimes. This abuse often occurred in childhood, although there is no shortage of adult survivors who were raped or assaulted either prior to or during their addiction.

Sexual trauma and substance abuse are covered further here.

LGBTQ and Substance Abuse

The causes of substance abuse in the LGBTQ community bear some similarities with the link between substance use and bullying. Many homosexuals, bisexuals, or non-binary individuals suffer from a strong sense of isolation. Some of this may be warranted by the actions and beliefs of those around them. In other cases, the sense of otherness they feel can arise from elements of their cultural environment. One such cultural element would be everyday language, such as that used to describe the moment a homosexual informs their friends and family about their sexual identity. Does not the very notion of “coming out of the closet” suggests a need to have hidden there in the first place?

Aside from stress and feelings of isolation or rejection, some members of the LGBTQ community encounter substance abuse issues when entering the club scene. Ecstasy, stimulants, ketamine, hallucinogens and alcohol may all appear in such settings. Regardless of the specific cause of using, members of the LGBTQ community have been found to be up to five times likelier to struggle with alcoholism. Between one-fifth and one-third of the LGBTQ community struggles with substance use in general. These issues appear to affect men more often than women, with men showing 12.2 times the propensity to abuse amphetamines and a 9.5 times greater likelihood toward heroin use.

Follow this link for a longer examination of the struggles facing LGBTQ substance users.

Veterans and Substance Abuse Statistics

It is a sad truth that many of the noble men and women who grace our armed forces have suffered for their valor. A 2014 spotlight report by the Substance Abuse and Mental Health Services Administration, in focusing on our military, noted that 1 out of every 15 veterans suffer from some form of substance abuse disorder. Speaking in a generally stereotypical way, many link this to PTSD such as that brought to the forefront of societal awareness after Vietnam. Certainly, that conflict led to a rise above the previous 3.7% rate of substance users in our military prior to the 1970s. However, at a rate of 12.7%, substance abuse statistics among veterans in post-9/11 America are higher than ever before.

Many factors may lead to this. Not only do veterans deal with post-traumatic stress as a result of exposure to circumstances foreign to most laypeople, they also find themselves at higher risk of chronic pain resulting from injuries sustained during combat. Additionally, since veterans are as human as anybody else, the higher-than-average addiction rates associated with veterans will combine with other risk factors to more greatly influence their likelihood of use. For instance, substance abuse statistics often skew higher between the ages of 18 and 25; likewise, young adults in our armed forces engage in problematic chemical use at a rate of approximately 25%, compared with the 12.7% of veterans in general who struggles with such issues.

Our comprehensive guide for veterans struggling with substance abuse can be found here.

Substance Abuse Treatment: A Way Out

Whether reading this guide from beginning to end or simply picking and choosing the sections most relevant to your experience, the above information can be a bit overwhelming. High rates of substance dependency and a plethora of factors increasing the likelihood of habitual use may combine to paint a dreary picture of inescapable suffering. This dreadful picture has proven accurate for those who have attempted to sally forth without embracing recovery in any of its many forms.

Take note of that: many forms. There are many levels of care for substance abuse treatment, and patients will learn a number of helpful tools in each one. These tools strengthen their ability to overcome withdrawals, cravings, and relapse—as long as the tools are used. Even in the case of relapse, recovery does not prove unsuccessful as long as the individual continues to get back up and keep moving forward. As for where to start, the next few sections of this guide will introduce you to a few forms of recovery that many

chemical dependents have found vital to their success in remaining clean and sober.

Substance Abuse Detox

The first of many levels of substance abuse treatment comprising a full continuum of care is the medical detoxification stage. During their stay in substance abuse detox, rehab patients begin learning about addiction and recovery while receiving medical treatment for their withdrawal symptoms. Such treatment may include medication-assisted therapy to reduce cravings, as well as a regimen of benzodiazepines administered in gradually reduced doses. This allows the patient to taper off, rather than quitting “cold turkey,” thereby forgoing some of the harsher symptoms associated with alcohol and drug withdrawal.

