National Institute on drug abuse
Images Credit: Freepik
Say No To Drugs
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“When you can stop, you don’t want to. And when you want to stop, you can’t. That’s addiction.”
“You don’t get over an addiction by stopping using. You recover by creating a new life where it is easier to not use. If you don’t create a new life, then all the factors that brought you to your addiction will catch up with you again.”
“Addiction is a monster; it lives inside, and feeds off of you, takes from you, controls you, and destroys you. It is a beast that tears you apart, rips out your soul, and laughs at your weakness. It is a stone wall that stands to keep you in and the rest out. It is a shadow that always lurks behind you, waiting to strike. Addiction lives in everyone’s mind, sitting, staring, waiting…”
Drugs, Brains, and Behavior: The Science of Addiction
Drug abuse or substance abuse refers to the use of certain chemicals for the purpose of creating pleasurable effects on the brain. There are over 190 million drug users around the world and the problem has been increasing at alarming rates, especially among young adults under the age of 30.
Drug craving and the other compulsive behaviors are the essence of addiction. They are extremely difficult to control, much more difficult than any physical dependence. They are the principal target symptoms for most drug treatment programs. For an addict, there is no motivation more powerful than drug craving.
A person who misuses drugs can lack motivation, feel depressed and is unable to enjoy things that they typically loved doing. They may also do things completely out of character or what they would ordinarily view as morally wrong in order to obtain the drug.
Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control. Those changes may last a long time after a person has stopped taking drugs.
Addiction is a lot like other diseases, such as heart disease. Both disrupt the normal, healthy functioning of an organ in the body, both have serious harmful effects, and both are, in many cases, preventable and treatable. If left untreated, they can last a lifetime and may lead to death.
Note: These PET scans compare the brain of an individual with a history of cocaine use disorder (middle and right) to the brain of an individual without a history of cocaine use (left). The person who has had a cocaine use disorder has lower levels of the D2 dopamine receptor (depicted in red) in the striatum one month (middle) and four months (right) after stopping cocaine use compared to the non-user. The level of dopamine receptors in the brain of the cocaine user are higher at the 4-month mark (right), but have not returned to the levels observed in the non-user (left).
Why do people take drugs?
In general, people take drugs for a few reasons:
- To feel good. Drugs can produce intense feelings of pleasure. This initial euphoria is followed by other effects, which differ with the type of drug used. For example, with stimulants such as cocaine, the high is followed by feelings of power, self-confidence, and increased energy. In contrast, the euphoria caused by opioids such as heroin is followed by feelings of relaxation and satisfaction.
- To feel better. Some people who suffer from social anxiety, stress, and depression start using drugs to try to feel less anxious. Stress can play a major role in starting and continuing drug use as well as relapse (return to drug use) in patients recovering from addiction.
- To do better. Some people feel pressure to improve their focus in school or at work or their abilities in sports. This can play a role in trying or continuing to use drugs, such as prescription stimulants or cocaine.
- Curiosity and social pressure. In this respect, teens are particularly at risk because peer pressure can be very strong. Adolescence is a developmental period during which the presence of risk factors, such as peers who use drugs, may lead to substance use.
If taking drugs makes people feel good or better, what’s the problem?
When they first use a drug, people may perceive what seem to be positive effects. They also may believe they can control their use. But drugs can quickly take over a person’s life. Over time, if drug use continues, other pleasurable activities become less pleasurable, and the person has to take the drug just to feel “normal.” They have a hard time controlling their need to take drugs even though it causes many problems for themselves and their loved ones. Some people may start to feel the need to take more of a drug or take it more often, even in the early stages of their drug use. These are the signs of an addiction.
Even relatively moderate drug use poses dangers. Consider how a social drinker can become intoxicated, get behind the wheel of a car, and quickly turn a pleasurable activity into a tragedy that affects many lives. Occasional drug use, such as misusing an opioid to get high, can have similarly disastrous effects, including impaired driving and overdose.
The effects of long-term drug use
Do people choose to keep using drugs?
The initial decision to take drugs is typically voluntary. But with continued use, a person’s ability to exert self-control can become seriously impaired. This impairment in self-control is the hallmark of addiction.
Brain imaging studies of people with addiction show physical changes in areas of the brain that are critical to judgment, decision-making, learning and memory, and behavior control. These changes help explain the compulsive nature of addiction.
