Our Specialty

Drug & Alcohol Recovery Centers specializes in Residential Drug and Alcohol Treatment placement. We offer services to men and women ages 18 and up in need of Residential Treatment for substance addiction. We partner with exclusive programs around the country that offer comprehensive, holistic treatment experiences. When your life or the life of a loved one has been damaged by addiction, we work tirelessly to develop an immediate plan of action and a solution for long-term recovery. Our Evaluation and Benefits Verification services are completely free of charge. Make this your final phone call. We can help and we will.

Our Team

Our staff is comprised of compassionate, highly qualified individuals with experience in treatment placement. Our Intake Specialists are ready with open ears and open hearts to help find immediate solutions for you or your loved one. If you wish to use private insurance benefits toward the cost of treatment, we provide benefits verification through our Utilization Review department during your initial phone call. As advocates for individuals in need, we promise our unwavering attention and commitment through the entire process. Call Now And See Why We Were Voted #1 For Service And Excellence. Start your road to recovery today with our proven approach to getting help with addiction. 866-303-7878

Our Programs

The treatment approaches utilized by Drug & Alcohol Recovery Centers are built upon the Twelve Step philosophy, further enhanced by appropriate psychosocial therapy and holistic therapeutic modalities to support and enhance the recovery process. We partner with programs that give our clients the absolute best chance at long-term recovery through the use of comprehensive therapies. The process of recovery is a mind, body and soul experience, and should be treated as such.

Programs or treatment providers interested in becoming part of our preferred providers group should contact us for more information.

Drug & Alcohol Recovery Centers include the following:

  • Highly trained, multi-disciplinary staff
  • Medical and clinical coverage 24 hours a day, 7 days a week
  • Comprehensive treatment approach to treat the whole individual, not just the addiction
  • Private facility grounds with state-of-the-art amenities
  • Specialized programs with focuses on chemical dependency, trauma, co-occurring disorders,
    family dynamics and more
  • Relapse Prevention Track, emphasizing relapse dynamics and triggers
  • Extensive Continuing Care Plan
  • Specialized tracks for First Responders and other Professionals
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Drug addiction is a complex illness characterized by intense and, at times, uncontrollable drug craving, along with compulsive drug seeking and use that persist even in the face of devastating consequences. While the path to drug addiction begins with the voluntary act of taking drugs, over time a person's ability to choose not to do so becomes compromised, and seeking and consuming the drug becomes compulsive. This behavior results largely from the effects of prolonged drug exposure on brain functioning. Addiction is a brain disease that affects multiple brain circuits, including those involved in reward and motivation, learning and memory, and inhibitory control over behavior. Because drug abuse and addiction have so many dimensions and disrupt so many aspects of an individual's life, treatment is not simple. Effective treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences. Addiction treatment must help the individual stop using drugs, maintain a drug-free lifestyle, and achieve productive functioning in the family, at work, and in society. Because addiction is typically a chronic disease, people cannot simply stop using drugs for a few days and be cured. Most patients require long-term or repeated episodes of care to achieve the ultimate goal of sustained abstinence and recovery of their lives.

Too often, addiction goes untreated: According to SAMHSA's National Survey on Drug Use and Health (NSDUH), 23.2 million persons (9.4 percent of the U.S. population) aged 12 or older needed treatment for an illicit drug or alcohol use problem in 2007. Of these individuals, 2.4 million (10.4 percent of those who needed treatment) received treatment at a specialty facility (i.e., hospital, drug or alcohol rehabilitation or mental health center). Thus, 20.8 million persons (8.4 percent of the population aged 12 or older) needed treatment for an illicit drug or alcohol use problem but did not receive it. These estimates are similar to those in previous years.1

Principles of Effective Treatment

Scientific research since the mid–1970s shows that treatment can help patients addicted to drugs stop using, avoid relapse, and successfully recover their lives. Based on this research, key principles have emerged that should form the basis of any effective treatment programs:

•  Addiction is a complex but treatable disease that affects brain function and behavior.

•  No single treatment is appropriate for everyone.

•  Treatment needs to be readily available.

•  Effective treatment attends to multiple needs of the individual, not just his or her drug abuse.

•  Remaining in treatment for an adequate period of time is critical.

•  Counseling—individual and/or group—and other behavioral therapies are the most commonly used forms of drug abuse treatment.

•  Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.

•  An individual's treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.

•  Many drug–addicted individuals also have other mental disorders.

•  Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long–term drug abuse.

•  Treatment does not need to be voluntary to be effective.

•  Drug use during treatment must be monitored continuously, as lapses during treatment do occur.

•  Treatment programs should assess patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk–reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases.


Effective Treatment Approaches

Medication and behavioral therapy, especially when combined, are important elements of an overall therapeutic process that often begins with detoxification, followed by treatment and relapse prevention. Easing withdrawal symptoms can be important in the initiation of treatment; preventing relapse is necessary for maintaining its effects. And sometimes, as with other chronic conditions, episodes of relapse may require a return to prior treatment components. A continuum of care that includes a customized treatment regimen—addressing all aspects of an individual's life, including medical and mental health services—and follow–up options (e.g., community – or family-based recovery support systems) can be crucial to a person's success in achieving and maintaining a drug–free lifestyle.


Medications can be used to help with different aspects of the treatment process.

Withdrawal. Medications offer help in suppressing withdrawal symptoms during detoxification. However, medically assisted detoxification is not in itself "treatment"—it is only the first step in the treatment process. Patients who go through medically assisted withdrawal but do not receive any further treatment show drug abuse patterns similar to those who were never treated.

Treatment. Medications can be used to help reestablish normal brain function and to prevent relapse and diminish cravings. Currently, we have medications for opioids (heroin, morphine), tobacco (nicotine), and alcohol addiction and are developing others for treating stimulant (cocaine, methamphetamine) and cannabis (marijuana) addiction. Most people with severe addiction problems, however, are polydrug users (users of more than one drug) and will require treatment for all of the substances that they abuse.