While undergoing substance abuse detox, patients will also receive counseling and therapy to address addiction and any specific underlying issues that may pertain to their particular experiences. Therapy may not be as intensive as in later stages of substance abuse treatment; however, the results are vital to the initiation of their recovery journey. There often exists a strong relationship between addiction and low self-worth. By taking the first step toward healing, substance users learn that they are stronger than their disorder. In learning more about themselves, they begin to see that they can identify as more than an alcoholic or an addict. This association between recovery and true identity—as opposed to the false identity they adopted during their period of substance use—will serve them well when they leave detox to pursue more advanced levels of substance abuse treatment.

To learn more about how detox can benefit your self-esteem, read our detailed look at this issue.

Holistic Treatment Plan for Substance Abuse

Many people associate the concept of holistic medicine or holistic therapy with practices considered unorthodox or perhaps even new age. This, however, is not entirely what “holistic” means. In reality, a holistic treatment plan for substance abuse is simply one that accounts for the patient’s overall health. More specifically, holistic treatment addresses not only physical and psychological health concerns but spiritual ones as well.

Since spiritual remedies may include meditation or faith-based support, the “new age” stereotype can be difficult for many to set aside. At its most basic level, spiritual healing really means assessing the cause of the patient’s emotional suffering that led to their addiction and helping them discover a new sense of identity that will help them overcome their struggles. Therapy, meetings, and other evidence-based treatment methods will constitute a part of the holistic approach. Other aspects of this approach may focus on physical elements such as diet and exercise, mental elements such as meditation and mindfulness training, and spiritual elements such as prayer.

Some holistic treatment components, such as yoga, bring together all three of these components into one activity that facilitates overall healing. These aspects of holistic treatment—in fact, practically all aspects of holistic treatment—are entirely optional. Nonetheless, those who choose to participate may find themselves learning more about which tools work for them and can play a potentially pivotal role in their ongoing recovery.

More information on holistic treatment for substance abuse can be found on our program page.

EMDR: Substance Abuse and Trauma Recovery

As noted in many of the earlier sections of this guide, trauma often increases the likelihood of developing substance use disorders. In addition, substance use has traumatic effects on the user. The physical, mental, and emotional effects of substance abuse leave wounds that take time to heal. This process is complicated by the fact that self-medication only temporarily covered up the scars of any pre-existing trauma the user may have suffered. Those wounds remain very much open, necessitating the concurrent treatment of both substance abuse and trauma if the patient is to recover from either one—let alone both.

Eye movement desensitization reprocessing, or EMDR, is one of the most popular methods of treating substance abuse and trauma simultaneously. Originally created in the 1980s as a treatment for PTSD, studies showing the strong correlations between trauma and substance abuse have led to its increased implementation in the field of chemical dependency treatment.

Patients undergo an eight-stage treatment process that uses strong mental images in combination with a specific pattern of rapid eye movements to desensitize themselves to the mental and emotional effects of those images. While the initial stages may prove difficult, requiring patients to revisit the traumas that led to their substance abuse, the following stages are all about healing and closure. By the end of EMDR therapy, the client should have the coping skills they need to face their past without letting it get the best of them.

Read our articles on EMDR for a more thorough breakdown of the therapeutic process.

Music Therapy for Substance Abuse

Therapists in numerous fields use music therapy to help patients heal. Music can help patients revisit memories, both pleasant and painful, allowing them to process how these memories affect them today. This application of music therapy has been used in the treatment of mental disorders such as dementia and aphasia. Music can also soothe the listener, leading to the use of music therapy in the treatment of physical complications such as chronic pain and asthma. Autism, speech disorders, and Parkinson’s are also on the list of conditions treated with music therapy. With such an extensive list, music therapy for substance abuse should hardly prove surprising.

Chemical dependents may engage in substance abuse for any number of reasons, which must be addressed in their rehabilitative treatment. Since a broad range of music exists, music therapy for substance abuse can be tailored to suit the most pervasive needs of the treatment population at any given time. One 2003 study found that music’s ability to target specific areas of treatment was among its key benefits. Looking more specifically at co-occurring disorders such as depression, a 2011 psychiatric journal found that patients who once seemed distant and isolated became more connected and engaged as a result of their exposure to music. This particular finding is noteworthy in light of the common expression that “the opposite of addiction is connection.”

Music therapy for substance abuse can act as a form of holistic treatment, and its ability to be personalized and targeted toward specific therapy goals makes it a highly useful tool. That said, it is hardly a science, and qualified professionals must know their patients at least moderately well in order to help them process the music in a healthy way. Very few facilities focus on music therapy as a primary mode of treatment. Most use it as a buttress for other evidence-based and holistic remedies already in place. Even in this diminished capacity, however, it often proves both therapeutically beneficial and personally enjoyable to the patients who experience it.

