You are here: home>resources>Trainings and Curricula>provider preparation>advocates ask addiction questions>

Question 4

What are the signs of drug abuse?

(**Note: Domestic violence and addiction definitions are adapted from definitions developed by the American Psychiatric Association and the American Society for Addiction Medicine and included in the Domestic Violence/Substance Abuse Task Force of the IL DHS 7/2000, Safety and Sobriety: Best Practices in Domestic Violence and Substance Abuse, see p.vi. For information about this publication contact: www.state.il.us/agency/dhs ).

Substance abuse is a destructive pattern of use of drugs including alcohol, which leads to clinically significant (social, occupational, medical) impairment or distress. Often the substance use continues in spite of significant life problems related to that use.

Substance use and misuse are behaviors. Research supports several theories related to causal etiologies of substance abuse and addiction including behavioral, medical and other models. According to the disease model, addiction, unlike domestic violence, is not a behavior. It is a disease. When a person begins to exhibit symptoms of tolerance (the need for significantly larger amounts of substance to achieve intoxication) and withdrawal (adverse reactions after a reduction of substance) it is likely that the person has progressed from abuse to dependence and addiction. While diversity of thought exists pertaining to addiction it is critical to learn to recognize and identify women with this condition and provide appropriate intervention.

Addiction, according to the disease model, is considered a primary chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. Addiction is characterized by continuous or periodic impaired control over drinking alcohol or using other drugs, preoccupation with drugs or alcohol, use of drugs or alcohol despite adverse consequences, and distortions in thinking, most notably denial. Addiction is treatable and long-term recovery is possible. Although a person may choose to use alcohol or drugs a person does not choose how one’s body will respond to that choice. Alcohol and drugs affect the brain and the body whether addiction is present or not. Addiction, however, is marked by the development of tolerance, loss of control, continued use in spite of adverse consequences and withdrawal symptoms.

Cues indicative of substance misuse may include but are not limited to:

1. The odor of alcohol on her breath
2. Red eyes, pin-point or dilated pupils
3. Track marks on arms, hands or feet
4. Inflamed, eroded nasal septum.
5. Rapid speech
6. Difficulty tracking
7. Scratching and picking at arms or face during a visit
8. Lethargy
9. Nodding
10. Cigarette burns (which may also be indicative of domestic violence).
11. Prescription drug seeking behavior
12. Distorted Perceptions

Note: Alcohol and other drugs distort perceptions. Chemically dependent battered women may have a hard time recognizing options or gauging their safety due to a variety of distortions in thinking. Blackouts may mean the absence of memories for some events. Experiencing a blackout does not mean a person has passed out or lost consciousness. Nor does it mean psychological blocking out of events or repression. A blackout is an amnesia-like period often associated with heavy drinking. People in a blackout state may appear to be functioning normally but later have no memory of what occurred (Kinney and Leaton, 1991).

Inability to remember events poses specific safety problems for battered women experiencing blackouts. Problems can include not being able to recall a safety plan, not being able to know how an inj”ury was sustained, making a report to police at the time of an assault and being unable to recollect the event mere minutes or hours later, let alone in court.

The only initial memory substance users have of what happens when they use is the one that is formed when they are under the influence of alcohol or in a drugged state. Thus if a person under the influence inaccurately assesses her level of danger or perceives herself as “able to handle it,” sobering up the next day may be insufficient to correct the distortion. This toxic thinking or distortion of perception is termed euphoric recall (Johnson, 1980) and theoretically has the potential to increase risk for substance abusing battered women.

Please contact the Alcohol Drug Help Line at 206-722-370 / 1-800-562-1240 (WA or AK only) or check their website for more specific information about signs and symptoms of alcohol and other drug use, abuse and addiction as well as for information about indicators of overdose and withdrawal. If you are concerned that a resident has overdosed or is experiencing acute withdrawal either could pose serious health consequences and medical attention should be sought immediately. If a person is not breathing or you are concerned symptoms may be life threatening call 911 or the applicable number for emergency medical services in your area.

 

Getting Safe and Sober: Real Tools You Can Use
©Alaska Network on Domestic Violence and Sexual Assault 2005

• community profiles
• resources
• news & events