The use of various substances to modify mood or behavior has
generally been regarded as acceptable in our society despite wide
cultural differences. Many people drink coffee or tea for stimulant
effects or engage in social drinking of alcohol. In addition, society
condones the use of certain drugs to use medically to relieve tension
or pain or even to suppress the appetite. When symptoms and
behavioral changes associated with the regular use of these substances
becomes maladaptive, however, substance use becomes substance abuse.
Common substance abuse is the misuse of alcohol and cigarettes which
are both legal. However, illegal drugs have also become a wide
spread problem. Alcohol and drug abuse combined affect approximately
twenty five million Americans. Very often a distinction is made
between substance abuse and substance dependence. Substance abuse
involves the inability to control the use of alcohol or other
drugs. The individual becomes intoxicated on a regular basis.
Usually daily, however, weekend or binge use is also common. Often,
the drug is often needed for normal functioning. In addition there
may be repeated attempts to stop using the drug, which fail. Even
though the individual knows that the use of the drug interferes with
family life, social relationships, etc. he or she is unable to stop.
Substance dependence victims on the other hand suffer all of the
symptoms of abuse plus an increasing tolerance for the drug. As a
result, increased amounts are necessary for the desired effect.
Alcohol, opiates, such as morphine, etc. lead to physical dependence
as well and the individual will develop withdrawal symptoms when
attempting to stop use of the drug.
Marijuana is perhaps the most common illicit drug in use in the
United States. It is estimated that at least sixty two million
Americans have at least tried marijuana once in their lives.
Marijuana is typically used in combination with other substances,
particularly alcohol. One out of four young adults who admit to
marijuana use indicate that they had drank alcohol at the same time.
Cigarette smoking by teenagers is another pattern strongly related to
marijuana smoking. Young adolescents aged fifteen to seventeen who
are cigarette smokers are five times more likely to use marijuana.
The most common problems with marijuana use is a tendency to graduate
to stronger drugs. Marijuana seems to have the effect of inducing
the individual to want a stronger, more potent "high". This is why
many individuals may use marijuana and alcohol in combination and why
heavy marijuana users very often go on to stronger drugs. In one
study 71% of individuals who used marijuana 100 or more times have
In commonly used dosage marijuana impairs short term memory,
concentration, judgement, and information processing skills. If
marijuana use is discontinued memory loss can continue for three to
six months. Immediately after smoking marijuana the heart beat
accelerates, causing a threat to those with abnormal cardiovascular
conditions. Long term consequence of long term marijuana use,
especially by children and adolescents, is sometimes termed the
"Amotivational Syndrome" and included apathy, loss of ambition and
effectiveness, diminished ability to carry out long term plans,
difficulty in concentrating, and a marked decline in school or work
performance. In animals marijuana has also been shown to interfere
with the body's immune response to certain infections and diseases,
however, significance with human beings is still under investigation.
Marijuana does have some serious reproductive effects, however. In
studies on women who use marijuana during pregnancy there is a very
definite threat to newborn babies in terms of birth defects.
While it has long been held that marijuana does not cause physical
addiction in the same since as Opiates, or Cocaine, it can cause very
severe physical, and psychological dependence which can have
disastrous effects. Marijuana use, in addition to showing a tendency
toward increased use of more potent drugs, can impair judgement, and
lead to other risky behaviors. Sexual risks for example could lead to
exposure to AIDS for example. In addition, driving is also impaired by
marijuana intoxication. In addition, in individuals who do not
progress to stronger drugs, there is an increased tendency to use
marijuana in combination with alcohol which can lead to alcoholism.
Marijuana does not seem to produce the physical withdrawal
symptoms that are present with other drugs. It can cause very strong
psychological dependence, however, and recovery can be difficult,
especially for daily users. Usually, there is some discomfort
experienced by the chronic user which leads to irritability, and a very
strong need to continue using the drug. Usually, this craving for the
drug will diminish about one week after the individual ceases it's
use; although, traces of marijuana can remain in the blood for up to
30 days after cessation. In addition, those with a daily pattern of
use may also feel somewhat groggy, and spacy for sometime after
discontinuing the drug. Daily users often begin to become more aware
of the effects of the drug when they attempt to stop. Memory lapses,
difficulty concentrating, etc., may not be more pronounced but will
become more noticeable after cessation. Residential treatment, while
not always necessary, may be needed in severe cases, and especially if
marijuana is being used with alcohol or other more addictive drugs.
The first step in treatment is admission by the abuser that he or she
has a problem. This is often the biggest obstacle to treatment.
Denial is a very powerful force with drug abusers. If denial
persists, it may be necessary for the family to take serious steps to
force a loved one into treatment. Many professional therapists
recommend a method called a family action intervention. After
several meetings with an experienced drug counselor, psychologist or,
social worker, the family confronts the user. Each member openly
communicates how the users behavior has effected him or her
personally. This at times can become very emotional, and the user is
forced to confront the effects of his or her substance abuse. While
family members are normally present, other participants in the
intervention can include: friends, and co-workers. During the actual
confrontation, the user made to choose between them, and their
continued use of the drug. The intervention is intended to catch the
addict of guard, and to over come the denial. A crucial part of the
program is presenting treatment alternatives that can be started
immediately after the intervention meeting.
If residential treatment is necessary the standard stay is 28
days. Initially the individual goes through detoxification, which is
the process of ridding the body of the drug. This can take several
days. Very often antidepressant drugs are needed to relieve the
depression and associated cravings, which accompany the withdrawal.
The goal of the treatment is to improve the user's self-image, and to
promote healthful, drug free living. Continued strength and support
by family members is also crucial to a recovering individual. It is
also important for the addict to continue outpatient treatment, and to
become involved with a self help group on a regular basis, such as
Alcoholics Anonymous, Narcotics Anonymous, or Cocaine Anonymous.
Professional support from these organizations is also available to
family members, who very often themselves need therapy to help deal
with the consequences of the addict's behavior. For more information,
the National Institute on Drug Abuse can be contacted at 1-800-662-