Addiction is the number one public health threat in the United States today.

Over 23 million Americans are addicted to alcohol and other drugs. Substance abuse involves the repeated and excessive use of a drug or alcohol to produce pleasure or escape reality despite its destructive effects. Although legal substances such as alcohol and nicotine can be and are abused, when we talk about drug abuse, we tend to think of illegal substances such as marijuana, cocaine, heroin or misuse of legal substances such as prescription drugs or fumes from household products.

What starts as so-called recreational use of substances, can spill over into craving and addiction, with dismal consequences for the user’s wellbeing, his entire family and the community as well.

The line is crossed when the drugs become a necessity, when it controls the user. The individual is convinced that the drug is necessary to have a feeling of wellbeing or even just to get through the day. Craving for the drug of choice eliminates most other thoughts, and tracking down and use of the drug takes over. Nothing is more important than getting high, not work, kids, spouse, or family. Getting high, becomes so important that the individual is willing to sacrifice everything even as the problem is denied.

For many people whose drug of choice is alcohol, the path to addiction is slower and more insidious. Because alcohol is a legal drug and many people use it successfully, those who have problems with it often go unnoticed for longer periods of time. Frequently, the person who has a problem with alcohol will be able to continue drinking because they continue to go to work, & will argue that their ability to work proves that they don’t have a problem.

Substance abusers are often the last ones to recognize their own symptoms of abuse, dependence and addiction. Even when they know they have a problem, drug abusers often try to downplay their drug use and conceal their symptoms. But if you suspect that a friend or loved one is abusing drugs, there are a number of warning signs you can look for.

Some behavioral symptoms include: Angry outbursts, mood swings, irritability, manic behavior, attitude change. Talking incoherently or making inappropriate remarks. Risky, secretive, or suspicious behavior. Deterioration of physical appearance and grooming. Absence from work or school or drop-off in quality of work or grades. Neglect of family responsibilities, money problems, or legal problems.

Physiological signs include: Frequent exhaustion or weakness, unexplained injuries and infections, blackouts, flashbacks, delusions, paranoia, withdrawal symptoms such as nausea, tremors, and sweating.


Pamela Egan, FNP-C, CDE is a board certified Adult & Family Nurse Practitioner, Certified Diabetes Educator & Clinical Specialist in Mental Health.