No single factor determines whether a person will become addicted to drugs.
Why do some people become addicted to drugs, while others do not?
As with other diseases and disorders, the likelihood of developing an addiction differs from person to person, and no single factor determines whether a person will become addicted to drugs. In general, the more risk factors a person has, the greater the chance that taking drugs will lead to drug use and addiction. Protective factors, on the other hand, reduce a person’s risk. Risk and protective factors may be either environmental or biological.
What biological factors increase risk of addiction?
Biological factors that can affect a person’s risk of addiction include their genes, stage of development, and even gender or ethnicity. Scientists estimate that genes, including the effects environmental factors have on a person’s gene expression, called epigenetics, account for between 40 and 60 percent of a person’s risk of addiction. Also, teens and people with mental disorders are at greater risk of drug use and addiction than others.
Children’s earliest interactions within the family are crucial to their healthy development and risk for drug use.
What environmental factors increase the risk of addiction?
Environmental factors are those related to the family, school, and neighborhood. Factors that can increase a person’s risk include the following:
- Home and Family. The home environment, especially during childhood, is a very important factor. Parents or older family members who use drugs or misuse alcohol, or who break the law, can increase children’s risk of future drug problems.
- Peer and School. Friends and other peers can have an increasingly strong influence during the teen years. Teens who use drugs can sway even those without risk factors to try drugs for the first time. Struggling in school or having poor social skills can put a child at further risk for using or becoming addicted to drugs.
What other factors increase the risk of addiction?
- Early use. Although taking drugs at any age can lead to addiction, research shows that the earlier people begin to use drugs, the more likely they are to develop serious problems. This may be due to the harmful effect that drugs can have on the developing brain. It also may result from a mix of early social and biological risk factors, including lack of a stable home or family, exposure to physical or sexual abuse, genes, or mental illness. Still, the fact remains that early use is a strong indicator of problems ahead, including addiction.
- How the drug is taken. Smoking a drug or injecting it into a vein increases its addictive potential. Both smoked and injected drugs enter the brain within seconds, producing a powerful rush of pleasure. However, this intense high can fade within a few minutes. Scientists believe this powerful contrast drives some people to repeatedly use drugs to recapture the fleeting pleasurable state.
Images of Brain Development in Healthy Children and Teens (Ages 5-20)
As the brain matures, experiences prune excess neural connections while strengthening those that are used more often. Many scientists think that this process contributes to the steady reduction in gray matter volume seen during adolescence (depicted as the yellow to blue transition in the figure). As environmental forces help determine which connections will wither and which will thrive, the brain circuits that emerge become more efficient. However, this is a process that can cut both ways because not all patterns of behavior are desirable or healthy. The environment is like an artist who creates a sculpture by chipping away excess marble; and just like bad artists can produce bad art, environments with negative factors (like drugs, malnutrition, bullying, or sleep deprivation) can lead to efficient but potentially harmful circuits that conspire against a person’s well-being.
The brain continues to develop into adulthood and undergoes dramatic changes during adolescence.
One of the brain areas still maturing during adolescence is the prefrontal cortex—the part of the brain that allows people to assess situations, make sound decisions, and keep emotions and desires under control. The fact that this critical part of a teen’s brain is still a work in progress puts them at increased risk for trying drugs or continuing to take them. Introducing drugs during this period of development may cause brain changes that have profound and long-lasting consequences.
Why is adolescence a critical time for preventing drug addiction?
As noted previously, early use of drugs increases a person’s chances of becoming addicted. Remember, drugs change the brain—and this can lead to addiction and other serious problems. So, preventing early use of drugs or alcohol may go a long way in reducing these risks.
Risk of drug use increases greatly during times of transition. For an adult, a divorce or loss of a job may increase the risk of drug use. For a teenager, risky times include moving, family divorce, or changing schools. When children advance from elementary through middle school, they face new and challenging social, family, and academic situations. Often during this period, children are exposed to substances such as cigarettes and alcohol for the first time. When they enter high school, teens may encounter greater availability of drugs, drug use by older teens, and social activities where drugs are used. When individuals leave high school and live more independently, either in college or as an employed adult, they may find themselves exposed to drug use while separated from the protective structure provided by family and school.