•  Opioids: Methadone, buprenorphine and, for some individuals, naltrexone are effective medications for the treatment of opiate addiction. Acting on the same targets in the brain as heroin and morphine, methadone and buprenorphine suppress withdrawal symptoms and relieve cravings. Naltrexone works by blocking the effects of heroin or other opioids at their receptor sites and should only be used in patients who have already been detoxified. Because of compliance issues, naltrexone is not as widely used as the other medications. All medications help patients disengage from drug seeking and related criminal behavior and become more receptive to behavioral treatments.

•  Tobacco: A variety of formulations of nicotine replacement therapies now exist—including the patch, spray, gum, and lozenges—that are available over the counter. In addition, two prescription medications have been FDA–approved for tobacco addiction: bupropion and varenicline. They have different mechanisms of action in the brain, but both help prevent relapse in people trying to quit. Each of the above medications is recommended for use in combination with behavioral treatments, including group and individual therapies, as well as telephone quitlines.

•  Alcohol: Three medications have been FDA–approved for treating alcohol dependence: naltrexone, acamprosate, and disulfiram. A fourth, topiramate, is showing encouraging results in clinical trials. Naltrexone blocks opioid receptors that are involved in the rewarding effects of drinking and in the craving for alcohol. It reduces relapse to heavy drinking and is highly effective in some but not all patients—this is likely related to genetic differences. Acamprosate is thought to reduce symptoms of protracted withdrawal, such as insomnia, anxiety, restlessness, and dysphoria (an unpleasant or uncomfortable emotional state, such as depression, anxiety, or irritability). It may be more effective in patients with severe dependence. Disulfiram interferes with the degradation of alcohol, resulting in the accumulation of acetaldehyde, which, in turn, produces a very unpleasant reaction that includes flushing, nausea, and palpitations if the patient drinks alcohol. Compliance can be a problem, but among patients who are highly motivated, disulfiram can be very effective.


Behavioral Treatments

Behavioral treatments help patients engage in the treatment process, modify their attitudes and behaviors related to drug abuse, and increase healthy life skills. These treatments can also enhance the effectiveness of medications and help people stay in treatment longer. Treatment for drug abuse and addiction can be delivered in many different settings using a variety of behavioral approaches.

Outpatient behavioral treatment encompasses a wide variety of programs for patients who visit a clinic at regular intervals. Most of the programs involve individual or group drug counseling. Some programs also offer other forms of behavioral treatment such as—

•  Cognitive–behavioral therapy, which seeks to help patients recognize, avoid, and cope with the situations in which they are most likely to abuse drugs.

•  Multidimensional family therapy, which was developed for adolescents with drug abuse problems—as well as their families—addresses a range of influences on their drug abuse patterns and is designed to improve overall family functioning.

•  Motivational interviewing, which capitalizes on the readiness of individuals to change their behavior and enter treatment.

•  Motivational incentives (contingency management), which uses positive reinforcement to encourage abstinence from drugs.

Residential treatment programs can also be very effective, especially for those with more severe problems. For example, therapeutic communities (TCs) are highly structured programs in which patients remain at a residence, typically for 6 to 12 months. TCs differ from other treatment approaches principally in their use of the community—treatment staff and those in recovery—as a key agent of change to influence patient attitudes, perceptions, and behaviors associated with drug use. Patients in TCs may include those with relatively long histories of drug addiction, involvement in serious criminal activities, and seriously impaired social functioning. TCs are now also being designed to accommodate the needs of women who are pregnant or have children. The focus of the TC is on the resocialization of the patient to a drug-free, crime–free lifestyle.

Treatment Within the Criminal Justice System

Treatment in a criminal justice setting can succeed in preventing an offender's return to criminal behavior, particularly when treatment continues as the person transitions back into the community. Studies show that treatment does not need to be voluntary to be effective.







Other Information Sources

For more detailed information on treatment approaches for drug addiction and examples of specific programs proven effective through research, view NIDA's Principles of Drug Addiction Treatment: A Research-Based Guide (o en Español).

For information about treatment for drug abusers in the criminal justice system, view NIDA's Principles of Drug Abuse Treatment for Criminal Justice Populations: A Research-Based Guide.


Data is from the National Survey on Drug Use and Health (formerly known as the National Household Survey on Drug Abuse), which is an annual survey of Americans age 12 and older conducted by the Substance Abuse and Mental Health Services Administration. This survey is available online at www.samhsa.gov and from NIDA at 877-643-2644.  

Substance abuse, also known as drug abuse, is a patterned use of a substance (drug) in which the user consumes the substance in amounts or with methods neither approved nor supervised by medical professionals. Substance abuse/drug abuse is not limited to mood-altering or psycho-active drugs. If an activity is performed using the objects against the rules and policies of the matter (as in steroids for performance enhancement in sports), it is also called substance abuse. Therefore, mood-altering and psychoactive substances are not the only types of drugs abused. Using illicit drugs – narcotics, stimulants, depressants (sedatives), hallucinogens, cannabis, even glues and paints, are also considered to be classified as drug/substance abuse.[2] Substance abuse often includes problems with impulse control and impulsive behaviour.

The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts. The terms have a huge range of definitions related to taking a psychoactive drug or performance enhancing drug for a non-therapeutic or non-medical effect. All of these definitions imply a negative judgment of the drug use in question (compare with the term responsible drug use for alternative views). Some of the drugs most often associated with this term include alcohol, amphetamines, barbiturates, benzodiazepines (particularly temazepam, nimetazepam, and flunitrazepam), cocaine, methaqualone, and opioids. Use of these drugs may lead to criminal penalty in addition to possible physical, social, and psychological harm, both strongly depending on local jurisdiction.[3] There are many cases in which criminal or antisocial behavior occur when the person is under the influence of a drug. Long term personality changes in individuals may occur as well.[2] Other definitions of drug abuse fall into four main categories: public health definitions, mass communication and vernacular usage, medical definitions, and political and criminal justice definitions. Substance abuse is prevalent with an estimated 120 million users of hard drugs such as cocaine, heroin and other synthetic drugs.

Substance abuse is a form of substance-related disorder.

Despite it being legal, Alcohol should still be considered a drug and becoming addicted to this substance  is a very problematic and common side effect. Some of the most apparent signs of Alcohol addiction are excessive drinking, loss of control, increased tolerance, memory loss or “blacking out”, using to cope with emotions such as stress or sadness, physical dependence and/or cravings.

