Substance Abuse and Addiction

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• QWhat is acetaldehyde?

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  A Discovery Health answered

  Acetaldehyde is a chemical that is produced when sugar is burned. Internal studies conducted by cigarette maker Phillip Morris revealed that adding acetaldehyde to nicotine significantly increases the desire to smoke.

  While patches and gum may help to stave off a craving for nicotine, they don't touch the acetaldehyde.

  It is no coincidence that it is harder to resist smoking when you are drinking a beer: once the acetaldehyde in your system is activated by the beer, you will crave more, in the form of a cigarette.

• QWhat are the symptoms of nicotine addiction?

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  A Dr. Michael Roizen, MD , Internal Medicine, answered

  Like all addictive drugs, nicotine affects your brain, making you feel good and wanting more of it. Nicotine has an upside: It can improve your concentration and alertness, boost your mood, and suppress your appetite. Of course, the downside, like the risk of lung and heart disease, far outweighs the upside, but try telling that to your addicted brain. When your brain doesn't get nicotine for even a few hours, you'll probably find yourself pacing around, feeling irritable and depressed, having a headache, and unable to concentrate.

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• QHow common is gambling addiction?

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  A Lily Cook , Addiction Medicine, answered

  It varies depending on how available gambling is in your geographic area. The lifetime prevalence is somewhere between .4% and 3.4% in adults. However, keep in mind that gambling is illegal in two states, Hawaii and Utah, and the prevalence is likely very low in those areas; whereas studies have found rates as high as 7% in other locations such as Puerto Rico and Australia. Higher rates of prevalence are found also in teenagers and people with substance use disorders, such as alcoholism.

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• QAre women or men more likely to become pathological gamblers?

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  A Dr. Howard J. Shaffer, PhD , Addiction Medicine, answered

  According to the National Epidemiologic Survey on Alcoholism and Related Conditions (NESARC), a huge study involving 43,000 Americans, pathological gambling is more common among men than among women. Also, men and women tend to prefer different forms of gambling.
  
  In the United States, men are about three times as likely to become pathological gamblers compared with women during their lives (0.64% vs. 0.23%). They're also about twice as likely to develop "subclinical" pathological gambling, a less severe form of the problem, which is estimated at about 7% for men and 3% for women. Men and women also tend to gravitate toward different forms of gambling: women are more likely to play bingo, slots, and keno; men seem to prefer gambling on the stock market, and table casino games, such as roulette.
• QAre many people compulsive gamblers?

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  A Dr. Michael Roizen, MD , Internal Medicine, answered

  A conservative estimate on the number of "problem" or compulsive gamblers in North America is around 1% of the population (between 3 million and 4 million people), but some say that number may now be as high as 7% -- up to 28 million men and women. Online gambling poses a unique risk because of how available it is. You sit back in your recliner wearing your PJs, turn on your computer, and -- bingo! -- you've got 24/7 to lose your savings account. As online gambling sites have increased in number from 15 in 1995 to more than 2,300 in 2010, so have revenues. The people who run the games took in $24 billion in one year. That's how much is being lost.
• QWhat medications can help treat pathological gambling?

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  A Dr. Howard J. Shaffer, PhD , Addiction Medicine, answered

  Several medications show promise for treating pathological gambling, but none is currently Food and Drug Administration (FDA)-approved. One study found that low doses of nalmefene, a drug that works similarly to naltrexone (medication for treating opioid dependence), improved pathological gambling symptoms, but the drug is not currently available in pill form, except for research purposes. A handful of studies indicate that naltrexone also improves the symptoms of pathological gambling, and one case study reported the drug's benefits for treating sexual addiction. Other medications that have shown promise for gambling addiction include topiramate and the antidepressants fluvoxamine (Luvox) and bupropion (Wellbutrin).
• QHow can I tell if I have a gambling problem?

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  A Dr. Howard J. Shaffer, PhD , Addiction Medicine, answered

  If you answer yes to any of the following questions, you might have a gambling problem that deserves further evaluation.
  
  During the past 12 months, have you:
  

  • become restless, irritable, or anxious when trying to stop or cut down on gambling?
  • tried to keep your family or friends from knowing how much you gambled?
  • had financial trouble as a result of your gambling such that you had to get help with living expenses from family, friends, or welfare?
• QWhat should I do if a family member is a problem gambler?

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  A Dr. Howard J. Shaffer, PhD , Addiction Medicine, answered

  The Substance Abuse and Mental Health Services Administration offers a Problem Gambling Toolkit, which offers the following advice for family members of problem gamblers:
  

  • Take the gambler's name off all credit cards.
  • Deposit the gambler's paycheck into an account in your name only, and agree to a weekly cash budget.
  • Call creditors, explain the gambler's problem, and promise to provide a restitution plan within 45 days.

  If gambling continues:
  

  • Take your name off any joint credit cards and bank accounts.
  • Alert all creditors and ask them not to extend any more credit to the gambler.
  • Assume payment of household bills, if possible.
  • Open a separate safe-deposit box to store valuables that the gambler might sell for cash.
  • Identify income and assets, establish a spending plan, and shift control of the finances to a nongambler.
• QHow does methamphetamine use affect the body?

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  A American Dental Association answered

  Methamphetamine (a powerful, cheap, and easy-to-make drug) use can have very harmful effects on health and well being. Even in small doses, it can cause:
  

  • shortness of breath
  • decreased appetite
  • irregular heart beat and high blood pressure
  • increased wakefulness
  • increased physical activity

  Long-term methamphetamine abuse can cause:
  

  • extreme weight loss
  • insomnia
  • confusion
  • irritability, anxiety and violent behavior
  • psychotic effects, including paranoia, hallucinations, and delusions (for example, the sensation of insects creeping under the skin)
• QHow does methamphetamine drug use cause tooth decay?

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  A American Dental Association answered

  Methamphetamine is a potent central nervous system stimulant that can cause shortness of breath, hyperthermia, nausea, vomiting, diarrhea, irregular heartbeat, high blood pressure, permanent brain damage and rampant tooth decay. Some users describe their teeth as "blackened, stained, rotting, crumbling or falling apart." Often, the teeth cannot be salvaged and must be extracted.
  
  The extensive tooth decay is probably caused by a combination of drug-induced psychological and physiological changes resulting in dry mouth and long periods of poor oral hygiene. Some reports have speculated that the acidity of the drug also damages teeth. A methamphetamine "high" lasts much longer than that produced by crack cocaine (12 hours versus one hour for cocaine). This can lead to long periods of poor oral hygiene. And while they are high, users often crave high-calorie, carbonated, sugary beverages or they may grind or clench their teeth, all of which can harm teeth.