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Drug Use and Addiction Explained

A drug is any substance which, when consumed, causes a physiological and/or psychological change in the person consuming it. Drugs come in a huge variety of types and forms, and may be taken for various purposes, including medicinal and recreational ones; some, however, are habit-forming, and their use over time can lead to dependence and addiction, with catastrophic consequences for the user.

Substance consumption, in this case, may mean eating/drinking, but also: inhaling, injecting, smoking, dissolving under the tongue, and absorbing either via a patch on the skin, rectally or vaginally.

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Drug Addiction Explained

Addiction is a much-misunderstood concept, with a different aspect of the condition often been confused and conflated by the general public. Strictly speaking, addiction is a disorder of the brain’s reward system in which an individual engages compulsively in certain behaviours – such as the consumption of drugs or continuous gambling – despite the awareness that doing so may have negative consequences.

Addiction is often used to refer to more specific concepts such as dependence, tolerance, substance abuse and compulsion, which may all play a role in addiction but which are distinct phenomena in themselves.

The Psychology of Drug Addiction

There are numerous different psychological interpretations of drug addiction, and it is safe to say that the neuropsychology of addiction is still not an exact science: the human psyche is incredibly complex, and each case of addiction is unique. Nevertheless, most psychologists agree that addiction is fundamentally a behavioural issue: the repeated engagement in specific behaviours regardless of the ramifications of doing so.

The reasons why someone may come to engage in those behaviours, and to repeat them to the point of developing an addiction, are extremely complex and may vary greatly from one person to the next. While numerous risk factors have been identified, we are still not yet certain why one person may develop an addiction while another, in very similar circumstances, may not. However, because of the behavioural foundation of addiction, much of the treatment of addiction is founded upon therapy, aiming to help the affected individual unlearn and avoid the behaviours which have resulted in addiction.

Neurochemistry of Drug Addiction

In neurochemical terms, addiction is a disorder of the reward system in the brain, which is the part of us thatdrives pleasurable behaviours such as eating and sex. Behaviours which we see as pleasurable – for example, taking drugs – may not be good for us, but the reward centre may disregard any negative consequences and drive further engagement in those behaviours. This may happen via the action of chemicals such as dopamine, whose function is seen as crucial to the development of addiction. Thus, it is creating feelings of enjoyment and satisfaction when we engage in them, and negative feelings such as irritation and dissatisfaction when we do not.

Addiction is also associated with activity in the amygdala, the part of the brain associated with emotion and memory. Positive memories – such as memories of enjoying drug-taking – can act as prompts to repeat the behaviours which caused them, leading to further engagement in activities which may feel good at the time but which may have very negative consequences down the line. Along with these factors, some drugs also drive a condition known as dependence.

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Difference between drug addiction, drug physical dependence, and drug tolerance

Addiction, dependence and tolerance are three closely related phenomena and are often conflated in many people’s minds.

Addiction is a primarily psychological condition resulting from a disorder of the brain’s reward system, while dependence is a primarily physiological issue occurring when an individual’s system becomes reliant upon the presence of a given substance to function normally. When dependent, our brains and bodies have adjusted to the presence of a specific substance (or substances) and have incorporated it into normal function. If someone dependent upon the substance ceases to take, their system may go into a period of abnormal functioning while it readjusts to the absence of the substance. This can manifest in various potentially unpleasant and dangerous symptoms collectively known as withdrawal syndrome.

Tolerance, like dependence, occurs when a substance is consumed over time, and the system of the person consuming it adjusts to its presence. This adjustment means that more and more of the same substance is required to produce the desired effects, because the person has become tolerant.

When someone is taking a drug to achieve certain effects, for example, a pleasurable “high”, has become tolerant to that drug, then they need to take greater quantities of it than they previously did. This can drive the acceleration of dependence and addiction, and can have serious ramifications for physical and mental health, as well as for life prospects and circumstances.

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Difference between drug use and drug abuse

Not all drug consumption is necessarily harmful, and not all drug use constitutes abuse. Taking medicine, for example, in ways recommended by a doctor, would technically be “using” drugs, as would the occasional non-problematic recreational use of other substances.

