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Substance abuse/chemical dependency affects a person in many different ways: mentally, physically, emotionally, behaviorally and spiritually.
Mentally
Mental effects include denial, delusions, paranoia, preoccupation, blackouts, memory impairment, poor judgment, trouble concentrating, difficulty thinking, and "amotivational" syndrome. Denial, as discussed previously, is an inability to see the negative consequences of the drug or alcohol use. Going along with this are delusions. Drug users often delude or trick themselves into believing things, such as thinking that using makes them more attractive, when it actually contributes to a poor appearance. Another common delusion is seen in the marijuana user who believes that smoking pot will make him/her smarter--when it actually inhibits high level thinking. Paranoia is another common side effect of drug use. The user may believe that people are out to get him. If someone expresses concern about the drug use, the user may view it as a threat or confrontation rather than a concern.
Drug or alcohol users often become preoccupied with the use of alcohol or drugs. The user begins to spend more time and energy using alcohol or drugs, while giving up other important activities. Thoughts of use may become all consuming. An example: the teenager who spends all day in school daydreaming about drugs, drawing pictures of drugs on his notebook, wearing clothing supporting drug use, listening to music about drug culture, and spending free time discussing plans with friends about getting high after school.
Impairment in the function of memory is common with drug use. Short-term memory is usually impaired by alcohol or marijuana use. An individual may be given instructions and not remember them ten minutes later. Blackouts are also common with chronic use of alcohol and drugs. Blackouts are memory lapses where the user is awake and appears to be engaged in normal activity but later is unable to remember what has been said or done. This is different than passing out, where the individual uses so much alcohol or drugs that he/she becomes unconscious. An example of a blackout: a user doesn't remember how he got home or where his pants are--and his friend tells him that he was dancing on the table with a lampshade on his head. The user doesn't remember any of it.
Poor judgment, which leads to bad decision making, is often seen in someone using alcohol and drugs. The person may engage in illegal activity or worse--attempt an act that could get him killed, such as driving under the influence. Drugs and alcohol distort our perceptions. Often, such poor decisions are considered perfectly acceptable to the individual under the influence. Someone who is drug dependent and experiencing withdrawal symptoms will often go to great lengths to obtain more drugs, in order to ease the unpleasant (and sometimes painful) withdrawal symptoms.
Difficulty thinking and concentrating is seen with the use of any drug or alcohol. This is especially important for the developing adolescent. Many important things are not learned--and the individual does not care. Amotivational syndrome is the clinical term for lack of motivation and the "I don't care" attitude. This syndrome is extremely common in drug users. Generally, the only activity that users find truly motivating is to get and use more drugs or alcohol.
Physically
Physical effects of substance abuse include tolerance, withdrawal, feeling tense, poor appearance, bloodshot or glassy eyes, fixed or dilated pupils, drowsiness, slurred speech, flushed face, agitation, rapid speech, dizziness, drastic weight loss or gain and many physical illnesses. A user develops a tolerance when his/her body adapts to the intake of alcohol or drugs. Over time, more and more of the drug is needed in order to get the desired effect or to achieve intoxication or a high. Someone who does not usually drink alcohol may become intoxicated from two drinks, while someone who has developed a tolerance to alcohol may need to drink twelve beers in order to get "drunk." Withdrawal occurs when the user's body has adapted to the drug or alcohol. When the individual suffers some physical withdrawal symptoms, it is because he/she is not putting the drug or alcohol into his/her body.
Alcohol or drugs can contribute to many physical illnesses. They affect every organ and system of the body. (See outline of these effects for each drug category elsewhere in this book.) Chronic use of alcohol or drugs interferes with the function of the immune system and can contribute to complications in immune system illnesses such as HIV/AIDS, even causing progression of such diseases. Intravenous drug users can spread many diseases, such as HIV, hepatitis, etc., via needles. While under the influence, poor judgment or blackouts can lead an individual to have unprotected sexual intercourse, which contributes to the spread of sexually transmitted diseases.
Poor physical appearance is apparent in users of alcohol and drugs. This is due in part to their attitude. People who are under the influence of alcohol or drugs often have amotivational syndrome, as previously discussed. They often don't care about their appearance or personal hygiene. They may not shower or brush their teeth regularly, or seek preventative health care from a physician or dentist. Users may wear certain clothes, hairstyles or makeup that helps them to fit in with the drug culture. Another way that drugs and alcohol affect appearance is the toll they take on the body. Drugs and alcohol are toxins that have a very negative effect on a person's physical health. They affect all the major organs of the body, including the skin, eyes, etc. The dehydrating effect of alcohol and drugs makes the skin wrinkle and sag more quickly, thus making a person appear older than his/her chronological age. Other physical effects include fixed or dilated pupils, bloodshot eyes, flushed face, etc. Physical ailments, DUI auto accidents and fights often prove fatal to chemically dependent users.