A certain amount of risk-taking is a normal part of adolescent development. The desire to try new things and become more independent is healthy, but it may also increase teens’ tendencies to experiment with drugs. The parts of the brain that control judgment and decision-making do not fully develop until people are in their early or mid-20s. This limits a teen’s ability to accurately assess the risks of drug experimentation and makes young people more vulnerable to peer pressure.
Because the brain is still developing, using drugs at this age has more potential to disrupt brain function in areas critical to motivation, memory, learning, judgment, and behavior control.
Can research-based programs prevent drug addiction in youth?
Yes. The term research-based or evidence-based means that these programs have been designed based on current scientific evidence, thoroughly tested, and shown to produce positive results. Scientists have developed a broad range of programs that positively alter the balance between risk and protective factors for drug use in families, schools, and communities. Studies have shown that research-based programs, can significantly reduce early use of tobacco, alcohol, and other drugs. Also, while many social and cultural factors affect drug use trends, when young people perceive drug use as harmful, they often reduce their level of use.
How do research-based prevention programs work?
These prevention programs work to boost protective factors and eliminate or reduce risk factors for drug use. The programs are designed for various ages and can be used in individual or group settings, such as the school and home. There are three types of programs:
- Universal programs address risk and protective factors common to all children in a given setting, such as a school or community.
- Selective programs are for groups of children and teens who have specific factors that put them at increased risk of drug use.
- Indicated programs are designed for youth who have already started using drugs.
Introducing the Human Brain
The human brain is the most complex organ in the body. This three-pound mass of gray and white matter sits at the center of all human activity—you need it to drive a car, to enjoy a meal, to breathe, to create an artistic masterpiece, and to enjoy everyday activities. The brain regulates your body’s basic functions, enables you to interpret and respond to everything you experience, and shapes your behavior. In short, your brain is you—everything you think and feel, and who you are.
How does the brain work?
The brain is often likened to an incredibly complex and intricate computer. Instead of electrical circuits on the silicon chips that control our electronic devices, the brain consists of billions of cells, called neurons, which are organized into circuits and networks. Each neuron acts as a switch controlling the flow of information. If a neuron receives enough signals from other neurons that it is connected to, it fires, sending its own signal on to other neurons in the circuit.
The brain is made up of many parts with interconnected circuits that all work together as a team. Different brain circuits are responsible for coordinating and performing specific functions. Networks of neurons send signals back and forth to each other and among different parts of the brain, the spinal cord, and nerves in the rest of the body (the peripheral nervous system).
To send a message, a neuron releases a neurotransmitter into the gap (or synapse) between it and the next cell. The neurotransmitter crosses the synapse and attaches to receptors on the receiving neuron, like a key into a lock. This causes changes in the receiving cell. Other molecules called transporters recycle neurotransmitters (that is, bring them back into the neuron that released them), thereby limiting or shutting off the signal between neurons.
How do drugs work in the brain?
Drugs interfere with the way neurons send, receive, and process signals via neurotransmitters. Some drugs, such as marijuana and heroin, can activate neurons because their chemical structure mimics that of a natural neurotransmitter in the body. This allows the drugs to attach onto and activate the neurons. Although these drugs mimic the brain’s own chemicals, they don’t activate neurons in the same way as a natural neurotransmitter, and they lead to abnormal messages being sent through the network.
Other drugs, such as amphetamine or cocaine, can cause the neurons to release abnormally large amounts of natural neurotransmitters or prevent the normal recycling of these brain chemicals by interfering with transporters. This too amplifies or disrupts the normal communication between neurons.
What parts of the brain are affected by drug use?
Drugs can alter important brain areas that are necessary for life-sustaining functions and can drive the compulsive drug use that marks addiction. Brain areas affected by drug use include:
- ganglia, which play an important role in positive forms of motivation, including the pleasurable effects of healthy activities like eating, socializing, and sex, and are also involved in the formation of habits and routines. These areas form a key node of what is sometimes called the brain’s “reward circuit.” Drugs over-activate this circuit, producing the euphoria of the drug high. But with repeated exposure, the circuit adapts to the presence of the drug, diminishing its sensitivity and making it hard to feel pleasure from anything besides the drug.
