Have you wondered if your substance use is problematic or if you're at risk for addiction?
With the additional stress from the COVID-19 pandemic, more and more people have turned to substances to help cope with their emotions. Are you concerned about your substance use, or wondering if you're at risk for addiction? In this episode, we discuss how substance use affects you so that you can make informed decisions and seek help if necessary.
Savvy Psychologist is hosted by Dr. Monica Johnson. A transcript is available at Simplecast.
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Have you wondered if your substance use is problematic or if you’re at risk of addiction?
Welcome back to Savvy Psychologist, I'm your host, Dr. Monica Johnson. Every week on this show, I'll help you face life's challenges with evidence-based approaches, a sympathetic ear, and zero judgment.
I’ve had several listener questions and comments related to substance use recently. Many people have noticed shifts in their use since the start of the pandemic—and with good reason. According to the Centers for Disease Control and Prevention, as of June 2020, 13% of Americans reported starting or increasing substance use to cope with stress or emotions related to COVID-19. In addition, nearly 100,000 people died of an overdose in the first year of the pandemic, which was an increase of 29% from the previous year. It’s also important to note that 75% of those deaths involved synthetic opioids.
All of these data points are me saying—your concerns are valid! There were many people who had questionable use before the pandemic that has worsened, as well as folks who barely used that now use on a regular basis. It’s important for you to understand some concepts related to substance use and its effects so you can make informed decisions for yourself and seek help if necessary.
The first thing to note is that when I speak about drugs, I am speaking about both illegal and legal substances. Obviously, the consequences of caffeine are different from the consequences of meth, but you can become dependent on both of these substances.
Legal drugs are usually caffeine, nicotine, alcohol, and, in some states, marijuana. There are also opiates which aren’t illegal when prescribed by and taken as directed by medical doctors.
It’s not uncommon to experiment with drugs. In fact, it’s estimated that 20% of people have tried an illicit drug of some kind (e.g. meth, marijuana, cocaine, or opiates). But depending on your biology and family history, as well as the addiction potential of the substance you’re trying, you may have a different susceptibility to addiction. More on that in a bit.
The definition of an addictive drug is one that stimulates the mesolimbic pathway. There are 3 general rules in psychopharmacology that apply to all drugs:
This is important to understand in terms of misuse and/or addiction. Because the brain's response to a drug is always to facilitate the opposite state, a person who engages in regular use has to take the drug in order to feel normal.
You also have to understand how the drugs get to the brain and the routes of use because this will play a role in addiction. Two terms to know are pharmacodynamics and pharmacokinetics. Pharmacodynamics are the drug's effects on the body. Pharmacokinetics relate to the body’s effect on the drug—how it’s absorbed, distributed, metabolized, and excreted from the body.
There are many routes of use and some are more dangerous than others. You may have known some people who struggled with substance use in your life or maybe you yourself have struggled and seen the progression over time. For instance, some patients I’ve worked with have said to me “I’ll never shoot up,” because they recognize how dangerous it is, but I’m getting a little ahead of myself. Let’s first review the different routes of use:
Inhalation: This is the quickest route to the brain and usually takes about 7-10 seconds.
Mucous membrane absorption:Takes about 10-15 minutes and includes snorting through the nose, under the tongue, between the cheek, rectum or vagina, and eyeball.
Oral ingestion: Takes about 20-30 minutes and the drug is absorbed by the stomach or small intestine.
Contact absorption: This method can take up to 2 days to reach full effect and relies on passive absorption through the skin.
Injection: This is the most dangerous method because it bypasses all of your body’s natural defenses. The time varies based on the type of injection—intravenously takes about 15-30 seconds, intramuscular and subcutaneous injection is 3-5 minutes.
When we talk about a drug metabolizing, what we are talking about is the process of the drug being broken down and inactivated. For many drugs, this process is done through the liver. You should thank your liver—it does a hard job. However, you should also give your liver a break if you’ve been using a lot because again, it does a hard job. Metabolism varies by the individual. I will talk about a few of the elements that come into play.
The first is age. Metabolism usually slows down with age, thus the older the person, the greater the effect. Have you ever had a conversation with your friends about how when you were 22, you could go to Vegas and drink for 3 days straight, but now you get a hangover from a glass of wine? Age plays a factor!
The second is ethnicity. Enzyme levels differ among various groups. For example, some Asian folks have an alcohol intolerance. Other factors are your biological sex and your heredity. What is your family history? Does addiction run in your family? It’s prevalent in more families than many are willing to admit—especially if they are “functional.” A lot of people will ignore the fact that Uncle Frank puts gin in his morning coffee as long as he can make it through a work day.
Your overall health and your emotional state will also play a role. Yes, your emotions can impact how a drug affects you! Emotions can exaggerate the effects of a drug. This is another reason why you want to be mindful of why and when you use substances. I noted earlier that many during the pandemic have been using substances to cope with depression and anxiety and I am here to tell you that doesn’t work! When you are depressed and you drink to mask it, you now have two problems to solve. There is a symbiosis that occurs between drugs and other mental health problems and they will combine their forces against you.
Next week, I’ll review common substances that people may use or overuse and what to watch out for to avoid your own use turning into misuse or addiction.
What substances would you like to hear me talk about? Let me know on Instagram @kindmindpsych. You can also reach out to me via my email at psychologist@quickanddirtytips.com, or leave a voicemail at (929) 256-2191.