Drug abuse, however, occurs when someone takes drugs either in quantities or via methods not recommended by a doctor, or uses them in any other way which could be seen to be harmful to themselves or others. This includes the consumption of drugs as a result of dependence and addiction, as such consumption helps to perpetuate those conditions which is by definition detrimental to the addict.

Classes of Drugs and Controlled Substances

In the United Kingdom, drugs are classified legally in a number of different ways. The most important legislation governing the treatment of drugs deemed illegal is the Misuse of Drugs Act 1971 [1], dividing many substances into three categories:

  • Class A, for those drugs deemed the most dangerous;
  • Class B, the drugs deemed less dangerous but still posing a significant risk;
  • Class C, drugs deemed to pose the least capacity for harm but which still require a degree of government control.

Drugs falling into these three classes are known as “controlled drugs” or “controlled substances” and may be illegal to possess under any circumstances. Some, however, may be legal to possess if prescribed by a qualified authority.

Alongside these three classes, drugs also divided into five “schedules” under the Misuse of Drugs Regulations 2001 [2]. These schedules grade drugs according to their medicinal value, ranging from Schedule 1 (research value only) down to Schedule 5 (very common medicinal usage).

The penalties for possession and supply of controlled substances vary from one class to another. For class A drugs, possession can lead to an unlimited fine and imprisonment of up to seven years, while supply and possession with intent to supply can result in an unlimited fine and a life sentence. For class B drugs, the figures are an unlimited fine and five years’ imprisonment for possession, and an unlimited fine and 14 years’ imprisonment for supply and possession with intent to supply. For class C drugs, the penalties are two years’ imprisonment and an unlimited fine, and 14 years’ imprisonment and an unlimited fine respectively.

Many drugs – including many household medications – do not come into any of the three categories, and are typically available in shops. Some substances, including alcohol and nicotine, are governed by separate regulations and are not classed as controlled substances despite being controlled by law.

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Routes of Drug Administration

The ways in which drugs are consumed vary significantly, depending on the nature and form of the drug in question. The most common methods include smoking, inhaling, snorting, and eating/drinking. Other substances may be injected, absorbed through the skin, taken rectally or vaginally, or absorbed under the tongue.

Risk Factors for Drug Abuse

What specifically drives one person to abuse drugs while another has not yet been completely established by medical science, and research into the nature of and links between different environmental, genetic, and epigenetic factors is ongoing. However, a number of prominent risk factors have been identified.

Genetic factors

While it is too much to say that addiction and substance abuse are entirely inherited conditions, a family history of drug abuse is a significant indicator of the likelihood that an individual will themselves go on to abuse drugs and struggle with addiction. Similarly, a family history of mental health issues is also known to be a major risk factor. Genetics may also play a part in how effectively certain substances are metabolised, and therefore how strongly their effects are felt, which may impact on future substance abuse decisions.

Environmental factors

Environmental factors known to influence substance abuse and the likelihood of addiction include: associating with a peer group in which substance abuse is common, exposure during childhood and adolescence to substance abuse in the home, ease of access to substances of abuse, the experience of trauma and/or life challenges, poverty, stress, cultural factors and discrimination.

The Stages of Drug Use and Abuse

It is important to recognise that every individual’s story and journey through substance abuse and addiction is unique, and there is no single roadmap which can be applied to every case. Some people experiment with drugs and never go on to abuse them while others fall into a full-blown addiction. Nevertheless, a few key stages may be identified.

  • Initial exposure/experimentation: first contact with a substance of abuse and the experience of its effects.
  • Repetition: engaging in repeated consumption of the substance, and increasing the awareness of and understanding of its effects.
  • Habituation: allowing the abuse of the substance in question to become a regular part of life, and devoting an increasing amount of time and resources to it.
  • Addiction: having the abuse of the substance in question take a dominant role in life, with potentially significant consequences to physical and mental health, life circumstances and life prospects; being unable to stop taking the substance.
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Recreational Drug Use and Misuse

When people talk about “taking drugs”, they usually refer to illegal substances. People take illegal substances for a huge variety of reasons, but the most common is simple recreation: the enjoyment of drug-taking as a pastime. Though frowned upon socially, occasional recreational drug use may not be physically harmful beyond its potential social and criminal consequences. However, it often spirals into misuse and subsequently into addiction and dependence.

It is also important to note that many substances can be dangerous by themselves even in the absence of addiction.

