FACTS & INFORMATION
Below are some questions and answers on several critical topics and issues:
Please feel free to submit additional questions!
Juuling & Vaping
If someone is taking prescription medication as directed, why can they become addicted and how quickly? answer
Do doctors over-prescribe opioids and what is being done to address this issue? answer
I have a prescription for a pain medication that I didn't finish; can I safely save it for future use? answer
Drug Availability & Dangers
What is the worst drug on the market today? answer
Is it really true that you can purchase a bag of heroin for less than $5 in nearby New Jersey towns? answer
Why does fentanyl lead to so many overdoses? answer
How is heroin linked to prescription drug misuse? answer
How are drugs smuggled into the U.S. and where do they come from? answer
Understanding Substance Misuse & Addiction
How would I know if someone is having issues with substance misuse or addiction? answer
If I think a loved one or a friend is using drugs, what should I do? answer
Why do only some people become addicted and others do not? answer
What is the most misunderstood thing about addiction? answer
Can an addict be responsible for his or her recovery when addiction is a disease? answer
Is there a connection between addiction and other mental health disorders? answer
What should someone NOT say to someone suffering from addiction? answer
Treatment & Recovery
Is rehab (in-patient or residential treatment) always the answer for someone suffering from addiction? answer
Is there a difference in quality between out-of-pocket rehab centers and ones covered by insurance? answer
Can addiction ever be fully cured? answer
What is the most effective evidence-based treatment for opioid addiction? answer
Talking to Our Children
What is the best way to engage our children to talk about these issues and let them feel safe doing so? answer
How can parents make sure their children are safe and are there any warning signs of substance misuse? answer
Should I be concerned if my child seems "addicted" to his/her phone, computer or playing online games? answer
With all the new paraphernalia available to hide drugs, how does a parent know where to look? answer
Can the use of marijuana lead to addiction and/or use of harder drugs?
It is possible to develop a dependence on marijuana and experience symptoms of withdrawal when stopping usage. Not everyone who uses marijuana will move onto harder drugs, but it is referred to as a "gateway drug" meaning someone using marijuana on a regular basis is more likely to try harder drugs, and most people who suffer from addiction will say they started out using marijuana. For more information, see this link on NIDA's website.
I have heard the argument that smoking pot is "no big deal" and past users have turned out OK?
The marijuana today is not the same as it was years ago. Marijuana today has a much higher THC concentration (the chemical in marijuana that produces the feeling of being high) which means it is more potent and is still considered a "gateway drug" which could lead a user to try harder drugs. Marijuana potency has steadily increased over the past few decades. While in the early 1990s, the average THC content in confiscated marijuana samples was roughly 3.8 percent, the average marijuana extract today contains more than 50 percent THC, with some samples exceeding 80 percent. These trends raise concerns that the consequences of marijuana use could be worse than in the past, particularly among those who are new to marijuana use or in young people, whose brains are still developing. For more information on the long-term effects of marijuana use on the brain, please see this Report.
What impact could the legalization of marijuana in New Jersey have?
In states where marijuana has been legalized for recreational use for people 21 and over, there are higher incidences of vehicle accidents and use disorder is on the rise. High school students in Colorado are currently #1 in the country (see this Report for more information) in marijuana usage since the legalization in that State. Unfortunately, age limits are not effective in curtailing underage purchases of the drug. You can contact your State legislators and advise them you are against the legalization of marijuana if this is of concern to you. In addition, since only State-authorized stores may sell marijuana once it is legalized, you can encourage your towns to pass local ordinances banning the opening of such stores even in advance of possible legalization.
What is marijuana use disorder?
Marijuana use can lead to the development of marijuana use disorder, a problem associated with dependence on marijuana in which people feel withdrawal symptoms when the stop taking the drug. Marijuana use disorder can lead to addiction in severe cases. According to the National Institute on Drug Abuse, recent data suggests that 30% of those who use marijuana may have some form of use disorder and people who began using marijuana before the age of 18 are 4-7 times more likely to develop marijuana use disorder. Please see the Research Report Series for more information.
What is juuling and vaping?
Using an e-cigarette is called vaping (juul is a brand of e-cigarette). It is a device that causes a vaporizer to heat a liquid inside the cartridge. The liquid contains nicotine, flavorings, and other chemicals and the vapor that is created is inhaled by the user. The product can sometimes look like a USB stick, pen or other common objects. New data and studies indicate that teens are using vaping devices in record numbers. See this Report from NIDA and the University of Michigan press release on this issue.
What are the dangers of e-cigarettes?
