Illicit drug use: health risks, dependence and getting help in the UK

Illicit drug use means taking drugs that are illegal to possess or supply, or using prescription or other substances in a way that was not intended. Not everyone who tries a drug becomes addicted, but regular use carries a risk of dependence.

The NHS defines addiction as not having control over doing, taking or using something to the point where it could be harmful to you. It is most commonly associated with gambling, drugs, alcohol and smoking. In the case of drugs, the substances affect the way you feel, both physically and mentally. These feelings can be enjoyable and create a powerful urge to use the substance again.

Over time, the NHS explains, being addicted means that not having the drug causes withdrawal symptoms, or a come down. Because these can be unpleasant it is easier to carry on using, and so the cycle continues. Often a person needs more and more to satisfy a craving and achieve the high.

There are lots of reasons why addictions begin. The NHS says some studies suggest a person's risk of becoming addicted is partly genetic, and that environmental factors, such as being around other people with addictions, also increase the risk. Behaviours such as substance misuse can be a way of blocking out difficult issues, and unemployment and poverty can trigger addiction, along with stress and emotional or professional pressure.

This means that drug problems are rarely a simple matter of willpower. The factors that raise risk are often the same circumstances that make help harder to ask for, which is why the NHS stresses that help is available and that you do not need to be at a crisis point to seek it.

The NHS says that substance misuse can have serious psychological and physical effects, and that managing an addiction can seriously damage work life and relationships. The specific health risks vary a great deal with the drug, the amount, the way it is taken and the person, so the best way to understand your own risk is a conversation with a GP or a drug service.

One of the harm-reduction measures the NHS describes is testing and treatment for infections. It says staff at your local drug service will help reduce the risks associated with your drug taking, and for example you may be offered testing and treatment for hepatitis or HIV.

FRANK, the national drugs information service, says that if you or someone else needs urgent help after taking drugs or drinking, you should call 999 for an ambulance. It asks you to tell the crew everything you know, because it could save their life.

The NHS says a GP may be a good place to start, and that if you are not comfortable talking to a GP you can approach your local drug treatment service yourself. Charities and the NHS provide most drug treatment, and there are also private organisations that you pay for.

At your first appointment, staff will ask about your drug use, work, family and housing situation, may ask for a urine or saliva sample, talk through your options and agree a treatment plan with you. You are given a keyworker who supports you throughout your treatment.

• Talking therapies, such as cognitive behavioural therapy (CBT), which help you see how thoughts and feelings affect behaviour.

• Treatment with medicines: if you are dependent on heroin or another opioid you may be offered a substitute medicine such as methadone or buprenorphine.

• Detoxification (detox) for people who want to stop opioids completely, helping you cope with withdrawal symptoms.

• Self-help and support groups such as UKNA (Narcotics Anonymous) or SMART Recovery.

• Harm-reduction support, including testing and treatment for hepatitis or HIV.

You may have treatment while living at home or, if you need intensive treatment such as detox, as a hospital inpatient. If residential treatment might be a good option, you may be referred to a residential rehabilitation service. The NHS says the drug treatment you receive depends on your personal circumstances and which drug you are using.

NHS and charity services are free at the point of use. Private drug and alcohol treatment is also available but you need to pay for it. Whichever route you choose, it is sensible to tell your GP, so that treatment for any physical or mental health conditions is coordinated.

Living with someone who uses drugs is difficult, and relatives often need support in their own right. The NHS says treatment staff can tell you about local support groups for drug users and their families or carers, and points to Adfam, a national charity for families affected by drugs and alcohol, for a list of useful organisations.