Overdoses kill many people each year, while some people are allergic to certain drugs without knowing it and suffer potentially fatal reactions when taking drugs for the first time.

Prescription Drugs and Dependence

Just because a drug is prescribed by a doctor does not mean that it is entirely safe: many medicines have a high dependence liability, meaning that taking them over time is likely to lead to the development of dependence and addiction. If you are prescribed any medicine, it is imperative that you always take it strictly in accordance with the instructions of the prescribing doctor, as well as any instructions on the packaging.

Co-Occurring Disorders: Mental Health Issues & Drug Addiction

Drug addiction and substance abuse have a complicated relationship with mental health: they are often a consequence of mental health issues, as people struggling with such issues self-medicate with drugs and/or use them to escape the unpleasant reality of their life circumstances. On the other hand, substance abuse and drug addiction can often cause mental health issues due to their physical impact upon the brain and the consequences for the quality of life and life prospects of addiction.

When a substance use disorder occurs alongside a mental health issue, is known as dual diagnosis. Treating such comorbid disorders is typically significantly more complicated than treating either addiction or the mental health issue by itself. Specialist care, typically involving behavioural therapy, is usually required.

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How Drug Abuse Changes the Brain

Drug abuse can have a wide variety of effects upon the brain. Alongside the development of dependence and tolerance, different drugs can affect the brain in different ways. For example, some can cause permanent brain damage after prolonged use, while others lead to long-term or permanent behavioural change.

If you are concerned about the effect that drug abuse is having or may have had upon your brain, speak with a GP and/or an addiction specialist about your situation and history of substance abuse. In general, however, you should assume that any form of substance use has the potential to cause permanent changes to your brain.

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Different Types of Drugs

A huge variety of drugs are consumed by people around the world for many different reasons. Some of the most popular drugs and drug groups taken recreationally in the UK include:

Hallucinogens: a hallucinogen is a drug which causes hallucinations, altered perceptions, and changes in thoughts, feelings and consciousness. Hallucinogens are typically divided into psychedelics, dissociatives, and deliriants; different substances in these different groups come in different forms and can have very different effects. Some of the most frequently encountered hallucinogens feature in the list below.
Inhalants: inhalants are a range of chemicals, of both household and industrial use, whose vapours can be inhaled to produce an intoxicating “high”. Some of the most frequently encountered inhalants include nail polish remover, glue, paint thinner, and amyl nitrate (“poppers”). Inhalants can cause various serious health issues including brain damage and death from hypoxia or cardiac arrest.
Heroin: one of the most notorious illegal drugs, heroin is an opiatederived from the opium poppy and an opioid. It typically comes in the form of a brown powder, which is usually either smoked, injected or snorted for its euphoric effects. Heroin is highly addictive, and is one of the most dangerous drugs in terms of its potential to cause a fatal overdose.
Methamphetamine/Meth/Crystal meth/Ice: methamphetamine is a potent stimulant of the central nervous system, commonly found in either powder or crystal form and either snorted, ingested, smoked or injected for its extremely euphoric and stimulant properties. It is highly addictive and has a high potential for overdose.
LSD/Acid: LSD – lysergic acid diethylamide – is a very strong hallucinogen typically causing very vivid visual and auditory hallucinations. Usually found in liquid form or soaked into blotter paper doses, acid is not typically thought to be habit-forming, and no fatalities have ever been attributed directly to an LSD overdose. However, numerous deaths resulting from altered behaviours have resulted from LSD use, and even one single experience of LSD consumption can result in permanent psychological damage and behavioural change.
Mephedrone: usually found in the form of a white powder, and swallowed, snorted or injected, mephedrone is a synthetic stimulant in the amphetamine and cathinone classes, producing stimulant and euphoric effects. Because of its relative newness (only reaching mainstream use this millennium) the long-term effects of mephedrone consumption are still not known, though it has been proven to be a factor in numerous deaths and is suspected to be strongly habit-forming.
PCP/Angel dust: phencyclidine, also known as PCP, is a dissociative hallucinogen renowned for causing extreme distortions of reality and for provoking violent behaviour in users. Normally available in powder form it is usually smoked, but can be ingested, injected or snorted. PCP is known to be habit-forming, and large doses can result in overdose featuring seizures which could be fatal.
Antidepressants: antidepressants are a range of medications used in the treatment of depression, typically available on prescription in tablet form. Rarely abused recreationally, many antidepressants nevertheless can be habit-forming, with serious withdrawal symptoms resulting from cessation of use. Moreover, antidepressant tablets are sometimes used in instances of intentional overdose.
Ketamine: ketamine is a strong anaesthetic with dissociative hallucinogenic properties, typically found in white powder form for snorting, but also available as a liquid and delivered by intravenous injection. It is known to be habit-forming, and an overdose can be fatal.
Amphetamines: amphetamines are a class of drugs based on the structure of amphetamine, which have various properties including stimulant, empathogenic and hallucinogenic effects. Amphetamines come in a wide variety of forms and may be taken in many different ways. Examples of amphetamines include amphetamine itself, methamphetamine and ecstasy.
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Cannabinoids: cannabinoids are a range of substances which act upon cannabinoid receptors in the brain, the most well-known of which is tetrahydrocannabinol (THC), the main psychoactive compound found in cannabis. A range of cannabinoids, including synthetic versions, are now available for recreational use, some with wildly different properties from those of cannabis itself. Some cannabinoids are known to be extremely habit-forming and can have very deleterious effects upon mind and body.
Cannabis/Marijuana: the most frequently consumed illegal drug, cannabis is a drug found in the cannabis plant, comprising tetrahydrocannabinol (THC) and at least 65 cannabinoids. Cannabis is usually smoked, though can be vaporised and ingested; it creates a euphoric and relaxing “high” in the user, but has the potential to cause a range of physical and mental health issues. Known to be mildly habit-forming, cannabis is not known to have a noteworthy overdose potential.
Crack cocaine: a very potent smokable form of cocaine, crack typically comes in crystalline “rock” form, and provides a very intense but short-lived high which leaves users craving more very quickly. Known to pose a large number of physical and mental health risks, crack is even more addictive than cocaine and is usually classed alongside heroin as one of the most destructive drugs commonly available in the UK.
DMT: DMT – more properly N,N-Dimethyltryptamine – is a substance that occurs naturally in many plants and animals, which has strong psychedelic properties and has been used by many cultures for ritual purposes. Most commonly smoked, DMT can also be inhaled, injected, vaporised and ingested, and creates an intense and vivid “high” which is interpreted by many people as having spiritual qualities. DMT is not known to be addictive, and no fatal overdoses of DMT have been recorded.
GHB: gamma-hydroxybutyric acid is a neurotransmitter occurring naturally in the brain, which is also taken as a recreational psychoactive drug, usually available in powder or liquid form for snorting, swallowing or injecting. It has euphoric, aphrodisiac and empathogenic qualities, and is not known to be addictive, but is considered dangerous especially when taken in conjunction with alcohol; GHB overdoses can be fatal.
Sedatives: “sedative” refers to any of a huge number of drugs with tranquilising and calming properties, acting on the brain in various ways (though most commonly affecting the GABA neurotransmitter). Sedatives include some of the most commonly prescribed drugs, as well as many of the most commonly used recreational substances; alcohol, benzodiazepines and opioids can all be classed as sedatives.

Cocaine: a strong stimulant derived from the coca plant, cocaine usually comes in white powder form for snorting, but can also be ingested, smoked and injected. Cocaine has a strong euphoric, stimulant and aphrodisiac effect, though poses a variety of health risks, some of which can be fatal; it is one of the most addictive illegal drugs.

Depressants: a depressant is any drug that lowers levels of neurotransmission in the brain, thus reducing levels of arousal and stimulation. Depressants come in many different forms, including alcohol, opioids, benzodiazepines and barbiturates.

Ecstasy/MDMA: the archetypal “club drug”, ecstasy (methylenedioxymethamphetamine) is a psychoactive stimulant which creates a strong euphoric and empathogenic “high” in the user. Usually available in tablet or crystal form, ecstasy is one of the most commonly consumed drugs in the UK, and is not considered especially addictive, though has been a factor in numerous deaths and is associated with various physical and mental health risks.

Polydrug use

Polydrug use” refers to the consumption of two or more different drugs together. Users often take a variety of drugs to experience different effects, but the combination of psychoactive drugs can have dangerous consequences, including significantly increasing their potency and thus increasing the likelihood of overdose.

