Drug Dependency

Drug Dependency

Clearing the Mind,
Cleansing the Body

Probably nobody you know actually tried to become addicted to drugs. But dependency sneaks up slowly, insidiously, one pill or marijuana cigarette at a time, until a woman is confronted with a problem that she never thought she'd have to handle.

And despite its reputation as an inner-city problem, drug abuse can strike right in your own neighborhood: the old college roommate, dependent on painkillers since an auto accident three years ago; the hard-driving boss, using cocaine to help her endure a 14-hour-a-day work schedule.

Maybe, if we're not careful, even us.

"Not everyone is in danger of becoming drug-dependent," says Joan Mathews Larson, Ph.D., director of the Health Recovery Center in Minneapolis and author of Seven Weeks to Sobriety. "But it cuts across all boundaries. You certainly don't have to be a poor urban youth to become hooked on drugs."

Drug use exacts a brutal toll. It can cost our money, our jobs, our friends, our spouses, our dignity. It can ravage and age our bodies. It can make us stop eating or compel us to eat in binges. It can make us forsake exercise or let our hygiene go. We can lose mental capacity. Drug dependency can even be fatal.

"It doesn't have to be that way," Dr. Larson says. "But unless a person takes action, she will likely continue to deteriorate. People dependent on drugs can fall an awfully long way."

Filling the Void

Studies show how widespread the country's drug problem has become. A large-scale study of residents of five U.S. cities showed that as many as 1 in 20 American women either abuse or are dependent on drugs.

And drug dependency is horribly expensive. Figures from the University of California, San Francisco, show that use of illegal drugs in America costs nearly $7 billion a year in treatment, loss of productivity and other costs.

Why do people become drug-dependent, despite the risks? Because drugs make them feel good--at least at first. "Drugs fill a need in a person's life," Dr. Larson says. "Heroin, for instance, can help a person deal with her natural anxiety. Alcohol acts as a depressant in most people. But in others, it actually stimulates them. It makes up for a natural deficiency in some brain chemicals."

The relief, however, is always short-lived. Over time, drug use interferes with production of endorphins, the body's natural "feel-good" chemicals. "That means you have to use more drugs to make up the difference," says Adam Lewenberg, M.D., a New York City physician whose private practice includes addiction treatment. "It becomes a cycle where you crave the drug more and more and eventually become dependent on its use."

And it's not just cocaine, marijuana, heroin and other illegal drugs that are causing the problem. Doctors and researchers have identified scores of over-the-counter and prescription drugs that can cause dependence, including cough syrups, anxiety drugs in the benzodiazepine family such as diazepam (Valium) and maybe even estrogen taken during hormone replacement therapy.

Women, in fact, are at higher risk than men of abusing prescription drugs such as tranquilizers, sedatives and stimulants simply because they are given them more often. They are also less likely to come forward about their abuse, resulting in more advanced drug dependency, Dr. Larson says. "More and more women are coming forward with problems. That's mainly because they're having trouble at work," she says. "But women who don't work tend to be secretive about their problems, and drug dependency can progress to a more out-of-control state."

While anyone can become dependent on drugs, heredity can play a big role. In his book The Good News about Drugs and Alcohol, Mark S. Gold, M.D., estimates that one in ten people is genetically predisposed to becoming dependent on drugs. "There's no question that drug dependence, like alcoholism, can run in families," Dr. Larson says. "Unfortunately, we can't test for it. But if you know of alcoholics or drug-dependent people in your family, you have to be extra careful."

Alcohol abuse also increases your chances of becoming dependent on drugs. We've all heard about how alcohol is a "gateway drug," opening the door to further drug abuse. Well, here's the proof: The National Institute of Mental Health interviewed more than 20,000 American men and women over age 18 from five sites across the country. Researchers found that women who abuse alcohol run nearly six times the risk of abusing drugs as well.

The same study found that having a history of mental disorders also raises your risk. People with disorders such as depression could be 4.7 times more likely to abuse or become dependent on drugs. And those with anxiety problems such as panic disorder or obsessive-compulsive behavior are 2.5 times more likely to become dependent on or abuse drugs.

The most important thing to remember about drug dependency, Dr. Larson says, is that it can happen to anyone. "It's not something to be ashamed of. It doesn't mean you have a moral flaw or a character flaw," she says. "No one sets out to become hooked on drugs. But for a variety of reasons, many of them beyond a person's control, it just happens. And then you have to deal with it."

Stopping before You Start

Clearly, the best way to beat drug dependency is to avoid it in the first place. To help stay out of trouble, consider these tips.

