Life Before and After Addiction: Impacts on Health, Relationships, and Finances
Substance use disorder (SUD), the medical condition defined by a compulsive use of a substance despite negative consequences, is a disease that affects people’s mental and physical health, personal and professional relationships, finances, and career.1 More than 40 million people aged 12 and older were identified as having drug or alcohol use disorders in the United States in 2020, but only about 4 million of those individuals (10%) received treatment.2 Addiction is treatable, recovery is possible, and the differences in people before and after drugs can be incredible.
Statistics on Drug Abuse and Prevalence
Drug misuse and abuse are prevalent issues in the United States. The following information provides an overview of some of the statistics:2,3
- Approximately 13.5% of individuals aged 12 and older reported illicit drug use within the previous month, when surveyed in 2020.
- In 2020, nearly 14 million people aged 12 and older reported misusing prescription medications, including psychotherapeutic drugs, painkillers, stimulants, and sedatives in the past 30 days.
- The number of drug overdose deaths quadrupled from 1999 to 2019.
- The number of drug overdose deaths increased by 5% from 2018 to 2019.
- In 2018–2019 opioid-related overdose deaths rose by more than 6%.
- Between 1999 and 2019, over 500,000 people died of an opioid-related overdose, both from prescription and illicit forms of opioids drugs.
- Marijuana was the most prevalent illicit drug used in 2020, with more than 49 million individuals reporting past-year marijuana use.
- The 2020 survey found that over 7 million people reported using hallucinogens in the past year.
- More than 9 million individuals reported past-year use of opioids in 2020.
Before Quitting Methamphetamines
Methamphetamines impact cardiovascular health in the short term, causing a fast heart rate, irregular pulse, and elevated blood pressure.5
Long-term physical and mental effects may include:6
- Alterations to brain structure and function.
- Psychotic symptoms including hallucinations, paranoia, and delusions.
- Twitching or repetitive movements.
- Loss of memory.
- Aggression or violent tendencies.
- Skin sores.
- Tooth decay and other dental issues.
- Unhealthy weight loss.
Before Quitting Cocaine
Via common routes of use (e.g., snorting, injecting, smoking), cocaine’s effects begin to be felt almost instantly and typically stop within about an hour.7 Short-term effects of cocaine include hypertension, rapid heart rate, dilated pupils, and a higher than usual body temperature.7 Cocaine also causes hypersensitivity to sight, sound, and touch.7
Long-term physical and mental side effects vary depending on the route of administration but may include:7
- Panic or anxiety attacks.
- Psychotic features such as paranoia and hallucinations.
- Loss of appetite, potentially resulting in malnourishment.
- Loss of smell (if snorted).
- Difficulty swallowing.
- Chronic runny nose.
- Irritation of the nasal septum.
- Lung damage (if smoked).
- Worsening asthma.
- Risk of contracting HIV or Hepatitis C (if injected).
- Increased risk of stroke.
- Inflammation of the heart.
- Aortic ruptures.
Before Quitting Alcohol
Immediate effects of excessive alcohol use include risks of injuries from falls, drownings, burns, and car accidents for those who drink and drive.8 Additionally, heavy drinking increases the risk of violence, such as suicide and sexual assault; risky sexual behavior; and alcohol poisoning.8
Some of the long-term physical and mental effects may include:8,9
- Memory and learning issues.
- Chronic hypertension, arrhythmia (irregular heartbeat), and other cardiovascular disease.
- Cardiomyopathy (enlarged, inefficiently functioning heart muscle).
- Fatty liver.
- Alcoholic hepatitis (inflammation of the liver).
- Pancreatitis (either acute or chronic inflammation of the pancreas, which can affect blood sugar control and digestion).
- Increased risk of certain cancers, including throat, larynx (voice box), esophagus, liver, breast (in women), and colon and rectum.
Before Quitting Opioids
Both prescription and illicit opioid drugs activate the body’s opioid receptors, alter pain signaling, and result in increased release of dopamine within the reward centers of the brain, which may strongly reinforce continued drug use.10 Short-term effects can include pain relief, euphoria, upset stomach, constipation, inability to think clearly, drowsiness, and slowed respiration.10
Continued misuse of opioids can have a number of adverse physical and mental consequences, including:10,11
- Marked tolerance to the desired effects, leading to dangerous escalations in use.
- Addiction development.
- Cumulatively increased risk of severe respiratory depression and overdose.
- Hypoxic brain injury (resulting from inadequate oxygen delivery to the brain, which can cause brain damage or death).
- Chronic gastrointestinal issues, including a risk of intestinal blockage.
- Damage to other organ systems including the musculoskeletal, cardiovascular, immune, endocrine, and central nervous systems.
Before Quitting Heroin
Heroin is an illicit opioid with drug effects that include a euphoric rush, a warm flushing of the skin, heaviness in the limbs, dry mouth, nausea and vomiting, skin itching, and states of semiconsciousness.12
Long-term physical and mental effects may include:12
- Inability to fall or stay asleep.