Smart drugs and designer drugs:

In recent decades, a great deal of research – both licit and illicit – has gone into developing new psychoactive chemicals, and a broad range of new drugs has reached the market in the last 20 years. These so-called “smart drugs” or “designer drugs” come in many different forms and have wildly differing effects, and their natures (and associated risks) are frequently very poorly understood. In the UK, the Psychoactive Substances Act 2016 [3] effectively imposed a blanket ban upon so-called “new psychoactive substances” (NPS). This means that what were formerly known as “legal highs” are now illegal to possess and/or supply.

Signs and Symptoms of Drug Use

Drug use can have many signs, varying from one specific substance to another. While it is important to recognise that the signs may not themselves be evidence of drug use or addiction, and could have other causes, some of the most prominent symptoms of drug use include:

  • behavioural changes
  • mood swings
  • withdrawal and isolation
  • loss of interest in personal hygiene and appearance
  • loss of interest in previously enjoyed activities
  • changed sleeping habits
  • changed eating habits
  • financial difficulties
  • problems at work or in education
  • changes in sex drive and sexual interests
  • health problems related to substance abuse
  • frequent flu-like symptoms
  • frequent red eyes
  • dilated pupils
  • unusual sweating
  • depression
  • paranoia
  • excitability
  • delusions
  • clenching and grinding teeth
  • frequent nausea
  • itching and scratching
  • frequent intoxication
  • changes in peer group
  • changes in vocabulary
  • furtive and/or secretive behaviour
  • deceitful and/or manipulative behaviour

Consequences and Health Damage Caused by Drug Addiction

The health risks of substance abuse can depend very significantly upon the specific substance being abused. However, addiction generally can have serious consequences for the life circumstances and physical and mental health. Some of the most prominent include:

  • alienation from friends and family
  • decreased quality of life
  • financial woes
  • malnutrition
  • illness related to poor hygiene
  • depression
  • anxiety
  • psychosis
  • paranoia
  • behavioural change
  • engagement in criminal activity
  • loss of academic and/or professional opportunities
  • reputational damage
  • drug-specific long-term health risks
  • risk-taking
  • brain damage
  • anhedonia
  • sexual dysfunction
  • low self-esteem
  • homelessness
  • despair
  • suicidal ideation

Living With & Managing Life with Drug Addiction

It is possible to balance a drug addiction with maintaining an outwardly successful life. However, most people fail to do this successfully, and the consequences of addiction are almost always detrimental in the long term. If you are living with addiction and have so far managed to avoid serious negative consequences, there is no guarantee that the pressure and stress you are currently managing will stay at the same level and that you will continue to be as strong indefinitely. Contact your GP and/or an addiction specialist to discuss getting help for your condition.

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Helping Someone who is Taking Drugs

If someone you know is engaging in substance abuse, though your impulse may be to confront and try to help them, you may do more harm than good by doing so. Contact an addiction specialist to discuss how best you can help a drug user. Always remember to prioritise your safety and that of those around you.

How to Prevent Teens Using Drugs

For various reasons teens and young people are especially susceptible to substance abuse and addiction. You may not be able to prevent them from engaging in substance use, but you can certainly educate them on the dangers of doing so. Try to ensure that recreational use never descends into abuse and addiction.

If you are worried about a teenager you know personally, speak with an addiction specialist who can give you advice based on your specific situation. Discuss their behaviours with other people who know them to make sure the changes in habits and/or health are not related to a known and logical reason (such as an illness).

Common Misconceptions about Drug Addiction

Addiction is a much-misunderstood concept, with a great deal of stigma attached to it. Some of the most common misconceptions about drug addiction include:

  • “Addiction is a choice people make.”
  • “Addiction is a result of laziness or selfishness.”
  • “If you’re holding down a job you can’t be an addict.”
  • “There’s a difference between being addicted to legal drugs and being an illegal drug addict.”
  • “Addicts are bad people.”
  • “Addicts can stop using drugs whenever they want; they just choose not to.”

Getting Help for Drug Addiction

Fortunately, there are now a great number of options, both NHS and private, for people struggling with addiction of all sorts. If you are an addict and are able to acknowledge your condition and reach out for help, speak with your GP and/or an addiction specialist as soon as possible to discuss treatment options which might be available to you.