- The extended amygdala plays a role in stressful feelings like anxiety, irritability, and unease, which characterize withdrawal after the drug high fades and thus motivates the person to seek the drug again. This circuit becomes increasingly sensitive with increased drug use. Over time, a person with substance use disorder uses drugs to get temporary relief from this discomfort rather than to get high.
- The prefrontal cortex powers the ability to think, plan, solve problems, make decisions, and exert self-control over impulses. This is also the last part of the brain to mature, making teens most vulnerable. Shifting balance between this circuit and the circuits of the basal ganglia and extended amygdala make a person with a substance use disorder seek the drug compulsively with reduced impulse control.
Some drugs like opioids also disrupt other parts of the brain, such as the brain stem, which controls basic functions critical to life, including heart rate, breathing, and sleeping. This interference explains why overdoses can cause depressed breathing and death.
How do drugs produce pleasure?
Pleasure or euphoria—the high from drugs—is still poorly understood, but probably involves surges of chemical signaling compounds including the body’s natural opioids (endorphins) and other neurotransmitters in parts of the basal ganglia (the reward circuit). When some drugs are taken, they can cause surges of these neurotransmitters much greater than the smaller bursts naturally produced in association with healthy rewards like eating, hearing or playing music, creative pursuits, or social interaction.
It was once thought that surges of the neurotransmitter dopamine produced by drugs directly caused the euphoria, but scientists now think dopamine has more to do with getting us to repeat pleasurable activities (reinforcement) than with producing pleasure directly.
Why are drugs more addictive than natural rewards?
For the brain, the difference between normal rewards and drug rewards can be likened to the difference between someone whispering into your ear and someone shouting into a microphone. Just as we turn down the volume on a radio that is too loud, the brain of someone who misuses drugs adjusts by producing fewer neurotransmitters in the reward circuit, or by reducing the number of receptors that can receive signals. As a result, the person’s ability to experience pleasure from naturally rewarding (i.e., reinforcing) activities is also reduced.
This is why a person who misuses drugs eventually feels flat, without motivation, lifeless, and/or depressed, and is unable to enjoy things that were previously pleasurable. Now, the person needs to keep taking drugs to experience even a normal level of reward—which only makes the problem worse, like a vicious cycle. Also, the person will often need to take larger amounts of the drug to produce the familiar high—an effect known as tolerance.
Long-term drug use impairs brain functioning.
What are the other health consequences of drug addiction?
People with addiction often have one or more associated health issues, which could include lung or heart disease, stroke, cancer, or mental health conditions. Imaging scans, chest X-rays, and blood tests can show the damaging effects of long-term drug use throughout the body.
For example, it is now well-known that tobacco smoke can cause many cancers, methamphetamine can cause severe dental problems, known as meth mouth, and that opioids can lead to overdose and death. In addition, some drugs, such as inhalants, may damage or destroy nerve cells, either in the brain or the peripheral nervous system (the nervous system outside the brain and spinal cord).
Addiction as a brain disease
Addiction and HIV/AIDS are intertwined epidemics.
Does drug use cause other mental disorders, or vice versa?
Drug use and other mental illness often co-exist. In some cases, mental disorders such as anxiety, depression, or schizophrenia may come before addiction. In other cases, drug use may trigger or worsen those mental health conditions, particularly in people with specific vulnerabilities.
Some people with disorders like anxiety or depression may use drugs in an attempt to alleviate psychiatric symptoms. This may exacerbate their mental disorder in the long run, as well as increase the risk of developing addiction. Treatment for all conditions should happen concurrently.
How can addiction harm other people?
The Impact of Addiction Can Be Far-Reaching
- Cardiovascular disease
- Hepatitis B and C
- Lung disease
- Mental disorders
Beyond the harmful consequences for the person with the addiction, drug use can cause serious health problems for others. Some of the more severe consequences of addiction are:
Negative effects of drug use while pregnant or breastfeeding: A mother’s substance or medication use during pregnancy can cause her baby to go into withdrawal after it’s born, which is called neonatal abstinence syndrome (NAS). Symptoms will differ depending on the substance used, but may include tremors, problems with sleeping and feeding, and even seizures. Some drug-exposed children will have developmental problems with behavior, attention, and thinking. Ongoing research is exploring if these effects on the brain and behavior extend into the teen years, causing continued developmental problems. In addition, some substances can make their way into a mother’s breast milk. Scientists are still learning about long-term effects on a child who is exposed to drugs through breastfeeding.
