Physical dependence on a substance (needing a drug to function) is not necessary or sufficient to define addiction.  There are some substances which don't cause addiction but do cause physical dependence (for example, some blood pressure medications) and substances which cause addiction but not classic physical dependence (cocaine withdrawal, for example, doesn't have symptoms like vomiting and chills; it is mainly characterized by depression).

See also drug abuse and drug abuse first aid.

Causes and Risks

Drug abuse can lead to drug dependence or addiction. Drug dependence may also follow the use of drugs for physical pain relief, though this is rare in people without a previous history of addiction.

The exact cause of drug abuse and dependence is not known. However, the genetic make-up of the individual, the pharmacology of the particular drug, peer pressure, emotional distress, anxiety, depression, and environmental stress are all factors which seem to be involved.

Risk factors that predispose people to drug dependence  are different from those which predispose to use or abuse.  Peer pressure may lead to use or abuse, but at least half of those who go on to addiction have depression, attention-deficit disorder, post-traumatic stress disorder or another psychological problem. .

Children  who grow up in an environment of illicit drug use may first see their parents using drugs. This may put them at a higher risk for developing an addiction later in life for both environmental and genetic reasons.

Signs of drug use in children include but are not limited to:

1. A change in the child's friends, a new group
2. Seclusive behavior
3. Long unexplained periods away from home
4. Lying
5. Stealing
6. Involvement with the law
7. Deteriorating family relations
8. Obvious intoxication (e.g., drunk) , delirious, incoherent, or unconscious
9. Distinct changes in behavior and normal attitude
10. Decreased school performance

Commonly abused substances include:

(1) Opiates and narcotics are powerful painkillers with sedative and euphoric qualities. These include heroin, opium, codeine, meperidine, (Demerol), hydromorphone (Dilaudid), Oxycontin and others.

(2) Central nervous system stimulants include amphetamines, cocaine, dextroamphetamine, methamphetamine, and methylphenidate (Ritalin). The most commonly used stimulants are caffeine and nicotine. These drugs have a stimulating effect and can produce tolerance.

(3) Central nervous system depressants include barbiturates  (amobarbital, pentobarbital, secobarbital), benzodiazepine (Valium, Ativan, Xanax), chloral hydrate, and paraldehyde. The most commonly used, by far, is alcohol. These substances produce a soothing sedative and anxiety-reducing effect and can lead to dependence.

(4) Hallucinogens include LSD, mescaline, psilocybin, and phencyclidine (PCP or "Angel Dust"). They have hallucinogenic properties and can produce psychological dependence.

Tetrahydrocannabinol (THC) is the active ingredient found in cannabis, marijuana, and hashish. Although used for their relaxing propreties, THC-derived drugs can also lead to paranoia and anxiety.

Acute drug intoxication and drug overdose may be accidental or intentional. Drug withdrawal symptoms can occur when use of a substance is stopped or reduced. Withdrawal symptoms vary, depending on the abused substance. The onset of withdrawal symptoms depends on the length of time the drug normally stays within the body. Drug intoxication, overdose, and withdrawal can be life-threatening in some situations.

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