To learn about further studies, as well as some music suggestions on various subjects, follow this link.

Relapse Prevention Techniques for Substance Abuse

After receiving the above forms of treatment, or any combination of the modalities and levels of treatment for substance abuse discussed (in addition to the many others that exist), the recovering user’s life will have changed greatly. The life changes experienced after treatment will have positive effects on the patient’s physical health, mental cognition, emotional balance, social life and spiritual peace. Nonetheless, it is important that they learn through their stay in drug and alcohol rehab to deal with triggers as they arise.

Many experts identify at least four primary relapse prevention techniques for substance abuse. The first is to delay. Typical cravings only last between 7 and 20 minutes, sometimes much shorter. If they last longer, as some do, the second step is to distract. Find a healthy, engaging activity. This is where the tools learned in treatment, whether holistic or step-based, will prove most useful. Sometimes, however, finding the motivation to pursue such activities can prove difficult. The third technique is therefore to de-stress. Many triggers throw the user into a state of alarm, and this is the feeling they believe using will help them overcome. Quite often, simple meditation or breathing exercises are enough to overcome such cravings—provided the patient has the presence of mind to give them a shot.

Finally, de-catastrophize. Triggers do not mean that recovery has failed, or that treatment hasn’t proven valuable. It takes time to learn how to apply the skills learned in substance abuse treatment to the world outside its walls. Treatment should prepare patients for such instances, but it then falls on the patients themselves to apply the lessons.

Look here for more information on the positive life changes that can occur after substance abuse treatment.

Common Interventions for Substance Abuse

Family and friends of those who struggle with substance use disorder will find that not all users recognize the severity of their condition. Their perceptions skewed by the effects of drugs and alcohol, it becomes difficult to see the impact of their addiction on others—or even on themselves. Before such users can undergo the various levels of substance abuse treatment, they must first receive help in seeing their substance use objectively. Five common interventions for substance abuse, along with others not mentioned below, are often employed to this end:

1. Confrontation – The confrontational intervention model does not receive as much use as the others, partly due to controversy and partly due to a perceived lack of effectiveness when compared to other interventions. In this model, loved ones will receive assistance from a professional interventionist as they directly—and sometimes aggressively—inform the user of their feelings about their substance abuse. Loud, tearful interventions depicted on television programs are usually following this model.

2. Tough Love – Less aggressive than the confrontational intervention, the tough love intervention combines loving support with firm boundaries. This approach has been widely used since the 1980s and involves something of an ultimatum. The user can seek treatment and receive support in their recovery, or they can lose financial (and possibly emotional) support as a result of their decision not to receive the help they need.

3. Love First – This substance abuse intervention is also commonly portrayed on television. Family members read letters expressing their feelings about the user’s substance abuse and what they hope to see happen as a result of seeking help. Much like the tough love intervention, there may be consequences for not seeking treatment; however, as the emphasis remains on love, the family will also find ways of easing any concerns their addicted love one may harbor. For instance, those afraid of losing their job will be offered assistance in finding work once they complete their stay in rehab.

4. Johnson Model – Among the most common and most effective interventions for substance abuse is the Johnson Model. Again, the family reads letters and voices their concerns while maintaining an emphasis on positive and supportive language. The tone may be a bit more aggressive than in the Love First model, and it can help to have a professional interventionist in the room to help mediate. The key here is to offer support, but still directly confront the harmful ways in which substance abuse has affected the family unit without overly sugarcoating the issue. While the user should not feel attacked, a degree of healthy conflict will be involved in the process.

5. ARISE – The ARISE Intervention not only lacks confrontation, but also surprise. In many cases, the user knows beforehand that the intervention will be taking place. One might expect this to lower success rates, but as many as 83% of documented ARISE Interventions have resulted in treatment. This method involves an interventionist, with its primary unique feature being the lack of an immediate ultimatum. The user is not told to enter treatment immediately or suffer consequences, as the intervention itself will last more than one session. These sessions involve a healthy dose of addiction education, not unlike the kind received during inpatient treatment. This allows for a bridge between the intervention process and the treatment process that follows.