- Injection-related issues such as skin abscesses, collapsed veins, inflammation/infections of the heart lining and valves.
- Damaged nasal tissue (from snorting heroin).
- Chronic gastrointestinal slowing, causing issues like severe constipation and stomach cramping.
- Liver and kidney disease.
- Lung problems, like pneumonia.
- Issues with sexual function for men.
- Irregular periods for women.
Before Quitting Hallucinogens
Hallucinogens are a diverse group of drugs that alter a person’s perceptions, causing individuals to see, hear, and feel things that are not there.13 Once ingested, some hallucinogens interfere with parts of the brain that affect the senses, mood, hunger, sleep, body temperature, sexual behavior, and gastrointestinal muscle contractions.13 Short-term effects may include upset stomach, quickened heart rate, loss of appetite, altered perception of time, and trouble breathing, panic, and paranoia, among others.13
Long-term physical and mental effects vary based on the drug but may include: 13
- Persistent psychosis, including paranoia and disorganized thought.
- Mood changes.
- Visual disturbances.
- Flashbacks, or recurrences of certain drug experiences.
Long-term physical and mental effects of marijuana misuse include:14
- Impairments in memory, thinking, and learning when marijuana use begins in adolescent years.
- Chronic lung irritation, illness, and infections (from smoking marijuana).
- Increased cardiovascular risks, including heart attack, as a result of persistently elevated heart rate (that can last for hours after each use).
- Upset stomach and/or severe vomiting (i.e., cannabinoid hyperemesis), which can lead to dangerous levels of dehydration.
- Worsened psychosis in people with pre-existing schizophrenia.
Marijuana may also be associated with an acute psychosis—including symptoms such as hallucinations and irrational thoughts—though these developments may be more likely with regular use of high potency cannabis products.14
After Quitting Drug and Alcohol Use
While some physical and mental effects from drugs and/or alcohol may be permanent, sustained abstinence can reverse some damage and allow an individual’s mind and body to heal.
After Quitting Methamphetamines
Studies indicate that chronic methamphetamine use can significantly alter the brain’s structure and function, affecting a person’s decision-making process, memory, and emotional regulation.6 However, studies have also shown that some of the effects of chronic meth misuse may be partially reversible over time.6 Some of the neurotoxic effects of the drug may subside after a year or more without meth; the resulting nerve cell recovery has been associated with improvements in verbal and motor memory after 14 months or more of methamphetamine abstinence.6
After Quitting Cocaine
Like methamphetamine, long-term cocaine use may be associated with certain types of brain pathology, including changes in grey matter volume.7 However, findings from various neuroimaging studies indicate that the brains of chronic cocaine users may recover after a period of abstinence, experiencing both a return to normal grey matter levels and restoration of function within certain types of brain circuitry.7
After Quitting Alcohol
Alcohol can have a detrimental effect on a wide range of vital organ systems, including the brain, cardiovascular system, liver, pancreas, and immune system.9 The good news is that many alcohol-related health issues can improve when drinking stops. Some types of alcohol-related brain damage, for instance, may be reversible, but that is completely dependent on different factors—how much, how often, and for how long alcohol was consumed, and the individual’s overall health.15 Additionally, some cardiovascular changes may be reversible when alcohol consumption ceases—or is substantially reduced.16 One clinical review found that individuals with alcohol-related cardiomyopathy, who abstained from drinking or cut back, demonstrated “major improvement” in cardiovascular functioning.16 Furthermore, quitting drinking can completely resolve fatty liver disease (hepatic steatosis).17 For others with various alcohol-related liver diseases, like cirrhosis, survival rates can improve.17
After Quitting Opioids
Brain chemistry needs time to stabilize after opioid addiction, which is why some medications like methadone and buprenorphine—that can help manage cravings and drug withdrawal symptoms—are an important part of treatment and sustained recovery of opioid use disorders.10 Additionally, behavioral therapies can help people addicted to opioids change their attitudes and behaviors related to their drug use, improve healthy life skills, and encourage them to stay in treatment.10
After Quitting Heroin
Medications used in opioid treatment, including buprenorphine and methadone, can normalize brain chemistry, relieve cravings, and help manage withdrawal symptoms.18 In conjunction with behavioral therapy, people can improve their health and maintain a sober lifestyle.19
After Quitting Hallucinogens
Many hallucinogens, including the classic hallucinogens like LSD, are not considered to be addictive or result in the same compulsive drug seeking behavior as certain other substances like alcohol and opioids. However their use can still be problematic and is associated with several potentially adverse effects.13 Many behaviors associated with hallucinogens, like sensory and visual effects, will correct themselves once a person stops using hallucinogens.11 For those who have continued flashbacks or more persistent psychotic symptoms brought on by hallucinogens, both psychiatric medications and behavioral therapies can help.13
After Quitting Marijuana
There are no FDA-approved medications to treat addiction to marijuana. However, since many people use marijuana to mitigate anxiety and sleep issues, insomnia can occur when someone stops using marijuana. Prescription sleep aids and/or anti-anxiety medications can sometimes help a person in early recovery from marijuana use.19
It’s common for substance use disorder and mental health challenges to happen at the same time.4 In fact, when a person meets the criteria for a substance use disorder and they have been diagnosed with one or more mental health disorders, this is called having co-occurring disorder. It’s not always clear which caused the other, or if there is even a link of causation, but substance use can trigger or worsen mental health conditions.4 As mentioned above, several different substances can cause both short- and long-term mental health issues such as paranoia, anxiety, depression, and suicidal thoughts.