The liquid in vaping devices typically contains nicotine, often unbeknownst to users. Nicotine is highly addictive - while some adult users may use e-cigarettes to stop smoking tobacco cigarettes (which is not necessarily a proven method to do so), the exposure to our youth is serious and can increase the risk of developing addiction to nicotine as well as other addictions and is particularly harmful to young people. It can also impact attention and learning and increases the risk of mood disorders. See the NIDA description of e-cigarettes and their risks for more information.
Why is it more dangerous for children to be exposed to nicotine?
E-cigarettes are now the most commonly used form of tobacco among youth in the United States. Their easy availability, alluring flavors, and targeted ads have helped make them appealing to this age group. The use of nicotine by young people, whose brains are not fully developed until their mid-20s, puts them at risk for long-lasting effects because nicotine affects the development of the brain. Continued e-cigarette use can not only lead to nicotine addiction, but it also can make other drugs such as cocaine and methamphetamine more pleasurable to a teen's developing brain. For more information on the impact of vaping on teens, and how to talk to your kids about vaping, see this link.
What are some important facts to know about e-cigarettes and risk of use?
E-cigarettes, despite the claims by manufacturers like Juul, are not considered an effective smoking-cessation device. While approximately 99% of e-cigarettes contain nicotine, studies show that only 63% of our youth realize that, which exposes them to the very real mental and physical risks (including long-term risks of mood disorders, addiction to other substances and a permanent decrease in impulse control) associated with nicotine addiction, not to mention their being four times more likely to move onto traditional cigarettes as opposed to those who don't use the product. See this link to the Surgeon General's information on the risks and facts about e-cigarettes and the CDC to learn more about e-cigarettes.
If someone is taking prescription medication as directed, why can they become addicted and how quickly?
It is vitally important to take prescription medications only as prescribed. Not all medications are addictive, however pain medications (OxyContin, Percocet, Vicoden, etc.) can be extremely addictive, although addiction varies person to person. If someone is susceptible to becoming addicted, this could happen in as little time as one week.
Do doctors over-prescribe opioids and what is being done to address this issue?
In the past doctors have generally over-prescribed opioids, but improved education and changes in laws have resulted in a decrease in the actual number of prescription pain medications for the past several years. It is now mandatory for doctors to utilize the Prescription Drug Monitoring Program, where they can enter a patient's name to see if that person has recently received other prescription pain medications. Conversations can be had with physicians to discuss alternatives to opioid pain relievers.
I have a prescription for a pain medication that I didn't finish; can I safely save it for future use?
You can save it for future use, but it is highly recommended that it be locked up and not just left in a drawer or medicine cabinet where it is accessible. Most local police departments have secure drop boxes where anyone can drop off unneeded or expired medications, to keep them away from those at risk of abusing them. For more information on the safe storage and disposal of medications and locations of drop boxes, please see our Resources page.
What is the worst drug on the market today?
Fentanyl is currently the most dangerous drug. It can be up to 100 times more potent than heroin and it is responsible for a large majority of overdoses. 2 mg of fentanyl is enough to be fatal - that would be equivalent to a pinch of salt.
Is it really true that you can purchase a bag of heroin for less than $5 in nearby New Jersey towns?
Shockingly, according to the DEA, the answer is yes. Unfortunately there is a steady supply of drugs to our State due to our proximity to airports, highways and waterways, all means of transporting and smuggling drugs. It is not clear whether the increased availability of heroin is causing the upsurge in use, or if the increased accessibility of heroin has been caused by increased demand. A number of studies have suggested that people transitioning from abuse of prescription opioids to heroin cite that heroin is cheaper, more available, and provides a better high.
Why does fentanyl lead to so many overdoses?
The fentanyl that is associated with recent overdoses are produced in clandestine laboratories. It can be sold in various forms, including being mixed with or substituted for heroin, or pressed into tablets that mimic other opioids like OxyContin. The high potency of fentanyl greatly increases risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains fentanyl. See NIDA for more information on fentanyl.
How is heroin linked to prescription drug misuse?
Harmful health consequences resulting from the misuse of opioid medications that are prescribed for the treatment of pain, such as Oxycontin®, Vicodin®, and Demerol®, have dramatically increased in recent years. For example, almost half of all opioid deaths in the U.S. now involve a prescription opioid. Even when these medicines are medically prescribed, when they are taken for reasons or in ways or amounts not intended by a doctor, or taken by someone other than the person for whom they are prescribed, they can result in severe adverse health effects and may actually open the door to heroin use. For more information, see NIDA's Prescription Opioids and Heroin.
How are drugs smuggled into the U.S. and where do they come from?