The user’s ability to hear the words of love and wisdom offered in these intervention forms may depend in part on their ability to maintain a degree of lucidity when not using. Their state of mind when not using, particularly if on withdrawals, will depend in part on their substance of choice. To better understand the various substances and their effects, the effects of individual substances will be covered comprehensively over the rest of this guide.

Alcohol Addiction

Alcohol addiction is also referred to as alcoholism and alcohol use disorder. There isn’t a single reason some people may become addicted to alcohol while others don’t. However, it’s believed that a combination of factors including genetic, behavioral, and psychological elements can all play a role.

Alcoholism is an addiction that changes the chemical makeup of the brain. When someone is addicted to alcohol, they aren’t in control of their use. When they’re drinking, they also lose control of their actions and behaviors.

The Levels of Severity Vary

As with other addictions, there are varying levels of severity of alcoholism. For example, some people drink every day when they struggle with alcoholism, while other people might binge drink in patterns and then not drink for a period of time.

Alcohol addiction is one of the more difficult areas of substance abuse to identify because drinking is such a common pastime for many people. It can be difficult to differentiate between alcohol addiction and social drinking in some cases.

Many people may start out only drinking in social situations, and then over time, their use of alcohol becomes more common. With alcoholism, trying to recognize early warning signs and treating those signs in the right way can help prevent a severe alcohol use disorder and the accompanying health concerns.

Further information on alcohol use disorder, its effects, and recommended treatment protocol can be found here.


Opioids are also referred to as opiates. These are drugs that can include prescription pain medicines like Vicodin and OxyContin, as well as drugs like heroin and fentanyl. Opioids or opiates bind to certain receptor sites in the central nervous system. When this happens, people can experience pain relief, but also a pleasurable sense of well-being. The use of opioids can also cause a euphoric high.

When the brain is exposed to opioids or opiates, and there is a sense of euphoria, it triggers a reward response in the brain. When that reward response is triggered, the brain wants to keep seeking out what created it. In the case of opioids and opiates, it’s the drugs.

Addiction can approach quickly

For many people, becoming addicted to opioids or opiates can occur very quickly. Along with the compulsive use of these drugs, opioids and opiates can also lead to physical dependence within a short amount of time.

Addiction is a psychological disorder, while dependence is physical. Physical dependence on opioids and opiates means that if someone stops using them cold turkey, withdrawal symptoms are likely to occur.

The abuse of opioids and opiates has become so pervasive in the U.S. that the use of these drugs, both prescription and illegal versions, is called the opioid epidemic. Each day more than 115 people in the U.S. die from an opioid overdose.

Check here for more information on opioid addiction.


Heroin is an opioid, and it acts on the brain and body much like prescription pain medicines. However, it is illegal. Heroin is made from morphine, which comes from the opium poppy plant. Heroin is a drug that people most commonly inject intravenously, and it can be snorted or smoked as well.

When someone uses heroin, it quickly binds to opioid receptors and has a very fast effect. The feelings that result from heroin use can include pain reduction, pleasure, and drowsiness. Most people describe heroin as having very fast effects, and the faster a substance creates the desired effects, the more addictive it is.

One addiction can lead to another

The use of prescription opioids can and often does lead to the abuse of heroin. According to the federal government in the U.S., almost 80 percent of the Americans who say they use heroin reported that they started with the abuse of prescription pain medicines.

Along with addiction and dependence, there are many long-term adverse health effects associated with heroin. For example, it can cause infections of the heart lining and valves, liver and kidney disease, and a variety of mental disorders including depression.

Take a look at our resource page for more info on heroin addiction and recovery.


Cocaine is a stimulant drug. When someone uses cocaine recreationally, it can create a sense of energy, elation, and sociability. When someone abuses cocaine, they may seem very happy and talkative. Physical effects of heroin use can include high blood pressure, the risk of a heart attack or stroke, and raised body temperature.

When someone uses cocaine regularly, they can become addicted. It’s also possible to be physically dependent on cocaine. Cocaine withdrawal symptoms can include fatigue, depression, paranoia, changes in mood, insomnia, and drug cravings. In some people who abuse cocaine, they may experience symptoms that are similar to schizophrenia when they try to stop using it.

Abuse & Overdose

When someone abuses cocaine, they may also overdose. A cocaine overdose can lead to serious and deadly effects like heart attacks, stroke, and brain and cardiovascular damage.

