Brief overview
- Description: physical and psychological dependence on a drug, often tranquilizers, sleeping pills and painkillers, stimulants
- Symptoms: loss of control over the time and duration of use, strong craving for the addictive substance, neglect of interests and tasks, physical and psychological withdrawal symptoms
- Causes: Permanent prescription of addictive drugs by the doctor, misuse of a drug, severe emotional stress
- Diagnosis: Criteria include withdrawal symptoms, loss of control, development of tolerance, great effort to obtain the drug, neglect of tasks and interests, concealment of consumption, prolonged use,
- Prognosis: gradual progression, addiction often goes unnoticed for a long time, can be overcome with therapeutic help
Drug addiction: Description
The term “addiction” is generally associated with alcohol or drug addiction. However, medication can also be addictive. According to experts, medication addiction is actually quite a widespread problem. Those affected develop physical or psychological withdrawal symptoms, or both, after stopping the drug in question.
Who is affected by drug addiction?
Differentiation between drug abuse and drug addiction
Doctors differentiate between drug addiction and drug abuse. Medication abuse always occurs when medication is used in a way other than intended by the prescribing doctor. This is the case when a medication is used for too long, in too high a dosage or without medical necessity. The misuse of medication is often the first step on the road to drug addiction. However, we only speak of drug addiction if the drugs consumed affect the psyche (psychotropic drugs).
Differentiation between physical and psychological dependence
Drug addiction: symptoms
The symptoms of drug addiction occur when the person concerned stops taking the medication in question for a certain period of time or takes too low a dose. Both physical and psychological withdrawal symptoms then occur.
With some medications, the abused substance itself can cause symptoms. For example, some drugs can cause profound personality changes if used excessively.
The drugs with the highest addiction potential are the following substance groups:
- Sleeping pills and tranquillizers, for example benzodiazepines
- stimulants and appetite suppressants (stimulants), for example amphetamines
- Painkillers and narcotics, for example opioids
Doctors often prescribe benzodiazepines for anxiety disorders, sleep disorders or signs of stress. Benzodiazepines are drugs that are available on prescription from pharmacies. They have an anxiolytic, relaxing and calming effect and are also known as tranquilizers (Latin: tranquillare = to calm). Sleeping pills can provide great relief, especially in acute stressful situations. However, both groups of active ingredients can lead to drug addiction if used for too long. Sleeping pills and tranquillizers should therefore not be taken for longer than four weeks.
Drug addiction: Stimulants and appetite suppressants (psychostimulants)
Symptoms: Symptoms of withdrawal include fatigue, psychomotor slowness, restlessness, sleep disorders and severe depression, including suicidal tendencies.
Drug addiction: painkillers and narcotics
Opioids are very effective painkillers and anaesthetics (analgesics) and are mainly used for very severe and chronic pain. These morphine derivatives also have a mood-lifting effect.
Symptoms of drug abuse
Apart from the active substances mentioned above, there are other substance classes that do not cause classic drug addiction as they do not affect the psyche. However, these drugs can also be addictive when abused and cause great damage. The following medications are frequently abused:
Nasal drops and sprays with a decongestant effect
Laxatives (laxatives)
The intestines quickly become accustomed to the effects of many chemical or herbal laxatives. After discontinuing the preparations, severe constipation sets in. The affected person then resorts to laxatives again. In this situation, too, excessive use can lead to a vicious circle that causes those affected to take laxatives again and again. Laxatives are often misused by people with eating disorders who want to regulate their weight with laxatives.
Growth and sex hormones
Steroids are broken down in the liver, which can lead to liver damage and even liver cancer if used excessively. Other symptoms that can occur with anabolic steroid abuse are increased sweat production, shortness of breath, skin problems (steroid acne), increased blood pressure, increased intraocular pressure, hair loss, prostate growth, breast formation in men (gynecomastia), headaches and depression. What is particularly annoying for those affected is that the muscles often lose size again without the continuous use of anabolic steroids.
Medicines containing alcohol
Drug addiction: Causes and risk factors
Drug addiction usually begins when a doctor prescribes a prescription drug. If the doctor prescribes medication with addictive potential too carelessly, the patient can slip into drug addiction. However, it is often the patient themselves who misuses a drug, for example because they value its psychological effects.