When a person loses control under the influence of Alcohol, this does not only mean unable to control ones actions but also is defined by the inability to control the amount of alcohol one consumes in a period of time. This can be a struggle with an alcoholic who may even be aware of a problem and vow to only have one or two drinks butby the end of a night for instance, will have consumed far more than the initial decided amount, losing control and unable to stop themselves.

Memory loss is something that can happen quiet frequently to an individual who is addicted to alcohol, whether they are combining alcohol with other drugs or simply or simply consuming well over their limit. You may have heard or said the phrase “I blacked out” or “I don’t remember what happened last night”. This is obviously an issue that should be addressed. Losing memory or blacking out can lead to unsafe activities such as unwanted sexual behavior, criminal acts and or driving under the influence.

Binge Drinking

A binge drinking may usually have restrained drinking habits, but when they drink, they don’t know how to hold back. Alternatively, someone may not necessarily set out to drink a lot, but may be unsure of their limits, which can result in drinking too much over a short period of time.

Alcohol Abuse

Can result in absence or impaired performance, neglect of responsibilities such as family, social or work obligations, legal issues resulting from criminal activities that would not otherwise have occurred if hadn’t been intoxicated. Individuals who abuse alcohol may continue to drink despite the knowledge that their drinking causes them recurrent and significant social, interpersonal, or legal problems.

Alcohol Dependence

Alcohol dependence is a chronic disease that is often progressive and fatal. An individual who is dependent upon alcohol typically uses it to avoid personal and social factors in his or her life. Although alcoholism tends to run in families, it is influenced by both genetic and environmental factors.

Alcohol Content:

Beer 2–6% alcohol
Cider 4–8% alcohol
Wine 8–20% alcohol
Tequila 40% alcohol
Rum 40% or more alcohol
Brandy 40% or more alcohol
Gin 40–47% alcohol
Whiskey 40–50% alcohol
Vodka 40–50% alcohol
Liqueurs 15–60% alcohol

Short-Term Affects of Alcohol:

bulletvomiting and memory loss
bulletInjury to yourself or others
bulletAlcohol poisoning


Long-Term Affects of Alcohol:

bulletPhysical and psychological dependence on alcohol
bulletSignificant damage to the brain and liver
bulletRisk of cancer of the mouth, throat or oesophagus
bulletPossible increased risk of neurological disorders, heart problems
bulletSexual problems (especially male impotency)
bulletRisk of emotional and mental health problems developing, such as depression and anxiety
bulletProblems at school, work and with relationships.

Alcohol Addiction Facts:

bulletApproximately 17% of men and 8% of women will be alcohol dependent in their lifetime.

bulletWomen metabolize alcohol slower than men and absorb alcohol in their bloodstream faster.

bulletA short-term consequence of drinking excessively can result in loss of consciousness, coma, or death, otherwise known as Alcohol Poisoning.

bulletWomen drinking regularly significantly increase their risk of liver damage over men even if they drink less.

bulletImpaired judgement from consuming alcohol can result to driving while under the influence, unintended sexual encounters, violence or other dangerous situations.

bulletAlcohol is the third largest cause of death in the United States, second only to heart disease and cancer.

bulletWomen can develop alcoholic liver disease after a shorter period of heavy drinking and at a lower level of daily drinking than men.

bulletMore alcoholic women die from cirrhosis than do alcoholic men.

bulletWomen experiencing sexual aggression were 9 times higher on heavy days of alcohol consumption compared with days of no alcohol consumption.

bulletThere is a greater incidence of alcohol misuse in women with eating disorders, especially bulimia, than in the general population.

bulletAlcoholism is considered a disease despite misconceptions it can be chronic that requires ongoing treatment to be managed.

Prescription drug abuse is rapidly growing at an alarming rate throughout the United States. Prescription drug abusers are not limited to street addicts. Abuse crosses demographic lines and affects all ages because sources of medications are diverse and difficult to control. Drugs are easily attained through a physician – or multiple physicians simultaneously – as there is no statewide tracking mechanism. Often, medications are prescribed for legitimate reasons but are later diverted to abusers.

There are three main classes of prescription drugs that typically lead to abuse:

-Opioids, such as Codeine, Oxycodone and Morphine – prescribed to treat pain.
-Central nervous system depressants, such as Benzodiazepines, Hypnotics and Barbiturates – used to treat anxiety and sleep disorders.
-Stimulants, such as Dextroamphetamine (Dexedrine and Adderall) and Methylphenidate (Ritalin® and Concerta) – used to treat narcolepsy, ADHD and obesity.

Signs of prescription drug addiction may include, but are not limited to, being in possession of prescription bottles from more than one doctor or from numerous pharmacies, seeking prescriptions from other doctors after their primary physician has refused, pills in plastic bags and mixing medications with other prescription medications or alcohol to increase the effect.

The most commonly prescribed drugs in the United States are pain killers and anti-anxiety medications. These are among the most widely abused prescription drugs. Detox from pain medications is done using alternative medications, and is not considered life threatening. Anxiety medication detox, however, can be life threatening, especially when these medications have been used with alcohol.

It is for these reasons that it is important to medically monitor our detox patients, in addition to providing the appropriate treatment.

Adderall is a mixture of four potent amphetamines — including those found in Dexedrine and Benzedrine. As a result, Adderall encourages to over-release the neurotransmitters (chemical messengers) known as dopamine and norepinephrine when the drug is used. These neurotransmitters are restrained from uptake, creating a flood of dopamine and norephinephrine in the brain. Adderall users then experience euphoria, heightened confidence, awakening and a better ability to concentrate as a result.

Signs of Adderall Addiction:

Adderall addicts experience a host of physical and mental symptoms. Physically, Adderall-addicted individuals will often experience rapid or irregular heartbeat (arrhythmia or tachycardia), panic attacks or hyperactivity. Chronic thirst and dangerous dehydration can also take place with continued Adderall abuse. Some users may experience a litany of digestive problems, including constipation, vomiting, nausea and stomach pains. Sleeping disorders are also common to Adderall-addicted individuals, including insomnia, hypersomnia,  and interrupted REM sleep. Other signs of Adderall addiction include migraine headaches, emotional disturbances such as depression and mood swings, weight loss and nightmares.