Treatments for cocaine abuse, addiction, and dependence are similar to the treatments available for other drug addictions. For example, options like cognitive behavioral therapy, motivational therapy, and 12-step programs may all be useful.

Our longer resource page for cocaine users will provide more information to those in need.


Crack is a drug that first rose to widespread national attention in the 1980s. It was a drug that plagued inner cities and was often associated with homeless people or low-income people. Crack use isn’t limited to one particular group of people, however. Crack is a stimulant drug, and it’s extremely powerful in its effects. It’s also very easy for someone to become addicted to crack because of the effects it has on the brain. Some researchers believe just one hit of crack cocaine can change the wiring and chemical makeup of the brain.

When someone uses crack, it creates an almost instantaneous effect. That effect leads to extreme energy and excitement that’s much like symptoms of mania. As the effects of the drug wear off, people will typically experience a significant crash. During this crash period, a person may sleep for long periods of time or may seem as if they’re depressed.

Habits of Abuse

To avoid the crash, many people will use crack in binge cycles. They will use large amounts of it over a relatively short period of time to keep up their high.

Crack is most commonly smoked, but it can be snorted as well. When someone is abusing crack one of the first symptoms that may be noticed by outsiders is a continuous runny nose or nosebleeds.

Crack is a very damaging drug, and most people require specialized treatment to stop using it. There are often many physical and psychological symptoms of crack abuse that have to be dealt with during addiction treatment as well.

Crack addiction is covered in more detailed by our resource page here.


Opium is something that’s derived from the poppy plant. Opium is used as the basis for some opioid medications including morphine. Synthetic opioids like fentanyl are also made to replicate the effects of naturally-occurring opium.

Opium has a long history as being a drug of abuse. Opium is not abused now as much as it was throughout history, but since it’s the basis for opioid drugs, it’s still a topic of discussion. Since ancient times, opium has been used to relieve pain and also as a recreational drug to get high.

The Feel-Good Effect

When someone uses opium, it triggers a reward response in their brain. Opium also causes a flood of feel-good neurotransmitters to go into the brain and body, which is how it creates euphoria.

Opium and other opioids are classified as depressants because they slow down the central nervous system. The central nervous system is responsible for essential functions that sustain life including breathing and heart rate. If someone uses too much opium or takes too high a dose of other opioids, it can overwhelm their central nervous system and cause them to overdose or completely stop breathing.

Follow this link for further info on opium, its analogs, and how to recover from their use.


When discussing substance abuse, ketamine for many people is one of the lesser-known substance, but it’s becoming increasingly used as a recreational drug.

Ketamine’s history dates back to the 1960s. During this time it was used to provide pain relief to soldiers in the Vietnam War. Ketamine’s effects vary based on the dosage in most cases. At low doses, it provides pain relief, and it can work well with sedatives.

However, ketamine is now abused as a club drug. When high doses are used, the effects are very different. Ketamine’s recreational effects can include hallucinations and a sense of dissociation with reality. People who use ketamine may have trouble moving or speaking. Ketamine, as a result, is used not only as a club drug, but it’s also used as a date-rape drug.

The Effects of Ketamine

Ketamine is recreationally abused in different ways, including by intravenous injection. Specific effects of ketamine abuse can include sedation, feeling like you’re in a dream, vivid dreams, feelings of grandiosity and strength, and out-of-body experiences.

Physical effects of ketamine abuse may include increased heart rate, increased blood pressure, and uncontrollable eye movement. Some people who abuse ketamine have extremely negative experiences. For example, ketamine substance abuse may cause seizures, psychosis or symptoms of paranoia.

Ketamine addiction and recovery are explained further here.


Oxycodone is a generic opioid pain reliever. Oxycodone is one of the most abused opioid prescription drugs, and it’s in brand-name drugs like Percocet and OxyContin. Oxycodone, as with other opioids, changes how the body senses and responds to pain. When someone is prescribed to take oxycodone, it’s extremely important they follow their doctor’s instructions. It’s easy to slip into oxycodone abuse, which then raises the risk of becoming addicted to the drug.

Street names for oxycodone and brand-name drugs it’s in include hillbilly heroin, oxy, and OCs.