Drug addiction caused by the doctor (iatrogenic drug addiction)
The risk of iatrogenic drug addiction therefore exists above all if the doctor is unable to make a causal diagnosis, but instead uses the medication for purely symptomatic treatment. This is particularly problematic if physical symptoms such as sleep disorders, headaches or other complaints are an expression of a mental disorder such as depression or anxiety disorder.
The long-term prescription of some psychotropic drugs is particularly dangerous. Due to all the educational work on the subject of drug addiction, it is now common practice to prescribe risky drugs for a few weeks at most. However, some patients circumvent this safety measure by constantly changing doctors.
However, not all psychotropic drugs are addictive. Antidepressants have no addictive potential. They should and must often be taken for months and years.
Individual factors: learning experiences, socio-cultural factors, age and gender
For a long time, scientists have also been looking into the question of whether there is a certain personality structure that makes a person particularly susceptible to drug addiction. So far, it cannot be assumed that there is “the one addictive personality”.
A person’s genetic make-up could also play a role. Family and twin studies have been carried out to clarify this. So far, however, genetic studies on drug addiction have not produced any clear findings.
Gender differences
Age as a risk factor
Many groups of drugs that carry the risk of drug addiction are prescribed more frequently with increasing age. These include, for example, painkillers and various psychoactive substances (especially benzodiazepines). The consumption of psychotropic drugs is particularly high among senior citizens living in retirement and nursing homes.
The correct dosage is also a source of danger: Changes in metabolic functions and organ disorders (e.g. impaired kidney function) in old age mean that the body breaks down some medicines more slowly. Seniors should therefore take a lower dose of many medications than people of a younger age. However, this is not always sufficiently taken into account, with the result that many older patients receive too high a dose.
Drug abuse for intoxication purposes
Drug addiction: Examinations and diagnosis
Drug addiction is sometimes referred to as a “secret addiction” because it often remains hidden from outsiders. Even patients are not always aware that they are addicted to medication. Unlike alcohol addicts, for example, there are no obvious signs of addiction. Even if symptoms such as tiredness or headaches occur, they are rarely associated with taking medication. Some people, on the other hand, are well aware of their drug addiction, but suppress it or refuse to seek urgently needed treatment.
The medical examination
- Do you regularly take medication to calm you down or for pain, anxiety or sleep disorders? If so, how often?
- Do you have the feeling that you urgently need this medication?
- Do you have the impression that the effect has worn off after a while?
- Have you ever tried to stop taking the medication?
- Have you noticed any side effects?
- Have you ever increased the dose?
If the suspicion of drug addiction is confirmed, the patient will be referred to a psychologist. The psychologist can determine whether there is a mental disorder requiring treatment in addition to the medication addiction.
The diagnosis of drug addiction
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), a diagnosis of drug dependence (drug addiction) requires substance use that leads to clinically significant impairment and suffering. In addition, at least three of the following criteria must apply for the diagnosis of “drug addiction”:
- Development of tolerance, which is manifested by an increase in dose or reduced effect at the same dose
- Withdrawal symptoms when stopping or reducing the dose of the medication
- Frequent use over a longer period of time or in increased quantities
- Persistent desire or unsuccessful attempts to control intake
- High time expenditure for the procurement of medication
- Restriction or abandonment of other activities at work and in leisure time
Drug addiction: Treatment
If those affected notice adverse effects of a medication or do not take the medication as prescribed by their doctor on a long-term basis, they should seek urgent help. The earlier a medication addiction is recognized, the easier it is to stop taking the medication. However, people who have been taking medication for a long time can also be helped with therapeutic and medical guidance. Older people should not shy away from treatment for drug addiction either, as successful therapy can significantly improve quality of life.
Withdrawal
Stabilization phase
After withdrawal, the patient must learn to use alternative calming methods instead of medication in the event of stress or inner tension. Such methods can be learned, but require regular practice and professional guidance. An important prerequisite for the successful treatment of drug addiction is the patient’s willingness to actively participate. To do this, it is necessary to make the patient understand that the medication no longer reduces the symptoms that occur, but instead causes these and other problems and is therefore harmful.
The treatment of concomitant mental illnesses
Drug addiction: course of the disease and prognosis
Drug addiction usually develops gradually. Patients complain to their doctor about anxiety, sleep disorders, other psychological complaints or pain. The doctor therefore initially prescribes a medication that initially achieves at least some of the desired effect. However, if an underlying mental disorder is not recognized and treated accordingly, the symptoms recur after some time. The person affected tries to get to grips with this by increasing the dose of medication, without realizing that they are actually making the symptoms worse.