With more than 1,400 products that are potentially dangerous when inhaled, abusers access to these substances is made easy. Chemicals such as typewriter correction fluid, air conditioning coolant, gasoline, propane, felt tip markers, spray paint, air freshener, butane, cooking spray, paint, and glue. Most are common products that can be found in the home, garage, office, school or as close as the local convenience store.

Also referred to as huffing, sniffing, dusting or bagging, abusers use these drugs through the mouth or nose. Huffing is when a chemically soaked rag is held to the face or stuffed in the mouth and the substance is inhaled. Sniffing can be done directly from containers, plastic bags, clothing or rags saturated with a substance or from the product directly. With Bagging, substances are sprayed or deposited into a plastic or paper bag and the vapors are inhaled.


Marijuana is a mixture of dry shredded stems, leaves, seeds or flowers from the hemp plant. The active chemical in Marijuana is THC delta-9-tetrahydrocannabinol.

THC stimulates cells in the brain to release dopamine, creating euphoria. It also interferes with how information is processed in the hippocampus, which is part of the brain responsible for forming new memories.

Gamma Hydroxybutyrate also known as GHB is a rapidly acting central nervous system depressant. This a chemical has become a major cause of drug-related comas. GHB is produced in clandestine laboratories with no guarantee of quality or purity, making its effects less predictable and more difficult to diagnose. GHB when distributed is a light-colored powder that easily dissolves in liquids or as a pure liquid packaged in vials or small bottles.Liquid GHB, it is clear, odorless, tasteless, and almost undetectable when mixed in a drink. GHB is typically consumed by the capful or teaspoonful. The average dose is 1 to 5 grams and takes effect in 15 to 30 minutes, depending on the dosage and purity of the drug. Effects can last from three to six hours.

Side Effects of GHB

bulletLoss of peripheral vision
bulletUnconsciousness and coma
bulletLowered Blood Pressure
bulletSlowed heart rate
bulletRespiratory distress

Street terms for GHB:bulletCherry Meth
bulletLiquid X
bulletOrganic quaalude
bulletSalty water
bulletGeorgia home boy
bulletGreat hormones at bedtime
bulletGrievous bodily harm
bulletLiquid E
bulletLiquid Ecstasy

Public health definitions


Source: A Public Health Approach to Drug Control in Canada, Health Officers Council of British Columbia, 2005

Public health practitioners have attempted to look at drug abuse from a broader perspective than the individual, emphasizing the role of society, culture and availability. Rather than accepting the loaded terms alcohol or drug "abuse," many public health professionals have adopted phrases such as "substance and alcohol type problems" or "harmful/problematic use" of drugs.

The Health Officers Council of British Columbia — in their 2005 policy discussion paper, A Public Health Approach to Drug Control in Canada — has adopted a public health model of psychoactive substance use that challenges the simplistic black-and-white construction of the binary (or complementary) antonyms "use" vs. "abuse". This model explicitly recognizes a spectrum of use, ranging from beneficial use to chronic dependence (see diagram to the right).


Medical definitions

In the modern medical profession, the three most used diagnostic tools in the world, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM),the World Health Organization's International Statistical Classification of Diseases and ICRIS Medical organization Related Health Problems (ICD), no longer recognize 'drug abuse' as a current medical diagnosis. Instead, DSM has adopted substance abuse[4] as a blanket term to include drug abuse and other things. ICD refrains from using either substance abuse or drug abuse, instead using the term "harmful use" to cover physical or psychological harm to the user from use. Physical dependence, abuse of, and withdrawal from drugs and other miscellaneous substances is outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) ). Its section Substance dependence begins with:

Substance dependence When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed. Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped. These, along with Substance Abuse are considered Substance Use Disorders…


However, other definitions differ; they may entail psychological or physical dependence,[4] and may focus on treatment and prevention in terms of the social consequences of substance uses.


Drug misuse


Legal drugs are not necessarily safer. A study in 2010 asked drug-harm experts to rank various illegal and legal drugs. Alcohol was found to be the most dangerous by far.

Drug misuse is a term used commonly for prescription medications with clinical efficacy but abuse potential and known adverse effects linked to improper use, such as psychiatric medications with sedative, anxiolytic, analgesic, or stimulant properties. Prescription misuse has been variably and inconsistently defined based on drug prescription status, the uses that occur without a prescription, intentional use to achieve intoxicating effects, route of administration, co-ingestion with alcohol, and the presence or absence of abuse or dependence symptoms.[5][6] Tolerance relates to the pharmacological property of substances in which chronic use leads to a change in the central nervous system, meaning that more of the substance is needed in order to produce desired effects. Stopping or reducing the use of this substance would cause withdrawal symptoms to occur.[7]

The rate of prescription drug abuse is fast overtaking illegal drug abuse in the United States. According to the National Institute of Drug Abuse, 7 million people were taking prescription drugs for nonmedical use in 2010. Among 12th graders, prescription drug misuse is now second only to cannabis.[citation needed] "Nearly 1 in 12 high school seniors reported nonmedical use of Vicodin; 1 in 20 reported abuse of OxyContin."[8]

Avenues of obtaining prescription drugs for misuse are varied: sharing between family and friends, illegally buying medications at school or work, and often "doctor shopping" to find multiple physicians to prescribe the same medication, without knowledge of other prescribers.