Oxycodone may be prescribed for certain conditions and the management of pain from arthritis, cancer, injury or surgery. However, oxycodone is only meant to be a short-term pain medication because the longer someone uses it, the greater the chance they will become addicted.

What Addiction Is

If someone takes higher doses of oxycodone than they’re prescribed, uses someone else’s prescription, or takes oxycodone longer than their doctor instructs them to, it’s considered substance abuse. Anytime someone recreationally uses oxycodone for the effects it can create, it can also be considered drug abuse.

The lines between recreational use, dependence, and addiction are often very thin. If someone uses oxycodone in any way other than what’s intended to get a faster or stronger effect, this is also classified as substance abuse. For example, people might crush up oxycodone to snort it or to liquefy it and inject it.

Our parent page on Oxycodone will provide further insight to those who need it.


OxyContin is a brand-name prescription opioid. OxyContin is a time-release version of oxycodone, and it can be prescribed for a variety of conditions that cause pain including cancer and injuries. The dosages of OxyContin range from 10 to 80 mg.

When someone uses OxyContin is provides an estimated 12 hours of relief from pain. This extended-release component of OxyContin is why it’s helpful to relieve chronic pain. Pain relief is around-the-clock with OxyContin. This 12-hour relief is in contrast to the maximum of four hours of pain relief that a person might get with immediate-release oxycodone.

Many Associated Risks

Despite the benefits of OxyContin for treating pain, there are many risks associated with this frequently abused drug. With time-release opioids, people will often crush them up so they can snort them or dissolve them in water and inject them. This causes a powerful and dangerous effect. All of the drugs that are supposed to be gradually released over 12 hours are immediately released into the system of the user.

People who abuse OxyContin are at high risk of overdose. The effects of the drug can be so overwhelming to the central nervous system when it’s abused that someone’s breathing slows or altogether stops. People who abuse OxyContin often say that to snort it or inject it creates a high and an effect similar to that of heroin.

A more comprehensive overview of OxyContin abuse and treatment can be found here.


Codeine is a commonly prescribed opioid. While it is a narcotic and a controlled substance, the effects of codeine are milder than many other prescription opioids. Even so, there is an abuse and addiction potential that can come with the use of codeine.

Codeine is typically prescribed to treat pain that ranges from mild to moderate in severity. Codeine is often included in prescription cough syrup formulations as well. When someone uses codeine, it can cause them to feel sleepy and at high doses, euphoric. Codeine isn’t an opioid that’s typically going to be prescribed for very severe pain.

The problem with codeine is that if someone does start using it, they may like the effects, and then they may move on to other more potent opioids. Signs someone is abusing codeine can include taking larger doses than what’s directed by a doctor, as well as using it without a prescription. Using codeine just for the pleasurable effects it creates is also considered abuse.

Codeine misuse is covered at length on our resource page here.


Fentanyl is one of the most dangerous opioids available right now, and it’s responsible for the majority of opioid overdose deaths in the U.S. Fentanyl is a strong, synthetic opioid meaning that it’s not naturally-derived like a drug such as morphine is. Fentanyl is estimated to be 50 to 100 times stronger than morphine.

Fentanyl does have some prescription applications. For example, it can be used to treat and manage severe pain following surgery. Fentanyl can also be used as a pain treatment for people who are already tolerant to other opioids and don’t get any effect from them anymore. Some of the prescription, brand name versions of fentanyl include Sublimaze, Actiq, and Duragesic.

Research & Statistics Are Showing

According to research from the National Vital Statistics Systems, fentanyl-related overdose deaths rose from 14.3 percent in 2010 to 46 percent in 2016. Based on those numbers, fentanyl is related to almost half of all overdoses stemming from opioid use.

Along with its strength, a significant issue associated with the use of fentanyl is the fact that it’s not always something used intentionally. Some people may seek out fentanyl, but more often than not it’s added to heroin or prescription pain pills that are purchased on the black market. The person buying the drugs may have no idea they’re ingesting fentanyl.

Check this page for more information on the dangers of fentanyl addiction and the path to recovery.


Hydrocodone is a generic narcotic. Hydrocodone-based medications can be used to treat pain ranging from moderate to severe. Like other strong prescription opioids, hydrocodone is only supposed to be used to manage pain in the short-term. For example, hydrocodone might be prescribed to someone to treat dental pain or pain related to injuries. However, the longer someone uses hydrocodone, the more likely they are to become addicted and dependent on it.