Emotionally
The emotional effects of substance abuse include irritability, anger, aggression, stubbornness, defiance, loneliness, isolation, depression, anxiety, mood swings, personality changes, suicidal thoughts or attempts and homicidal thoughts or attempts.
Another term for drugs or alcohol is "mood-altering chemicals" (MACs). Substances are classified as mood altering because they have a significant effect on the user's emotional state. Some common effects include those listed above. Feeling "high" is an emotional state. Often, withdrawal symptoms effect emotions. Examples include irritability, agitation, or depression, which are symptoms of cocaine withdrawal. Emotional maturity is stunted when an individual begins to use alcohol or drugs. The drugs are used as a coping device for dealing with emotions such as anger, sadness, or disappointment; thus, the person never learns how to deal with these emotions in a mature manner. A user's age at the time he/she begins using is the point at which his/her emotional development stopped. This is why we often see 35-year-old chemically dependent people behaving like teenagers; they simply never learned how to deal with emotions in an adult manner.
Mood swings and drastic personality changes are common in a person using drugs. Someone who is normally a friendly person may become violent or have angry outbursts while under the influence of drugs or alcohol. We have often heard a family member describe the user as a totally different person when he/she is actively using. Feeling sick or experiencing withdrawal symptoms can lead a person into a mood change and an unpleasant demeanor. When an individual is experiencing these mood swings, feeling of depression may lead to suicidal thoughts or attempts.
Behaviorally
The behavioral effects of substance abuse include: loss of control, preoccupation with use, hiding or protecting the supply, using alone, illegal acts (such as stealing, prostitution, DUI, destructive behavior), or neglecting responsibilities.
Loss of control is part of chemical dependency. Even the first step of the Alcoholics Anonymous program states, "We came to believe that we were powerless over alcohol/drugs and that our lives had become unmanageable (AA Big Book, p. 59)." The individual may drink/use more than he/she originally intended or over a longer period of time than intended. The drugs/alcohol take over the user's life. This loss of control is linked with the preoccupation with use, neglecting responsibilities, and many negative consequences. A person's priorities may change and alcohol or drugs become the most important thing in their lives.
The mental effects of drugs and alcohol use generally lead to behavioral problems. When a lack of judgment is present, the individual makes poor decisions. It is common for a user to become involved in the legal system. Common legal charges include: DUI, DWI, theft, robbery, assault, solicitation (prostitution), possession of a controlled substance, underage consumption, disorderly conduct, resisting arrest, public intoxication, etc. Some users spend time in jail, in prison, on probation or parole. Other behavior problems include insubordination in employees, conduct problems in teenagers, frequent verbal and physical fights, acting inappropriately, and embarrassing self or others. Common behavioral signs of chemical dependency include: hiding a supply of drugs or alcohol, gulping drinks to get drunk quickly, using more than originally intended, using alone, or using early in the morning. With drugs that are smoked, early morning use is known as "wake and bake."
Financial problems, too, usually occur for a drug or alcohol user. Drug or alcohol use is an expensive habit. Users often spend large amounts of money on drugs or alcohol and, as their tolerance increases, more drugs are needed. The user's financial situation can also be affected by loss of a job, legal costs, fines, and paying for accidents or damages.
Spiritually
Spiritual effects of drug and alcohol use include: loss of meaning in life, violating one's value system, a negative or cynical attitude, dishonesty, hostility toward religion, or losing faith in one's previous religious beliefs.
Chemical dependency affects the person's spirit or their sense of self. A user often violates his/her own value system. Many of the previously discussed behaviors are violations of a person's morals. When a substance-induced personality change occurs, a person behaves in ways that he/she normally would not. Once a violation of values begins, the person may feel guilt or shame. Once the person feels guilty, he/she may drink/use more. This, in turn, may lead to more demoralizing behavior. This guilt and shame contributes to low self-esteem and low-self worth. The low self-image then may lead to more demoralizing behavior. This vicious cycle continues, often making the individual feel that life has no meaning. This, in turn, often leads to the person questioning his/her faith and rejecting God or religion. This spiritual downfall, coupled with amotivational syndrome (negative attitude) may lead to a lack of desire to live. Suicidal thoughts and attempts may occur. Unfortunately, sometimes they are successful.
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