Increasingly, law enforcement is holding physicians responsible for prescribing controlled substances without fully establishing patient controls, such as a patient "drug contract." Concerned physicians are educating themselves on how to identify medication-seeking behavior in their patients, and are becoming familiar with "red flags" that would alert them to potential prescription drug abuse.[9]


As a value judgment

Philip Jenkins points out that there are two issues with the term "drug abuse". First, what constitutes a "drug" is debatable. For instance, GHB, a naturally occurring substance in the central nervous system is considered a drug, and is illegal in many countries, while nicotine is not officially considered a drug in most countries. Second, the word "abuse" implies a recognized standard of use for any substance. Drinking an occasional glass of wine is considered acceptable in most Western countries, while drinking several bottles is seen as an abuse. Strict temperance advocates, which may or may not be religiously motivated, would see drinking even one glass as an abuse, and some groups even condemn caffeine use in any quantity. Similarly, adopting the view that any (recreational) use of marijuana or amphetamines constitutes drug abuse implies that we have already decided that the substance is harmful, even in minute quantities.[10]


Signs and symptoms

Depending on the actual compound, drug abuse including alcohol may lead to health problems, social problems, morbidity, injuries, unprotected sex, violence, deaths, motor vehicle accidents, homicides, suicides, physical dependence or psychological addiction.[11]

There is a high rate of suicide in alcoholics and other drug abusers. The reasons believed to cause the increased risk of suicide include the long-term abuse of alcohol and other drugs causing physiological distortion of brain chemistry as well as the social isolation. Another factor is the acute intoxicating effects of the drugs may make suicide more likely to occur. Suicide is also very common in adolescent alcohol abusers, with 1 in 4 suicides in adolescents being related to alcohol abuse.[12] In the USA approximately 30 percent of suicides are related to alcohol abuse. Alcohol abuse is also associated with increased risks of committing criminal offences including child abuse, domestic violence, rapes, burglaries and assaults.[13]

Drug abuse, including alcohol and prescription drugs can induce symptomatology which resembles mental illness. This can occur both in the intoxicated state and also during the withdrawal state. In some cases these substance induced psychiatric disorders can persist long after detoxification, such as prolonged psychosis or depression after amphetamine or cocaine abuse. A protracted withdrawal syndrome can also occur with symptoms persisting for months after cessation of use. Benzodiazepines are the most notable drug for inducing prolonged withdrawal effects with symptoms sometimes persisting for years after cessation of use. Abuse of hallucinogens can trigger delusional and other psychotic phenomena long after cessation of use and cannabis may trigger panic attacks during intoxication and with use it may cause a state similar to dysthymia[citation needed]. Severe anxiety and depression are commonly induced by sustained alcohol abuse which in most cases abates with prolonged abstinence. Even moderate alcohol sustained use may increase anxiety and depression levels in some individuals. In most cases these drug induced psychiatric disorders fade away with prolonged abstinence.[14]

Drug abuse makes central nervous system (CNS) effects, which produce changes in mood, levels of awareness or perceptions and sensations. Most of these drugs also alter systems other than the CNS. Some of these are often thought of as being abused. Some drugs appear to be more likely to lead to uncontrolled use than others.[15]

Traditionally, new pharmacotherapies are quickly adopted in primary care settings, however; drugs for substance abuse treatment have faced many barriers. Naltrexone, a drug originally marketed under the name "ReVia," and now marketed in intramuscular formulation as "Vivitrol" or in oral formulation as a generic, is a medication approved for the treatment of alcohol dependence. This drug has reached very few patients. This may be due to a number of factors, including resistance by Addiction Medicine specialists and lack of resources.[16]

The ability to recognize the signs of drug use or the symptoms of drug use in family members by parents and spouses has been affected significantly by the emergence of home drug test technology which helps identify recent use of common street and prescription drugs with near lab quality accuracy.




Disability-adjusted life year for drug use disorders per 100,000 inhabitants in 2002.

  no data

  less than 40











  more than 440

The initiation of drug and alcohol use is most likely to occur during adolescence, and some experimentation with substances by older adolescents is common. For example, results from 2010 Monitoring the Future survey, a nationwide study on rates of substance use in the United States, show that 48.2% of 12th graders report having used an illicit drug at some point in their lives.[17] In the 30 days prior to the survey, 41.2% of 12th graders had consumed alcohol and 19.2% of 12th graders had smoked tobacco cigarettes.[17] In 2009 in the United States about 21% of high school students have taken prescription drugs without a prescription.[18] And earlier in 2002, the World Health Organization estimated that around 140 million people were alcohol dependent and another 400 million suffered alcohol-related problems.[19]

Studies have shown that the large majority of adolescents will phase out of drug use before it becomes problematic. Thus, although rates of overall use are high, the percentage of adolescents who meet criteria for substance abuse is significantly lower (close to 5%).[citation needed] According to BBC, "Worldwide, the UN estimates there are more than 50 million regular users of morphine diacetate (heroin), cocaine and synthetic drugs."[20]


Total recorded alcohol per capita consumption (15+), in litres of pure alcohol[21]





In 1932, the American Psychiatric Association created a definition that used legality, social acceptability, and cultural familiarity as qualifying factors:

…as a general rule, we reserve the term drug abuse to apply to the illegal, nonmedical use of a limited number of substances, most of them drugs, which have properties of altering the mental state in ways that are considered by social norms and defined by statute to be inappropriate, undesirable, harmful, threatening, or, at minimum, culture-alien."[22]

In 1966, the American Medical Association's Committee on Alcoholism and Addiction defined abuse of stimulants (amphetamines, primarily) in terms of 'medical supervision':

…'use' refers to the proper place of stimulants in medical practice; 'misuse' applies to the physician's role in initiating a potentially dangerous course of therapy; and 'abuse' refers to self-administration of these drugs without medical supervision and particularly in large doses that may lead to psychological dependency, tolerance and abnormal behavior.

In 1973, the National Commission on Marijuana and Drug Abuse stated:

...drug abuse may refer to any type of drug or chemical without regard to its pharmacologic actions. It is an eclectic concept having only one uniform connotation: societal disapproval. ... The Commission believes that the term drug abuse must be deleted from official pronouncements and public policy dialogue. The term has no functional utility and has become no more than an arbitrary codeword for that drug use which is presently considered wrong.[23]



The first edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (published in 1952) grouped alcohol and drug abuse under Sociopathic Personality Disturbances, which were thought to be symptoms of deeper psychological disorders or moral weakness[citation needed].

The third edition, published in 1980, was the first to recognize substance abuse (including drug abuse) and substance dependence as conditions separate from substance abuse alone, bringing in social and cultural factors. The definition of dependence emphasised tolerance to drugs, and withdrawal from them as key components to diagnosis, whereas abuse was defined as "problematic use with social or occupational impairment" but without withdrawal or tolerance.