Hydrocodone is frequently combined with other non-opioid pain relievers such as acetaminophen or ibuprofen. This way, the prescription drug can fight pain in multiple ways for more effectiveness. Brand name versions of hydrocodone can include Vicodin, Lortab, and Norco.

Recent Drug Classification

Until a few years ago, hydrocodone was classified as a schedule III controlled substance in the U.S. Hydrocodone abuse became more common, and people were recreationally using it by crushing it up to snort or inject the drug. In 2014, the federal government moved to make hydrocodone a schedule II drug. Schedule II drugs are viewed as having a high potential for abuse and dependence.

As with other prescription narcotics, it’s imperative that people who are prescribed hydrocodone follow their doctor’s instructions very carefully.

Learn more about hydrocodone here.


Lortab is a brand-name version of the drug hydrocodone. Lortab is a semi-synthetic opioid, and when someone uses large doses of the drug or uses it outside of how it’s prescribed, the effects are similar to OxyContin.

People may seek out Lortab because of the feelings of euphoria, relaxation, and even sedation it can create. As the brain is repeatedly exposed to a narcotic like Lortab, the use of the drug can become compulsive and out of the control of the user. Lortab and other drugs like it are not intended to be used for more than a few weeks in most cases. It is not a long-term pain treatment option.

A Concern Regarding Lortab

Along with addiction to Lortab itself, there is a concern with the use of this prescription opioid that people may move to using stronger opioids like heroin. It’s not uncommon for people to use heroin after becoming addicted to prescription opioids. Heroin is often cheaper and easier to obtain, which are reasons this can occur.

Signs someone is abusing Lortab can include confusion, small pinpoint pupils, a sense of euphoria, and drowsiness or nodding off. One of the biggest red flags that someone may have a problem with prescription drugs is often having multiple prescriptions from different doctors, which is known as “doctor shopping.”

Lortab use is covered extensively on our resource page.


Dilaudid is the brand-name version of hydromorphone. Hydromorphone is a powerful prescription opioid pain medication. Hydromorphone is available in extended-release versions, and it’s often something that’s given to patients who are already opioid-tolerant and who require around-the-clock pain management. Hydromorphone is derived from morphine, and Dilaudid is one of the most potent pain relievers available.

It’s not uncommon for someone using Dilaudid, particularly if they’re abusing it recreationally, to develop a dependence within just two or three weeks. People can also develop a tolerance quickly, meaning they need higher and higher doses to achieve the desired effects. These high doses can lead to an overdose.

A Specific Situation

Even though Dilaudid is supposed only to be prescribed in very specific situations, such as for cancer pain and severe injuries like burns, it is diverted from medical use and may be available to people without a prescription.

As with other prescription narcotics, Dilaudid abuse usually includes people injecting the medicine to get faster, more powerful effects. With the strength of Dilaudid, using it intravenously ups the chances of an overdose even more. Signs of a Dilaudid overdose can include a weak pulse, clammy or bluish skin, loss of consciousness, shallow breathing, and a weak pulse.

You’ll find a more exhaustive write-up on Dilaudid use here.


Kratom is a substance that’s derived from a tree native to Southeast Asia. Certain compounds within the tree can create psychoactive effects in users, making it a recreational drug. Kratom is not illegal in the U.S. currently, although, with the increase in its use, there have been moves to regulate it.

Kratom can be purchased online, and it can be taken as a capsule, a pill or an extract. It’s also possible to use the leaves of the kratom tree and chew them or brew them to make a tea.

Similar Drugs & Symptoms

Kratom can have effects similar to stimulant drugs as well as opioids. For example, there are certain compounds in kratom that are believed to affect opioid receptors. This can cause symptoms such as decreased pain, sedation, and euphoria. These effects most commonly occur when large amounts of kratom are used.

When smaller amounts of kratom are used, effects can include increased energy and sociability. Kratom can have dangerous effects, and it can also lead to dependence. If someone is dependent on kratom and they try to stop using it, they may have withdrawal symptoms. Kratom withdrawal symptoms can include muscle aches, irritability, changes in mood and emotion, aggression, and hostility.


Morphine is a drug that has a long history of use in medicine and pain relief, but it also has a history of recreational use and abuse. Morphine is an opioid. Opioids are also called narcotics. When someone is administered morphine, it affects opioid receptors found throughout the body including in the brain and spinal cord.