As previously stated, substances can potentially trigger or worsen mental health issues while someone is actively misusing drugs or alcohol. Additionally, substance use may feel like a form of self-medication at times as well, but has the potential to worsen mental health symptoms over time, hurts more than it helps.20
An integrated care treatment model for co-occurring disorders is considered the standard of care by the Substance Abuse and Mental Health Services Administration (SAMHSA).21 The goal of integrated treatment is to help people with co-occurring disorders learn how to maintain sobriety or reduce their substance use as well as manage the symptoms of their mental illness.22
Social and Professional Life
Substance use disorders often strain a person’s social and professional relationships.23 Family, friends, and coworkers may feel angry, frustrated, and worried by an individual’s substance use, which many include erratic behaviors, mental health issues, and health complications that affect the individual’s job performance and personal relationships.23 Housing instability, job loss, and criminal behavior are other potential social and professional consequences of addiction.23
During Active Addiction
Substance use disorders can strain personal relationships by placing an emotional burden on family and friends who are worried about someone they love struggling with addiction. They may feel angry, scared, or embarrassed by their loved one’s actions.23
Family instability may result from abuse or violence brought on by substance use.23 Children of parents who have substance use disorders may be more likely to experience abuse, neglect, and physical health issues, as well as be at higher risk for certain cognitive, developmental, and psychiatric issues like conduct disorders, depression, anxiety, and poor emotional or behavioral regulation.23
Families often experience the economic burden of a person’s substance use disorder, not only because of the money spent on substances but also because of lost time or productivity at work and, in some cases, job loss.23
When people stop using substances and begin their recovery, it is important they remember that their family and social relationships may need time to recover from their addiction as well. Groups like Al-Anon and Nar-Anon provide support for those who have a family member or loved one struggling with a substance use disorder.23
It is possible to rebuild trust in relationships during recovery. Family counseling can be beneficial to address issues within the family that may have arisen due to addiction and substance abuse.24 Social support is vital to everyone’s recovery.23
During Active Addiction
The economic burden of substance use disorders on individuals and families can be substantial. Not only is there the money spent on the substances to consider, but there is also the possible job loss and/or legal issues and fines that are often incurred by various drug-seeking behaviors like theft or driving under the influence. 23
After Addiction Treatment
For individuals, quitting substance use means no longer spending money on drugs and/or alcohol, though it also often means spending money on treatment. However, unlike the ongoing costs associated with continued substance misuse, treatment costs occur for a finite period. Plus, active addiction can make it difficult to hold a job or advance at work. Employment opportunities and personal income may improve with recovery.
How Rehab Can Help You
The goal of rehab is to help people recover from substance use disorders. Many treatment programs incorporate elements of behavioral therapy to help people build coping skills to avoid relapse, enhance motivation to change, and rebuild aspects of their lives that have been negatively impacted by addiction.24 Medication may also be an element of treatment, depending on the substance used.24
Some rehab programs require participants to live at the center for the duration of treatment while others do not. The American Society of Addiction Medicine (ASAM) established various levels of care for the treatment of substance use disorders. These include:25
- Early intervention and prevention (level 1).
- Outpatient treatment (level 2).
- Intensive outpatient and partial hospitalization (level 3).
- Residential/inpatient treatment (level 4).
- Intensive inpatient services (level 5).
Within those levels of care, there are a range of services available, and what works for one person may not work for the next.25 Each person’s treatment plan should be individualized to meet their health-related, lifestyle, and cultural needs.24
It is critical for people in recovery to have support. Social factors, such as being part of mutual-interest or mutual-help groups, connecting with friends and family, and having positive role models all have the potential to positively influence recovery.26 Peer groups, such as 12-Step recovery groups, provide a place for people to connect with others who understand their experiences and can provide empowerment and respect.
Addiction is a chronic, relapsing condition and it’s not uncommon for people to require more than one treatment attempt to achieve long-term recovery.24 However, without treatment, it can be very difficult to break free. Substance use disorder should be treated like other relapsing conditions, where a relapse indicates that an adjustment to the treatment plan is needed, not that a failure has happened.24
While the idea of treatment can be intimidating, the differences in people’s lives—from the physical and mental health to their relationships and finances—before and after drugs make it worth it.