Negative effects of secondhand smoke: Secondhand tobacco smoke exposes bystanders to at least 250 chemicals that are known to be harmful, particularly to children. Involuntary exposure to secondhand smoke increases the risks of heart disease and lung cancer in people who have never smoked. Additionally, the known health risks of secondhand exposure to tobacco smoke raise questions about whether secondhand exposure to marijuana smoke poses similar risks. At this point, little research on this question has been conducted. However, a study found that some nonsmoking participants exposed for an hour to high-THC marijuana in an unventilated room reported mild effects of the drug, and another study showed positive urine tests in the hours directly following exposure. If you inhale secondhand marijuana smoke, it’s unlikely you would fail a drug test, but it is possible.
Increased spread of infectious diseases: Injection of drugs accounts for 1 in 10 of cases of HIV. Injection drug use is also a major factor in the spread of hepatitis C, and can be the cause of endocarditis and cellulitis. Injection drug use is not the only way that drug use contributes to the spread of infectious diseases. Drugs that are misused can cause intoxication, which hinders judgment and increases the chance of risky sexual behaviors, such as condom-less sex.
Increased risk of motor vehicle accidents: Use of illicit drugs or misuse of prescription drugs can make driving a car unsafe—just like driving after drinking alcohol. Drugged driving puts the driver, passengers, and others who share the road at risk. In 2016, almost 12 million people ages 16 or older reported driving under the influence of illicit drugs, including marijuana. After alcohol, marijuana is the drug most often linked to impaired driving. Research studies have shown negative effects of marijuana on drivers, including an increase in lane weaving, poor reaction time, and altered attention to the road.
drug abuse and addiction have grave consequences on our existing social systems, effecting crime rates, hospitalizations, child abuse, and child neglect, and are rapidly consuming limited public funds. The intravenous drug abuser represents the fastest growing vector of HIV virus. This report focuses on the social and economic implications of substance abuse and addiction and discusses the merits and limitations of several popular solutions to the problem. Considering how widespread this issue is, it makes you wonder how substance abuse affects society as a whole. The loved ones of individuals with drug or alcohol addictions make up our communities. Their parents, siblings, friends, and co-workers are people we may come across at any given moment and are more interconnected than we think. The impact of drug and alcohol abuse on the community can’t be narrowed down to one thing but, instead, has to be broken down into several categories. Effects of Drug Abuse on Family
Those closest to drug-addicted people are the ones who are most impacted. This includes parents, siblings, cousins, spouses, and children. Reemerging themes in families where one individual is addicted to drugs or alcohol include high levels of criticism and negativity, parental inconsistency, or lack of parental guidance, and even denial. Misdirected anger is also a common side effect of drug abuse on families, in which non-addicted family members may lash out in an attempt to cope with the situation.
Moreover, children of drug addicts often take up the responsibility of their parents, often functioning in denial of their parents’ problems with drugs or alcohol. Children in these situations often lack necessities, like shelter and health care. When calculating the national average, one survey found that a parent struggled with drug or alcohol abuse of the children who were removed from their homes and placed in out-of-home care. Other possible effects of parental drug abuse on children include increased risk of mental and behavioral disorders, abuse, neglect, and increased risk of developing a substance use disorder when they’re older.
Financial Effects of Drug Abuse
How drug abuse affects society also goes beyond financial costs and includes other costs like crime, unemployment, domestic abuse, divorce, homelessness, foster care, overdose-related deaths, birth defects in children, and the spread of diseases like HIV/AIDS and hepatitis.
Connection Between Drugs and Crime
Drug abuse and crime are also connected, as drug abuse increases the rates of violent crime. Alcohol plays a significant role in nearly every 4 of 10 crimes committed annually. Drug-related criminal activity, such as drug trafficking, can also significantly impact society.
