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Table of Contents

Written by Amethyst Recovery

Amethyst Recovery is a foremost authority on addiction and a trusted online source of substance abuse information. Their expert team of addiction professionals provide well researched content for people in the grip of addiction. All posts are fact checked and sourced.

Substance Abuse Problems

Substance-Abuse-Drugs-Alcohol-RecoverySubstance 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.

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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.


Substance-Abuse-Addiction-Treatment-RehabOpioids 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 mean 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.


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.


Substance-Abuse-Drugs-Alcohol-RehabCocaine 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.


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 are 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.

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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.


Substance-Abuse-Group-RehabWhen 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.


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.


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 drug that’s supposed to be gradually released over 12 hours is 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.


Substance-Abuse-Addiction-Detox-RehabCodeine 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


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.


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.

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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, 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 the 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.”


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.

Substance-Abuse-Recovery-Detox-RehabIt’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.


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.


Substance-Abuse-Recovery-SunsetMorphine 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.


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.


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.

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