Addiction to substances such as alcohol, sleeping pills and painkillers, pain relievers and drugs is a common problem that sometimes goes unnoticed for a long time. This patient guide focuses primarily on issues related to heroin addiction.
Sometimes those around them notice changes in the person’s behavior. The problem may be revealed when you have overdosed or diagnosed with another disease, such as hepatitis or infection with HIV. If the person uses drugs by injection into a vein (intravenously), they are at risk of contamination by all kinds of bacteria and viruses, including when they use unsterile “dirty” needles.
At first, the consumer thinks he still has his consumption under control, but that can change quickly. Those around him may be the first to point out to him that there is a problem: because his behavior changes, that he no longer meets his social obligations (school, work, family) and that he spends too much time researching and consuming the substances.
In this case, it is important to seek help quickly: doctors, social workers, educators, psychologists, friends and family can be of considerable support. The desire to tackle the problem and the motivation promote withdrawal.
How to recognize it?
Drug dependence is often revealed by the simultaneous appearance of other physical illnesses or mental disorders.
Physical ailments
- Various forms ofhepatitis (especially C and B) are common among people who inject drugs. During the acute phase, yellowing of the eyes and skin (jaundice) may appear, accompanied by loss of appetite and weight loss.
- Infections usually develop at the injection sites, so in the folds of the elbow, on the hands and on the feet. They can range from local infection, with redness and swelling, to abscess formation or even contamination of the blood with inflammation of the inner lining of the heart (endocarditis).
- An overdose shows signs of damage to the nervous system, with damage to muscles and nerves. These problems can manifest as decreased strength, unsteadiness in gait, and symptoms of paralysis.
- Specific signs: Cannabis users often have red eyes and mucous membranes in the mouth; users of opiates (opioids) have very small pupils, almost like a tiny dot; and amphetamine users (speed, ecstasy, etc.) are often hyperactive and have fast beating hearts.
- In pregnant women with drug addiction, it is important to take into account the risks for the child, during pregnancy and after childbirth.
Psychic affections
- Drug use is also often associated with excessive consumption of alcohol. All of this can be accompanied by personality disorders, mood disorders (eg depression) and anxiety, for example.
- Chronic psychiatric disorders such as schizophrenia are more common in drug users than in others. The psychosis are also more common, especially delusions of persecution and hallucinations. Which means that people perceive things that are not there.
- Drug use also leads to sleep disturbances, which lead to the use of sleeping pills and sedatives. In turn, these can be addictive.
What tests will the doctor perform?
The doctor will always carry out a series of examinations to establish a correct picture of the consumer’s state of health. They will do a blood test to check the function of the liver and the possible presence of hepatitis or infection with HIV. A urinalysis may be done to identify the types of drugs that have been used.
What treatment will the doctor put in place?
It is of course essential to stop using drugs. This cessation can sometimes be achieved with the support of drugs that reduce withdrawal symptoms (withdrawal treatment). But this is usually not sufficient for users of opiates (such as heroin), for whom the doctor may temporarily prescribe substitution products (substitution treatment).
Depending on the results of the blood test, the consumer is also given a vaccine against hepatitis A and hepatitis B.
Withdrawal treatment
Stopping drug use leads to unpleasant withdrawal symptoms, which can be more or less controlled with medication. Medicines that are habit-forming and addictive, such as sedatives and sleeping pills (e.g. benzodiazepines), should be avoided. They may, however, be needed to treat extreme restlessness and insomnia. This is why the doctor will then opt for a drug with a short duration of action and for a short period of treatment of 3 to 5 days.
Severe psychosis and anxiety are treated with an antipsychotic. In case of depression, the doctor will prescribe an antidepressant. A rapid heartbeat caused by amphetamines is sometimes treated temporarily with a medicine that slows the heartbeat.
Withdrawal treatment usually lasts between 2 and 4 weeks. The doctor assesses whether the treatment can take place at home or whether a short admission to a detoxification center is necessary. It depends on the seriousness of the problem, the psychological distress or other simultaneous ailments, the age (minors are sometimes hospitalized under duress), legal factors and the wishes of the people concerned.
Substitution treatment
This type of treatment is mainly used for opioid addiction (especially heroin) or when withdrawal from other drugs fails with usual treatment.
When it is not possible to stop drug use suddenly, a substitute product is given temporarily. The goal is to break away from drug use by consuming another, less addictive product. It is actually a combination of withdrawal treatment and substitution treatment. The most widely used substitutes are buprenorphine and methadone. After a while, these products can also be gradually reduced until they are stopped.
The substitution treatment is prescribed by a doctor with specific skills in this area. The replacement product is dispensed by a permanent pharmacist.
Find out more ?
- Protecting yourself when using drugs – PPS – AIDS prevention platform
- Alcohol, Ecstasy, Speed, Internet, Cannabis, Cocaine, Sleeping pills or tranquilizers, Gambling, update on your consumption – Stop or else?
- Infor-Drogues – Another listen
- Benzodiazepines – CBIP – Belgian Center for Pharmacotherapeutic Information
- Antidepressants – CBIP – Belgian Center for Pharmacotherapeutic Information
- Antipsychotics – CBIP – Belgian Center for Pharmacotherapeutic Information
- Medicines for opioid dependence – CBIP – Belgian Center for Pharmacotherapeutic Information
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