In 1987, the DSM-IIIR category "psychoactive substance abuse," which includes former concepts of drug abuse is defined as "a maladaptive pattern of use indicated by...continued use despite knowledge of having a persistent or recurrent social, occupational, psychological or physical problem that is caused or exacerbated by the use (or by) recurrent use in situations in which it is physically hazardous." It is a residual category, with dependence taking precedence when applicable. It was the first definition to give equal weight to behavioural and physiological factors in diagnosis.

By 1988, the DSM-IV defines substance dependence as "a syndrome involving compulsive use, with or without tolerance and withdrawal"; whereas substance abuse is "problematic use without compulsive use, significant tolerance, or withdrawal." Substance abuse can be harmful to your health and may even be deadly in certain scenarios

By 1994, The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association, the DSM-IV-TR, defines substance dependence as "when an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed." followed by criteria for the diagnose[4]

DSM-IV-TR defines substance abuse as:[24]

•   A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:

1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household)

2. Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)

3. Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)

4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)

•   B. The symptoms have never met the criteria for Substance Dependence for this class of substance.

The fifth edition of the DSM (DSM-5), planned for release in 2013, is likely to have this terminology revisited yet again. Under consideration is a transition from the abuse/dependence terminology. At the moment, abuse is seen as an early form or less hazardous form of the disease characterized with the dependence criteria. However, the APA's 'dependence' term, as noted above, does not mean that physiologic dependence is present but rather means that a disease state is present, one that most would likely refer to as an addicted state. Many involved recognize that the terminology has often led to confusion, both within the medical community and with the general public. The American Psychiatric Association requests input as to how the terminology of this illness should be altered as it moves forward with DSM-5 discussion.


Society and culture


Legal approaches

Related articles: Drug control law, Prohibition (drugs), Arguments for and against drug prohibition

Most governments have designed legislation to criminalize certain types of drug use. These drugs are often called "illegal drugs" but generally what is illegal is their unlicensed production, distribution, and possession. These drugs are also called "controlled substances". Even for simple possession, legal punishment can be quite severe (including the death penalty in some countries). Laws vary across countries, and even within them, and have fluctuated widely throughout history.

Attempts by government-sponsored drug control policy to interdict drug supply and eliminate drug abuse have been largely unsuccessful. In spite of the huge efforts by the U.S., drug supply and purity has reached an all time high, with the vast majority of resources spent on interdiction and law enforcement instead of public health.[25][26] In the United States, the number of nonviolent drug offenders in prison exceeds by 100,000 the total incarcerated population in the EU, despite the fact that the EU has 100 million more citizens.[citation needed]

Despite drug legislation (or perhaps because of it), large, organized criminal drug cartels operate worldwide. Advocates of decriminalization argue that drug prohibition makes drug dealing a lucrative business, leading to much of the associated criminal activity.



Policymakers try to understand the relative costs of drug-related interventions. An appropriate drug policy relies on the assessment of drug-related public expenditure based on a classification system where costs are properly identified.

Labelled drug-related expenditures are defined as the direct planned spending that reflects the voluntary engagement of the state in the field of illicit drugs. Direct public expenditures explicitly labeled as drug-related can be easily traced back by exhaustively reviewing official accountancy documents such as national budgets and year-end reports. Unlabelled expenditure refers to unplanned spending and is estimated through modeling techniques, based on a top-down budgetary procedure. Starting from overall aggregated expenditures, this procedure estimates the proportion causally attributable to substance abuse (Unlabelled Drug-related Expenditure = Overall Expenditure × Attributable Proportion). For example, to estimate the prison drug-related expenditures in a given country, two elements would be necessary: the overall prison expenditures in the country for a given period, and the attributable proportion of inmates due to drug-related issues. The product of the two will give a rough estimate that can be compared across different countries.[27]



As part of the reporting exercise corresponding to 2005, the European Monitoring Centre for Drugs and Drug Addiction's network of national focal points set up in the 27 European Union (EU) Member States, Norway, and the candidates countries to the EU, were requested to identify labeled drug-related public expenditure, at the country level.[27]

This was reported by 10 countries categorized according to the functions of government, amounting to a total of EUR 2.17 billion. Overall, the highest proportion of this total came within the government functions of Health (66%) (e.g. medical services), and Public Order and Safety (POS) (20%) (e.g. police services, law courts, prisons). By country, the average share of GDP was 0.023% for Health, and 0.013% for POS. However, these shares varied considerably across countries, ranging from 0.00033% in Slovakia, up to 0.053% of GDP in Ireland in the case of Health, and from 0.003% in Portugal, to 0.02% in the UK, in the case of POS; almost a 161-fold difference between the highest and the lowest countries for Health, and a 6-fold difference for POS. Why do Ireland and the UK spend so much in Health and POS, or Slovakia and Portugal so little, in GDP terms?

To respond to this question and to make a comprehensive assessment of drug-related public expenditure across countries, this study compared Health and POS spending and GDP in the 10 reporting countries. Results found suggest GDP to be a major determinant of the Health and POS drug-related public expenditures of a country. Labelled drug-related public expenditure showed a positive association with the GDP across the countries considered: r = 0.81 in the case of Health, and r = 0.91 for POS. The percentage change in Health and POS expenditures due to a one percent increase in GDP (the income elasticity of demand) was estimated to be 1.78% and 1.23% respectively.

Being highly income elastic, Health and POS expenditures can be considered luxury goods; as a nation becomes wealthier it openly spends proportionately more on drug-related health and public order and safety interventions.[27]



The UK Home Office estimated that the social and economic cost of drug abuse[28] to the UK economy in terms of crime, absenteeism and sickness is in excess of £20 billion a year.[29] However, the UK Home Office does not estimate what portion of those crimes are unintended consequences of drug prohibition (crimes to sustain expensive drug consumption, risky production and dangerous distribution), nor what is the cost of enforcement. Those aspects are necessary for a full analysis of the economics of prohibition.[30]

The Home Office has a recent history of taking a hard line on controlled drugs, including those with no known fatalities and even medical benefits,[31] in direct opposition to the scientific community.[32]



The 2004 study The economic costs of drug abuse in the United States by the Executive Office of the President Office of National Drug Control Policy, lists the overall costs of drug abuse for the years 1992–2002 as follows:


Cost (billions of dollars)























These figures represent overall economic costs, which can be divided in three major components: health costs, productivity losses and non-health direct expenditures.