Morphine and other opioid pain medicines change how pain signals are sent to the brain. They’re also effective as pain relievers because they change the emotional response to pain. As a short-term medical treatment, morphine is effective for pain.

However, tolerance to morphine can develop quickly as can dependence and addiction. Due to how often morphine is used in medical settings, it’s often diverted from medical use and sold on the black market. Signs of morphine abuse and addiction can include trying to stop using it unsuccessfully, using it outside of medical purposes, or making obtaining and using more morphine a primary focus.


Vicodin is one of the most well-known and frequently prescribed prescription narcotics. Vicodin is a brand-name drug that is a combination of the opioid hydrocodone and acetaminophen. Hydrocodone helps relieve pain by affecting signals sent throughout the central nervous system. Acetaminophen is a pain reliever available over-the-counter that’s in medicines like Tylenol.

Like other opioids, Vicodin is a schedule II controlled substance in the U.S. Schedule II drugs are believed to have a high potential for abuse and dependence. While schedule II drugs do have accepted medical uses in the U.S., they are intended to be prescribed only in very certain circumstances.

The Potential Risk of Overdose

If someone abuses Vicodin, they’re not only at risk for overdose because of the hydrocodone. Taking too much acetaminophen can also be dangerous or deadly. If someone is abusing Vicodin, the acetaminophen can cause liver damage or acute liver failure.

Some of the effects of Vicodin abuse can include constipation, depressed heart rate, and breathing, drowsiness, and nausea or vomiting. When someone becomes addicted to Vicodin, they often didn’t notice what was happening until it was too late. Signs of addiction to Vicodin can include continuous cravings for the drug, forgoing other responsibilities to use or get more Vicodin, and needing larger doses to get the same effects.

Follow this link for more reading on Vicodin abuse and recovery.


Methamphetamine, also just referred to as meth, is one of the most troubling stimulant drugs abused by people. Crystal meth is one of the most commonly abused forms of meth, and it’s a form of the drug that can look like glass or clear rocks. Methamphetamine can be abused in many ways including by inhaling or smoking it or snorting it.

Methamphetamine’s effects can start to occur quickly, but these effects can also dissipate quickly. For that reason much like crack, meth tends to be a drug that people binge on. They will use it several times within a short period of time to avoid crashing after the effects wear off.

The Effects of Methamphetamine

Meth is similar to most other drugs in that it artificially floods the brain with feel-good neurotransmitters. Specifically, when someone uses meth, it triggers a huge release of dopamine in the brain. Dopamine is related to the brain’s reward cycles.

Along with seeming very wakeful, energetic, and talkative, meth can cause people to lose their appetite and have a fast or irregular heartbeat. Meth can also lead to increased blood pressure and body temperature.

The long-term effects of meth use can be incredibly dangerous. It can cause extreme weight loss, major dental problems, skin sores, cognitive and psychological problems, anxiety, paranoia, hallucinations, and violent or aggressive behavior.

Further reading on meth addiction and recovery are found here.


Outside of prescription opioids, drugs classified as benzodiazepines are among the most commonly abused prescribed drugs. Xanax is a benzodiazepine, and the generic name is alprazolam. Xanax is prescribed to help treat insomnia, panic disorders, and generalized anxiety disorder. Due to how frequently Xanax is prescribed, it’s widely available, and people often become addicted to it after stealing it from friends and family members.

Xanax has a calming and sometimes sedative-like effect on users. Benzodiazepines like Xanax affect the central nervous system. They increase the level of something called GABA in the brain. GABA is responsible for slowing neural activity in the brain, thus the calming effect of Xanax.

Problems with Xanax Use

As a central nervous system depressant, Xanax can cause users to seem as if they’re disoriented, or they are having problems with coordination. Slurred speech is another symptom of Xanax use. People who are abusing Xanax may take large doses, inject it, or snort it.

With benzodiazepine abuse, it’s also common to mix these drugs with other substances. For example, a person might use Xanax and alcohol together, or Xanax and opioids. This can heighten the effects of the substances but can also be deadly. When two central nervous system depressants such as Xanax and alcohol or opioids are combined, they can cause fatal respiratory depression.

Check these resources to learn more about Xanax addiction and treatment.

The End.

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