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Types of Drug Addiction Treatment

Addiction treatment can be approached in many different ways, and different facilities and organisations offer different treatment regimes. Usually, treatment consists of two main phases: detoxification and withdrawal being the first and therapy as the second.

Drug addiction withdrawal and detox

Detoxification (“detox”) is a necessary first stage of treatment for anybody who has been using substances of abuse for any length of time. Their system needs to be cleansed of any such substances via a period of abstinence. During this detox period, anyone who has developed a substance dependence is likely to go through withdrawal, during which distressing and potentially dangerous symptoms may manifest. Because of this, detoxification should only ever be attempted with the help of medical professionals. Supervised detox can happen both in a medical environment (such as a rehab centre) or at home. Do not attempt to detox alone: it could be fatal.

Medications used in drug addiction treatment

Various medications are used in the treatment of addiction, though it is important to note that there is no single pharmaceutical cure for addiction. Medicines can be applied during detox and withdrawal, to alleviate withdrawal symptoms and increase patient safety:

  • prior to treatment, in the form of substitution or other drugs enabling tapering and/or encouraging abstinence;
  • after treatment to deal with lingering withdrawal symptoms and also to disincentivise relapse.

For information on specific medications which may be relevant to you, speak with your GP and all the doctors at any rehab you may be considering attending: don’t self-medicate.

Drug addiction treatment and rehab

Residential rehabilitation (“rehab”) provides a dedicated, secure and confidential environment in which addiction treatment can be provided. Rehab provides a holistic addiction treatment plan consisting of medically assisted and managed detox, followed by therapy in any of a great many forms (varying by institution), and other elements including dietary and fitness regimes. Rehab can be attended as an inpatient or on an outpatient basis.

Drug Addiction Support Groups in the UK

A range of support organisations operate across the UK, including Alcoholics Anonymous [4] and Narcotics Anonymous [5], providing help for addicts in recovery and those who want to be. Many support groups, including the two aforementioned, are free to attend, and attendance is often considered an important element of a recovery plan. For more information on support groups active in your area, speak with your GP and/or an addiction specialist.

Drug Statistics in the UK

  • In 2016, there were over 115,000 drug law offences committed in the UK.
  • There were 3,070 deaths from drug overdoses in the UK in 2015. [6]
  • There are currently over 330,000 high-risk opioid users in Britain. [7]
  • Approximately 11% of Britons aged 16 to 34 smoke cannabis.
  • Over 40% of those admitted for addiction treatment are users of heroin.
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Ready to get Help?

If you are suffering from an addiction you need professional help. However, only you can take the first step towards recovery by acknowledging your condition and reaching out for that help.

Help is out there: a good many facilities, both private and NHS-funded, now provide addiction treatment across the country. Don’t allow addiction to take away any more of your life: get in contact with your GP and/or an addiction specialist today to discuss the treatment options available to you

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Related FAQ’s

Why do people take drugs?
People take drugs for a great many reasons: recreationally, for medical purposes, in rituals and ceremonies, because of addiction and dependence, and many more.
What are the most addictive drugs?
Although each person’s susceptibility to addiction is different, and while it is very difficult to provide a robust methodology by which different levels of addictiveness may be measured, the most addictive drugs are usually considered to be heroin and other strong opioids, as well ascrack cocaine. However, that does not mean that other drugs are not potentially highly addictive.
Am I addicted to drugs?
As a rule of thumb, if you consider being addicted to drugs, you probably are recognising specific symptoms in yourself. This is often a valuable, and valid conclusion. If you worried about your drug use and believe you may have developed an addiction, you should speak with a GP and/or an addiction specialist to discuss your situation and ask about potential treatment.
What are the signs of drug use?
There are a great number of different signs which may be evidence of drug use and abuse – though they may also have other, less worrying causes. See the section “Signs and Symptoms of Drug Use” above for more details.
How do I stop taking drugs?
First and foremost, if you wish to stop taking drugs, you will have to take the first step: make an effort to stop your drug use, and if necessary, change your circumstances to avoid situations in which drug use might be likely. However, it may well be that you are unable to stop taking drugs even if you try, in which case you are suffering from a drug addiction and need to get professional help. Speak with your GP and/or an addiction specialist about your situation, and asked them what help might be available to you.

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