According to the DEA, many drugs are smuggled into the U.S. from Mexico and South America. Drugs can be smuggled via airlines, container ships, vehicles crossing the border, and via individual smugglers. They can be difficult to detect especially as it relates to drugs coming in via container ships as it is impossible to search every single container. Mexico remains the primary source of heroin, methamphetamine and marijuana, while fentanyl and other synthetic opioids are often sourced from China. Fentanyl can be imported in low weight, high concentration shipments via mail and express consignment from China. Distribution networks can purchase drugs on the "dark web" and sell it in the same manner. In October 2018, the DEA published its National Drug Threat Assessment Report.
How would I know if someone is having issues with substance abuse or addiction?
It can be difficult at times to detect when someone is having an issue with substance abuse or addiction. People with substance abuse issues may act differently than you are accustomed to and there are certain signs that you can look for if you suspect someone is struggling.
If I think a loved one or a friend is using drugs, what should I do?
Any action is better than none. As difficult as it may be, for a school-age friend, you could contact their parents or school counselors; school counselors could refer you to places to go for assistance. For a loved one, it is very important to let them know you are concerned about their safety and that if they are having a problem, there is help for them. For more information on help and treatment options, please see our Resources page.
Why do only some people become addicted and others do not?
Addiction is a complex and chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences. The initial decision to take drugs is voluntary for most people, but repeated drug use can lead to brain changes that interfere with their ability to resist intense urges to take drugs. These brain changes can be persistent, which is why drug addiction is considered a "relapsing" disease—people in recovery from drug use disorders are at increased risk for returning to drug use even after years of not taking the drug. No one factor can predict if a person will become addicted to drugs. A combination of factors influences risk for addiction. The more risk factors a person has, the greater the chance that taking drugs can lead to addiction. For more information, see Addiction Science as well as Understanding Drug Use and Addiction.
What is the most misunderstood thing about addiction?
An addiction is an illness, just as heart disease and cancer are illnesses. An addiction is not a weakness. It does not mean someone is a bad person. People from all backgrounds can get an addiction. It doesn't matter if you are rich or poor, where you live, whether or not you went to college. An addiction can happen at any age, but the chances are higher when a person starts using drug when they're young. People may mistakenly think that those who use drugs lack moral principles or willpower, and that they could stop their drug use simply by choosing to do so. In reality, drug addiction is a complex disease which can change the brain and those changes can last a long time. For more information, see What is an Addiction?
Can an addict be responsible for his or her recovery when addiction is a disease?
Addiction is complicated and there is an element of choice, particularly in terms of accepting and seeking help, but addiction also takes away a person's control making it extremely difficult to accept or seek the help they need. An addiction can take over your life and taking drugs can become more important than anything else, even when taking drugs hurts yourself and those you love and care about, and it becomes difficult to stop or quit even when a person truly wants to.
Is there a connection between addiction and other mental health disorders?
Many people who have a substance use disorder also develop other mental illnesses, just as many people who are diagnosed with mental illness are often diagnosed with a substance use disorder. For example, about half of people who experience a mental illness will also experience a substance use disorder at some point in their lives and vice versa. Although substance use disorders commonly occur with other mental illnesses, this does not mean that one caused the other, even if one appeared first. Research suggests that there are many genes that can contribute to the risk of developing both a substance use disorder and a mental illness. A gene can also influence how a person responds to a drug. For more information, see Comorbidity and Addiction.
What should someone NOT say to someone suffering from addiction?
"Just stop" or "You are doing this on purpose" or "I will never trust you again" are all examples of what NOT to say. It is best to keep the lines of communication open and approach conversations in a caring and non-judgmental way. At the right time, you may want to offer to help the person connect with providers or treatment options that may help him or her. You can be firm about not being able to do things that might enable the person (lend money, use the car, etc.), but understand these are consequences of the person's addiction (and not a punishment) - you love them and want to keep them safe. Emphasize that they can choose help when they are ready, you are not forcing or controlling them, and reinforce all positive behaviors. There are professional resources available to help train families to get loved ones into treatment. See our Resources page for more information on treatment options and counseling for families. You can also check out the 20-minute guide from The Center for Motivation and Change.
Is rehab (in-patient or residential treatment) always the answer for someone suffering from addiction?
No single treatment is right for everyone and effective treatment must address all of the patient's needs, not just his or her drug use. Counseling and behavioral therapies are forms of treatment and, in many cases, medications are a part of treatment. A range of care options with a tailored treatment program can be critical to success. Rehab can be very effective for certain situations as it may provide more structure, intensive care, medical attention and, in some cases, recovery housing to help people make the transition to an independent life. See our Resources page for more information on treatment options.
Is there a difference in quality between out-of-pocket rehab centers and ones covered by insurance?