Know the warning signs. "When thoughts of a drug fill your mind, you have a problem," Dr. Larson says. If you feel you can't relax, be happy, get to sleep or do anything at all without first using a drug, it's probably time to seek help.

Other signs of trouble include lying to doctors to refill prescriptions, missing work because of drug binges or hangovers, raiding savings to pay for drugs and consistently forsaking food, friendship or family to get and use drugs.

Shake your family tree. Look for signs of drug abuse in your family, because it may indicate that you're more prone to dependency. Include alcoholism in your search. And don't overlook things such as Grandpa's painkillers or Aunt Sophie's Valium.

"If you find signs of it in your family, be extra careful," Dr. Larson says. "Don't ever experiment with drugs, because it may take only once for you to get hooked."

Resolve conflicts. People use drugs to avoid dealing with problems such as anxiety, boredom, depression, frustration, bad relationships, pressure at work and unemployment. "Meet these problems head-on," Dr. Larson suggests. "Drinking or taking drugs to avoid them isn't going to solve anything. It's just going to add another layer--drug dependency--to the mix."

If you're bored, find a hobby or do some volunteer work. If you're having trouble at work or with your spouse, seek counseling. Whatever you do, don't turn to drugs for temporary comfort, no matter how appealing they sound.

Stick to the label. If your doctor gives you prescription drugs, particularly painkillers and tranquilizers, use them exactly the way you're told to. And never try to have them refilled unless the doctor says so. "Prescription drugs don't act differently in your body than illegal drugs," Dr. Lewenberg says. "In some ways, they're more dangerous because they're available and legal. People who wouldn't think of buying cocaine would not see the same problem in misusing a prescription drug. But they should."

When you're done taking a drug, throw away the bottle. If there's some left, don't shove it in the medicine closet, or you or someone else may be tempted to use it later, without a doctor's approval.

Just say no. It's a trite phrase, but it still rings true. Avoid illegal drugs. Because for some people, "recreational" drug use can quickly lead to dependency. "You can't become addicted to illegal drugs unless you use them," Dr. Lewenberg says.

When You Need Help

If you think you may already have developed a drug dependency, experts offer this advice.

Ask for help. "I'll say it again: Don't be ashamed," Dr. Larson says. "Tell a trusted friend. Tell your spouse. The sooner it's out in the open, the sooner you'll start dealing with it in constructive ways." You don't need to broadcast your problem to the world. But if there's even one person out there who knows and cares, you'll get the support you need to get back on the right track.

Find strength in numbers. Twelve-step groups are great aids to some women. You can find people with similar problems and hopes who can help you make it through the inevitable rough spots of recovery.

Start by looking for a local chapter of Alcoholics Anonymous, Cocaine Anonymous or Narcotics Anonymous. Call or write these groups for more information:

* Narcotics Anonymous, World Services Office, P.O. Box 9999, Van Nuys, CA 91409

* Cocaine Anonymous, 3740 Overland Avenue, Suite G, Los Angeles, CA 90034; 1-800-347-8998

* National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345

Exercise in moderation. If you've been abusing drugs, you've been abusing your body, too. You may not have gotten any exercise for months, a factor that may only heighten depression or anxiety.

So start working out. Begin with moderate exercise; walking for about 20 minutes a day, at least three times a week, is best. Heavy-duty exercise isn't a good idea at first, according to Dr. Lewenberg. You're probably not in peak shape right now and could easily be injured or discouraged. And it's possible to become addicted to exercise, too, since it stimulates endorphin production. "It's not a bad trade, really--drugs for exercise," Dr. Lewenberg says. "But the idea is to bring your body back to normal slowly."

Eat right. Drugs do strange things to your appetite. People dependent on marijuana, for instance, are prone to overeating and obesity. And cocaine abuse can lead to malnutrition and even eating disorders such as anorexia nervosa. "When you're dependent on drugs, eating well is rarely a priority," Dr. Larson says.

Try to eat a balanced diet, whether you feel like eating or not. Replace sweets with fruits and vegetables. "Feeding your body and brain what it needs is a very necessary first step to recovery," Dr. Larson says.

Consider treatment. Inpatient and outpatient recovery centers offer people the chance to both detoxify their bodies and address the underlying causes of their drug dependencies. "Where there's addiction, there's depression," says Dr. Lewenberg. "It's not enough to go cold turkey and not deal with the other problems." Dr. Lewenberg's program has included nonaddicting drug therapy to handle depression and even electroacupuncture, which he says helps stimulate endorphin production and make medication more effective.

Many employers and insurance companies will cover the costs of recovery centers.