If you’re still wondering, “How do drugs impact society?” we can narrow it down to:
- Increased child abuse and neglect
- Increased child custody losses
- Increased risk of homelessness and poverty
- Increased domestic disputes
- Increased health care costs
- Increased rates of co-occurring disorders
- Increased drug-related incarcerations and crimes
- Increased insurance premiums and taxes
- Decreased work productivity
- Increased strain on co-workers and employers
- Increased rate of violent crimes on college campuses
- Losses of revenue for businesses and schools
The effects of drugs on society are heartbreaking. No one is immune to addiction, and nearly every person who’s close to someone with an addiction is impacted. If you have a drug or drinking problem, don’t wait any longer to get help.
Can addiction be treated successfully?
Yes, addiction is a treatable disorder. Research on the science of addiction and the treatment of substance use disorders has led to the development of research-based methods that help people to stop using drugs and resume productive lives, also known as being in recovery.
Can addiction be cured?
Like treatment for other chronic diseases such as heart disease or asthma, addiction treatment is not a cure, but a way of managing the condition. Treatment enables people to counteract addiction’s disruptive effects on their brain and behavior and regain control of their lives.
These images showing the density of dopamine transporters in the brain illustrate the brain’s remarkable ability to recover, at least in part, after a long abstinence from drugs—in this case, methamphetamine.
TIPS FOR PREVENTING YOUTH ADDICTION
Recovery from addiction, whether it be alcohol, drugs or any behavioral addiction, can be one of the most challenging journeys of your life. Recovery is a daily battle requiring focus, determination, support and hope.
Overcoming the all-consuming power of addiction is no easy feat. You will often most likely awake to good days, or days filled with temptation and struggle. Somedays, you might lack the motivation to continue to fight.
Drug addiction recovery is a challenging experience. Fortunately, a tremendous amount of resources is available to help you along the way.
Life is a precious gift from God; we must honor and respect it.
Don’t Be Afraid to Say No: Sometimes, our fear of negative reaction from our friends, or others we don’t even know, keeps us from doing what we know is right. Real simple, it may seem like “everyone is doing it,” but they are not. Don’t let someone else make your decisions for you. If someone is pressuring you to do something that’s not right for you, you have the right to say no, the right not to give a reason why, and the right to just walk away.
Connect With Your Friends and Avoid Negative Peer Pressure: Pay attention to who you are hanging out with. If you are hanging out with a group in which the majority of kids are drinking alcohol or using drugs to get high, you may want to think about making some new friends. You may be headed toward an alcohol and drug problem if you continue to hang around others who routinely drink alcohol, smoke marijuana, abuse prescription drugs or use illegal drugs. You don’t have to go along to get along.
Make Connections With Your Parents or Other Adults: As you grow up, having people you can rely on, people you can talk to about life, life’s challenges and your decisions about alcohol and drugs is very important. The opportunity to benefit from someone else’s life experiences can help put things in perspective and can be invaluable.
Enjoy Life and Do What You Love – Don’t Add Alcohol and Drugs: Learn how to enjoy life and the people in your life, without adding alcohol or drugs. Alcohol and drugs can change who you are, limit your potential and complicate your life. Too often, “I’m bored” is just an excuse. Get out and get active in school and community activities such as music, sports, arts or a part-time job. Giving back as a volunteer is a great way to gain perspective on life.
Follow the Family Rules About Alcohol and Drugs: As you grow up and want to assume more control over your life, having the trust and respect of your parents is very important. Don’t let alcohol and drugs come between your and your parents. Talking with mom and dad about alcohol and drugs can be very helpful.
Get Educated About Alcohol and Drugs: You cannot rely on the myths and misconceptions that are out there floating around among your friends and on the internet. Your ability to make the right decisions includes getting educated. Visit Learn About Alcohol and Learn About Drugs. And, as you learn, share what you are learning with your friends and your family.
Be a Role Model and Set a Positive Example: Don’t forget, what you do is more important than what you say! You are setting the foundation and direction for your life; where are you headed?
Plan Ahead: As you make plans for the party or going out with friends you need to plan ahead. You need to protect yourself and be smart. Don’t become a victim of someone else’s alcohol or drug use. Make sure that there is someone you can call, day or night, no matter what, if you need them. And, do the same for your friends.
Speak Out/Speak Up/Take Control: Take responsibility for your life, your health and your safety. Speak up about what alcohol and drugs are doing to your friends, your community and encourage others to do the same.
Get Help!: If you or someone you know is in trouble with alcohol or drugs, (What to Look For), get help. Don’t wait. You are not alone.