•   Health-related costs were projected to total $16 billion in 2002.

•   Productivity losses were estimated at $128.6 billion. In contrast to the other costs of drug abuse (which involve direct expenditures for goods and services), this value reflects a loss of potential resources: work in the labor market and in household production that was never performed, but could reasonably be expected to have been performed absent the impact of drug abuse.

Included are estimated productivity losses due to premature death ($24.6 billion), drug abuse-related illness ($33.4 billion), incarceration ($39.0 billion), crime careers ($27.6 billion) and productivity losses of victims of crime ($1.8 billion).

•   The non-health direct expenditures primarily concern costs associated with the criminal justice system and crime victim costs, but also include a modest level of expenses for administration of the social welfare system. The total for 2002 was estimated at $36.4 billion. The largest detailed component of these costs is for state and federal corrections at $14.2 billion, which is primarily for the operation of prisons. Another $9.8 billion was spent on state and local police protection, followed by $6.2 billion for federal supply reduction initiatives.



Treatment for substance abuse is critical for many around the world. Often a formal intervention is necessary to convince the substance abuser to submit to any form of treatment. Behavioral interventions and medications exist that have helped many people reduce, or discontinue, their substance abuse. From the applied behavior analysis literature, behavioral psychology, and from randomized clinical trials, several evidenced based interventions have emerged:

•   Behavioral marital therapy

•   Motivational Interviewing

•   Community reinforcement approach

•   Exposure therapy

•   Contingency management[33][34]

•   Pharmacological therapy - A number of medications have been approved for the treatment of substance abuse.[citation needed] These include replacement therapies such as buprenorphine and methadone as well as antagonist medications like disulfiram and naltrexone in either short acting, or the newer long acting form (under the brand name Vivitrol). Several other medications, often ones originally used in other contexts, have also been shown to be effective including bupropion (Zyban or Wellbutrin), Modafinil (Provigil) and more.

According to some nurse practitioners, stopping substance abuse can reduce the risk of dying early and also reduce some health risks like heart disease, lung disease, and strokes.[35]

In children and adolescents, cognitive behavioral therapy (CBT)[36] and family therapy[37] currently have the most research evidence for the treatment of substance abuse problems. These treatments can be administered in a variety of different formats, each of which has varying levels of research support[38]

Social skills are significantly impaired in people suffering from alcoholism due to the neurotoxic effects of alcohol on the brain, especially the prefrontal cortex area of the brain.[39] It has been suggested that social skills training adjunctive to inpatient treatment of alcohol dependence is probably efficacious,[40] including managing the social environment.


Special populations


Immigrants and refugees


Process and context of migration

Governments, advocacy organizations, academics, and migrating persons often define the term "immigrant" differently, assigning unique meanings to the word, and often using the following terms somewhat interchangeably: aliens, immigrants, nonimmigrants, undocumented aliens, refugees, asylum seekers, and lawful permanent residents. The U.S. government classifies migrating persons into multiple categories based on both the type and legality of migration. "Lawful permanent residents" is the legal term for immigrants who have arrived in the United States through legal channels and with appropriate documentation. "Nonimmigrants" refers to students, tourists, short-term contract workers, and any person temporarily visiting the country while intending to return to their country of origin. "Illegal alien" is any immigrant who has entered the country illegally or who, although entering the country legally, has fallen "out of status." Illegal aliens may be deported at any time if brought to the attention of immigration authorities.[41] The term "illegal alien" has drawn much criticism from advocacy groups as a label that is demeaning and dehumanizing. For this Wikipedia entry, the term "immigrants" will be used to refer to both documented and undocumented migratory persons.

The United States Immigration and Nationality Act of 1952 defines a "refugee" as any person who is outside his or her "country of nationality" and who is unable or unwilling to return to that country because of persecution or a well-founded fear of persecution, which must be based on the individual's race, religion, nationality, membership in a particular social group, or political opinion. The number of refugees allowed to enter the U.S. is restricted by quantity and geographic location of origin in accordance with federal policies. After one year of residence within the U.S., refugees may be eligible to obtain Lawful Permanent Residence status.[42]

Despite the relatively short history of the nation, patterns and outcomes of immigration to the United States have been complex. Noted historians, journalists, educators, and scholars, such as Tatcho Mindiola,[43] Howard Zinn,[44] and Samantha Power[45] have extensively detailed the evolution of federal immigration and refugee policy within the U.S., signifying the economic, political, and social contexts and motivations shaping policy initiatives. The nation's earliest immigration legislation, such as the "Free White Persons Act" of 1790 and the Chinese Exclusion Act of 1882, reflected political manipulations of the economic incentives and social pressures of the times and provided a foundation for the codification of discriminatory practices based upon race and nationality within later policy designs. Further policy actions, including the Johnson-Reed Act of 1924, the "Bracero" guestworker program begun in 1942 and consequent Operation Wetback in 1954, and the USA Patriot Act of 2001 continued the process of selective immigration and detention according to racial and ethnic categories. Consequently, immigrant and refugee accessibility to the United States is limited according to fiscal, political, and humanitarian priorities; "numerical ceilings" for each fiscal year are determined by Congressional budget and appropriations.[46]

Immigrant and refugee migration is often analyzed as a process consisting of three phases: 1) the pre-migration or departure phase, 2) the transit phase, and 3) the resettlement phase.[47] Many economic, social, and psychological stressors are associated with each stage. Physical trauma and depression and anxiety due to separation from loved ones often characterize the pre-migration and transit phases. During the resettlement phase, "cultural dissonance," language barriers, racism, discrimination, economic adversity, overcrowding, social isolation, and loss of status regarding important social roles are just a few of the obstacles immigrants and refugees may encounter. For undocumented immigrants, difficulty obtaining work and fears of deportation are common. Refugees frequently experience concerns about the health and safety of loved ones left behind and uncertainty regarding the possibility of returning to their country of origin.[48][49]


Etiology of substance abuse

Many of the genetic, psychological, and environmental factors identified as potentially contributing to the development of substance abuse behaviors by multiple-generation by non-recent immigrants and refugees are similar for more recent immigrants and refugees. Heritable genetic, cognitive, and temperamental characteristics may signify increased risk or protective factors for biological family members. Psychological theories, such as the psychoanalytic, behavioral, cognitive, and social learning models may help to explain the role of environment in shaping substance abuse behaviors and patterns. Sociocultural models focusing on family interactions, peer influences, and social environments may describe the interpersonal mechanisms partially leading to substance abuse behaviors[50]

However, several models have been proposed that specifically apply to the development of substance abuse behaviors and disorders among immigrants and refugees. The majority of these models relate to individual experiences of migration and assimilation, integration, and segregation upon entry into a new culture.