Addiction treatment is complicated every situation is unique. Many residential programs do not accept insurance and can be quite costly. It is always advisable to do research into any program to determine the quality of the medical services, therapy, family work, and use of medications to treat addiction. Unfortunately, there are programs that are less than ideal, and some are actually scams that prey on sufferers and their families. See our Resources page for information on ways to get help and find treatment.
Can addiction ever be fully cured?
Addiction is a chronic illness, but it is treatable and can be managed and sufferers can stop using drugs and lead productive lives. While it takes time, sometimes years, proper treatment helps the individual counteract addiction's disruptive effects on their brain and behavior and regain control of their lives. See NIDA for more information on the science of addiction and information on recovery.
What is the most effective evidence-based treatment for opioid addiction?
Each approach to drug treatment is designed to address certain aspects of drug addiction and its consequences for the individual, family, and society. Behavioral approaches help engage people in drug abuse treatment, provide incentives for them to remain abstinent, modify their attitudes and behaviors related to drug abuse, and increase their life skills to handle stressful circumstances. There are various pharmacotherapies that, when combined with behavioral therapies, have proven effective for opioid addiction. See these evidence-based behavioral therapies and pharmacotherapies used to treat opioid addiction.
What is the best way to engage our children to talk about these issues and let them feel safe doing so?
According to the Center for Alcohol and Drug Resources, it is best to engage your children early and often in discussions about the misuse of alcohol, tobacco and other drugs. Teens who have opted not to use drugs and alcohol, when interviewed, often cite their not wanting to disappoint their parents and the importance of their family's values as being important to them. It is critical to have conversations with children and teens about the importance of brain development and how drinking, using nicotine products or drugs can adversely impact them and their inherent dangers. See this link for tips and guidance on how to talk to children, teens and young adults. The Partnership for Drug-Free Kids has information on how to talk to your child once you discover your teen or young adult is using drugs. Motivational interviewing and the CRAFT (Community Reinforcement and Family Training) method can be helpful strategies to engage someone who is struggling as described in the 20 Minute Guide (The Center for Motivation and Change).
How can parents make sure their children are safe and are there any warning signs of substance misuse?
As a parent, you know your child better than anyone else. Changes in our children are often the catalyst to raising suspicions of substance misuse. If your child is suddenly struggling in school, showing signs of distress or very different behavior than you are used to seeing, or if you see items that are unfamiliar or resembling items you may know to be associated with substance use, it is better to err on the side of caution and express your concerns to your child in a loving way. You may want to tell your child that it is your job to keep them healthy and safe. Unusual odors, closed doors that were once kept open, over-concern for privacy can be reasons to suspect there may be an issue. For more information on signs of drug or alcohol use, see this link.
Should I be concerned if my child seems "addicted" to his/her phone, computer or playing online games?
According to the Center for Alcohol and Drug Resources, there are many studies on the effects of too much screen time and other pursuits that offer instant gratification to the developing brain. While there may not be a direct correlation to substance use, there are still concerns about how these things that trigger dopamine receptors can play a detrimental part in young people having less ability to tolerate situations that require delayed gratification.
With all the new paraphernalia available to hide drugs, how does a parent know where to look?
The DEA recommends looking around your child's room from time to time. Unfortunately there are products out there that look innocent, but actually contain compartments to hide items within such as soda cans or water bottles that can be twisted apart. If you see a can or bottle that has been in your child's room for a period of time, pick it up and give the top and bottom a twist. This is just one example. The DEA (and the Bergen County Prevention Coalition) runs a program called "Hidden in Plain Sight" which presents a mock-up of a teenager's bedroom in which various drug paraphernalia or "stash items" are hidden. The event includes a presentation identifying and explaining some of the items the audience discovered and how parents may be unaware of the item's potential uses.
What is Narcan and what substances does it reverse?
Narcan or Naloxone is a medication designed to rapidly reverse opioid overdose. It reverses the effects of heroin and prescription painkiller overdoses. It is available over the counter at many pharmacies. As every second counts in an overdose, learning how to administer Narcan and being properly trained is critical. For more information on Naloxone, see our Resources page.
If we know someone who is dealing drugs, what is our obligation to turn them into the authorities?
You can contact your local police department, anonymously if you wish, and provide as specific information as possible to report suspected activities relating to the sale or distribution of drugs. The DEA also has a contact form to report what appears to you as a possible violation of controlled substances laws and regulations. Violations may include the growing, manufacture, distribution or trafficking of controlled substances.
How can we address the fear of criminal persecution when someone wants to report drug use?
Information can be provided anonymously, but it is important to know that someone coming forward with such information will not be criminally charged. There is also legislation in place to protect people from being arrested who are the victims of an overdose or who report witnessing an overdose. Please see the section on "Important Information" on our Resources page for more information about these laws.