Even if you consider yourself an occasional recreational
drug user and you don't think you have any problems, it’s worth
understanding what dependency is all about (especially the warning
signals). The thing about developing a dependency it that generally
you are not aware of the condition until it has developed into a problem.
Dependency is a medical term which is defined
as “impaired control of substance use and continuous use despite
adverse consequences”. That means the drug use is out of control,
despite the damage it is doing to you. Addiction is a more common
term, but that refers more specifically to a “physical bodily
need that results in withdrawal symptoms if not satisfied” i.e.
it’s very hard to kick the habit due to the hectic cravings.
There are so many facets and aspects to this dependency thing, not
even the medical community can agree amongst itself as to exactly
what's what.
However with drugs that we see, there are broadly
two types of dependency. One is a physical dependency which is about
those blood curdling cravings and the other is a psychological dependency,
which is more to do with the psychological processes in your brain
where the pleasure mechanisms keep calling for more. Generally it's
easier to beat a psychological dependency than a physical one, but
that varies from person to person and from drug to drug.
Some drugs are more dependency producing potential than others, but
ultimately you can get hooked on anything. Repeated use of certain
drugs like Nicotine, Cocaine, Kat, Heroin and others can result in
a dependency as described above. Other drugs such as LSD and Cannabis
don’t necessarily cause withdrawal symptoms, although you can
still develop a habit. With some drugs, we can say that the dependency
onset rate is much quicker. For instance, its said by many that one
only has to use Heroin a couple of times before the cravings start.
It's also very important to know that the treatment data shows that
the full recovery rate of people who have developed severe dependencies
is low. There is also the issue of tolerance, that is the more often
you use that drug, the more you have to take to have the same effect.
Environment plays a big part - even if you don't have a dependency
as above, some times you will associate use of a drug or substance
with a place or social ritual, for instance drinking if you go to
a bar, dropping a pill at a rave, snorting lines in the loos at a
wedding, ... the list goes on. You might feel out of place if you
are not doing a certain thing in this social context: you can't enjoy
yourself with out it. This can form part of or lead to a dependency,
but this is more about a habit.
Alcoholism is the biggest drug problem many countries
face, certainly in South Africa yet society generally does not see
alcohol as a 'drug'. What's different about Alcoholism is that it
generally the condition of lifestyle deterioration and dependency
only becomes chronic later in life. Treatment data shows most patients
are around 40 years old, yet they probably have been drinking regularly
most of their lives. You might have heard someone saying that alcoholism
is a disease - that's because it took a while for the medical profession
to understand addiction. Eventually they came up with the 'Disease
Model of Addiction'. Them in this case was the American Medical Association
(AMA). Ultimately the mainstream medical community has accepted addiction
as a disease. This means that these conditions fall within a framework
for professional treatment. In the USA, it also means people under
treatment have more rights in certain circumstances.
Some people talk about having an addictive personality - perhaps some
people are more vulnerable to dependency than others, perhaps its
genetic but this where it gets messy. Essentially if you use an addictive
drug often enough, chances are that you will end up with a dependency
problem. Smoking cigarettes is a fine, and for many who spend years
trying to give up, a horrid example. The odd fag will not mean you
are hooked but start smoking every weekend, the hard-to-resist cravings
will kick in and it will soon become a pack-a-day affair. There are
a few people who claim to use drugs like Heroin recreationally (that
is every now and again), and perhaps they can, but these people are
extremely few and far between, they are the exception rather than
the rule, do not take them as role models. Age is also a factor here,
perhaps because some people get wised up as they get older (but this
is not always the case:) Resisting the urges and cravings for more
takes considerable will power. Hindsight is also useful. But be careful
of drug bravado, just because you can handle one, does not mean you
can handle all. Not all drugs are the same!
The medical profession uses the 'Symptoms of Dependency'
(as published by the American Psychiatric Association) to test if
you have a dependency. Only three out of these nine symptoms are necessary
for the diagnosis of dependency.
1. You take more drugs than you planned or over
a longer period than you planned. i.e. Just one drink turns into a
all night boozing spree.
2. You know that things are kinda out of control,
and you are unable to put a lid on it.
3. You spend a lot of time finding the money to
buy your goodies, taking them and/or recovering from them.
4. You suffer intoxication or withdrawal symptoms
when you should be doing you work, or studying or being a good spouse/parent/child/lover.
5. You give up important social, work or recreation
activities.
6. With heavy and prolonged use, you develop physical
problems yet continue despite the fact that continued use is making
it worse (e.g. smoking)
7. Significant long term tolerance develops, and
you have to take more for the same effect (e.g. speed)
8. With continued use, you find withdrawal symptoms
develop when you try to stop or reduce intake. This is symptom of
psychical dependency (e.g. Heroin)
9. After developing unpleasant withdrawal symptoms,
you take the drug to relieve or avoid this withdrawal. This might
be taking the drug throughout the day (e.g. Cocaine)
Remember that you only need to score 3/9 to be
defined as a dependent. If you have any doubt as to which way you
are going, better speak out sooner than later. Just being open and
honest with understanding close friends or family members can help
you out initially. The next step might be an appointment with psychologist
who might refer you to a treatment centre.
So the bottom line is: KNOW what is transpiring
in your life, be honest with yourself at all times, be on the lookout
for problems and make changes if necessary. “After all, you are
the one doing the breathing !”
Further reading/viewing:
- 'Forbidden
drugs'
Book by Philip Robson, 2nd Ed, Oxford University Press, 1999
- 'Trainspotting'
Novel by Irvine Welsh, made into a film as well
- 'Sid &
Nancy'
A film by Alex Cox