One theory suggests that immigrants and refugees simply continue the substance use and abuse patterns and behaviors they maintained while residing in their country of origin, regardless of the stressors and any process of cultural adaptation they may experience in their new country.[49]

Conversely, the acculturation (or assimilation) model proposes that substance abuse behaviors may be explained by examining the process in which recent immigrants and refugees adopt the attitudes, behaviors, and norms regarding substance use and abuse that exist within the dominant culture into which they are entering. With this theory, patterns of substance abuse among immigrants and refugees will more closely resemble the patterns of the dominant society than patterns existing within the culture of origin, if there are significant differences.[49]

Similarly, the acculturative stress model suggests that substance abuse functions as a coping mechanism to attempt to deal with the stressors that result directly from the process of immigration, such as forced migration, involuntary settlement, "cultural conflict" and alienation, role transition and loss of status, economic insecurity, and the scarcity of resources.[49]

Finally, the intracultural diversity model argues that universal theories attempting to explain substance abuse by immigrants and refugees fail to address diversity within and between cultural groups. This model proposes multiple pathways to addiction and recovery that cannot be generalized as applying to specific racial and ethnic populations. Proponents of this theory also point to intergenerational differences in substance abuse behaviors as evidence supporting the model and to identify potential risk and protective factors among individuals.[49][51]


Empowerment social work and culturally competent practice

The National Association of Social Workers (NASW) provides standardized guidelines regarding professional values and codes of ethical conduct for individual social workers. The NASW identifies the following core values: service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence. Furthermore, the association provides detailed guidelines related to confidentiality, informed consent, self-determination, and many other aspects of practice with clients and colleagues.[52] All social work values and ethics are implicated in direct practice with immigrants and refugees; however, special attention must be paid to codes of conduct regarding client self-determination, informed consent, cultural competent practice, and confidentiality.

A variety of strategies have been suggested for social work practice in the field of substance abuse recovery when working with immigrants and refugees.

In a literature review of the research on immigration, acculturation, and substance abuse, Leow, Goldstein, and McGlinchy (2006) recommend tailoring intervention and treatment services and materials for specific racial and ethnic cultures by utilizing language, images, values, and norms belonging to each culture and incorporating knowledge of cultural themes, attitudes, family structures, and service access points. However, before services can be provided, they contend, social workers should recruit and consult with members of the immigrant and refugee communities they are intending to serve regarding program development and implementation. Additionally, social work staff and volunteers should demonstrate cultural competency in two significant ways: 1) by possessing the "attitudes, knowledge, and skills" necessary when working with diverse groups, and 2) by continually evaluating their personal values and beliefs and recognizing differences in perspective.[53]

Similarly, Pumariega, Rothe, and Pumariega (2005) focus on the overall accessibility, acceptability, and relevance of programs for immigrants and refugees coming from specific cultural backgrounds. Differences in "symptom expression" between various racial and ethnic groups may bias both social workers and diagnostic tools during assessment and intervention efforts. Ignorance of the role and significance of such factors as site location, documentation, language, social stigma, and treatment methods on individual and community perceptions regarding services may render intervention and treatment efforts largely ineffective. The authors also discuss the importance of incorporating the process of cultural transition into direct practice with immigrants and refugees by utilizing unique practices from a culture of origin into "Western-oriented" mental health services and re-evaluating characteristics and traditions within that culture that have been "negatively valued" in dominant, American culture. This includes recognizing and building on existing individual and cultural strengths to increase resilience.[48]

When working directly with refugees, Adams, Gardiner, and Assefi (2004) emphasize the necessity of interpreters and advise the use of a preventive screening tool, such as an adaptation of the Harvard trauma questionnaire, to gather information regarding exposure to physical and psychological trauma, the presence of acute and chronic illnesses, use of alcohol and other drugs, and participation (voluntary and coerced) in specific cultural and medicinal practices, such as female genital surgery. Furthermore, they highlight the importance of contextualizing and understanding the migration process by inquiring as to an individual's country of origin and reasons for migration, experience of migration (time spent in refugee camps, circumstances surrounding travel, etc.), social roles and status prior to migrating (employment, education, etc.), and the status and location of close family members.[54]



Impulsivity is characterized by actions based on sudden desires, whims, or inclinations rather than careful thought.[55] Research has found that individuals with substance abuse have higher levels of impulsivity.[56] It was also found that individuals who use multiple drugs tend to be more impulsive. In a study that looked at the genetic influence of impulsivity [57] hypothesized that the loss of impulse control may be due to impaired inhibitory control resulting from drug induced changes that take place in the frontal cortex. The neurodevelopmental and hormonal changes that happen during adolescence may modulate impulse control that could possibly lead to the experimentation with drugs and may lead to the road of addiction.

Previous research done on drug use and impulsivity [58] examined the behavior of high-functioning drug abusers and healthy controls using the Iowa gambling task. In this experiment players were asked to make a series of choices from four deck of cards. The choices led to monetary gains and losses. The results showed that in a forgone payoff condition, people who were drug abusers made more risky choices. In another study conducted by researchers,[59] they found that by using the Iowa gambling task, the control group made better deck choices compared to the marijuana group. Results showed that the marijuana group made better choices than the stimulant group.


See also

•   Addictive personality

•   Combined drug intoxication

•   Drug addiction

•   Drug overdose

•   Harm reduction

•   Herbert Kleber

•   Low-threshold treatment programs

•   Needle-exchange programme

•   Poly drug use

•   Polysubstance abuse

•   Risk factors in pregnancy

•   List of controlled drugs in the United Kingdom

•   List of drug-related deaths

•   Self-medication

•   Substances controlled for their drug effects by the US federal government