What Exactly Is Substance Abuse?

Substance Abuse

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You should not underestimate the dangers of substance usage. It happens when you use alcohol, prescription medication, and other legal and illegal substances excessively or incorrectly.

Addiction is not the same as substance misuse. Many people who have drug abuse problems are able to quit or adjust their destructive habit. Addiction, on the other hand, is a sickness. It means you can’t quit utilising even if your condition is causing you damage.

Substance abuse, often known as drug abuse, is defined as the use of a drug in quantities or ways that are harmful to the user or others. It is a type of substance abuse disorder. Drug abuse is defined differently in public health, medicine, and the criminal justice system.

Criminal or anti-social behaviour may occur in some situations when a person is under the influence of a drug, and long-term personality changes in individuals may also occur. In addition to potential physical, social, and psychological harm, the use of some drugs may result in criminal consequences, which vary greatly depending on the local jurisdiction.

Drugs That Are Commonly Abused

Both legal and illegal medicines contain substances that can alter how your body and mind function. They can provide a nice “high,” alleviate tension, or assist you in avoiding problems in your life.

Alcohol, amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, and hallucinogens are the drugs most commonly linked with this word. The precise root of substance abuse is unknown, but there are two leading theories: a hereditary susceptibility or a learned habit that, if addiction develops, manifests as a chronic disabling disease.


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Everyone is affected differently by alcohol. However, if you drink excessively and frequently, your chances of injury or accident increase. Heavy drinking can also cause liver and other health issues, as well as lead to a more serious alcohol disorder.
You’re drinking too much if you have more than four drinks on any given day or more than 14 in a week as a guy. Heavy drinking for women is defined as more than three drinks in one day or more than seven drinks per week.

One of the drinks is:

12 ounces normal beer
8-9 ounces malt liquor (stronger than beer)

5 ounces  of wine
1 1/2 ounces distilled alcohol such as vodka or whisky

Medicine, both prescription and over-the-counter (OTC).

These have the potential to be just as harmful and addictive as illegal substances. You can become addicted to medication if you:

  • Take medication that was prescribed for someone else.
  • Take extra doses or utilise a medicine in a way that is not recommended.
  • Take the medication for a non-medical reason.

Prescription medicines that are commonly abused include:

  • Opioid analgesics
  • Stimulant drugs are those that are used to treat attention deficit hyperactivity disorder.
  • Anxiety and sleep aids
  • Cough and cold medications containing dextromethorphan, which can make you feel drunk or intoxicated in high dosages, are the most widely abused OTC pharmaceuticals.

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Nicotine is the most abused substance in the world. Despite the fact that smoking has fallen in recent years, it is believed that 40 million Americans are nonetheless addicted to nicotine, despite its well-publicized negative effects.

Again, just because something is legal does not imply it cannot be exploited. The fact that the detrimental health effects of nicotine take a long time to show may contribute to the widespread use of tobacco.


Caffeine is the most regularly used mood-altering medication in the world, while nicotine is the most abused. Yes, too much caffeine is bad for your health.

Caffeine usage has also been linked to a number of mental illnesses, including caffeine-induced sleep disorder and caffeine-induced anxiety disorder, according to research. Caffeine use should be reduced or eliminated for people with generalized anxiety disorder, panic disorder, primary insomnia, and gastroesophageal reflux.


Designer drugs and synthetic drugs, such as bath salts and synthetic marijuana, are not (yet) illegal, although they can be abused and are potentially more hazardous than other narcotics.

Other designer medications that are frequently abused are:

  • Amphetamines
  • sEcstasy
  • sLSD
  • sGHB
  • sKetamine
  • PCP Rohypnol (dating rape drugs)
Steroids anabolic

Despite the fact that anabolic steroids do not have any mood-altering or intoxicating qualities, they can nevertheless be abused. Because of the harmful side effects of steroid use, using anabolic steroids to improve performance or increase muscle and strength is considered abusive. In some circumstances, these might vary from merely irritating to life-threatening. Substance abuse occurs when the usage of a substance can cause harm. Almost any substance, in theory, can be abused.

Value assessment

According to Philip Jenkins, the word “drug abuse” has two problems. To begin, the definition of “drug” is controversial. For example, GHB, a naturally occurring substance in the central nervous system, is classified as a drug and is outlawed in many countries, yet nicotine is not classified as a drug in the majority of countries.

Second, the term “abuse” implies that any substance has a recognised standard of use. In most Western countries, drinking a glass of wine every now and then is regarded acceptable, however drinking several bottles is considered excessive. Drinking even one glass would be considered an abuse by strict temperance advocates, who may or may not be religiously motivated.

In the United States, narcotics are legally classified into five schedules: I, II, III, IV, or V under the Controlled Substances Act. The medications are categorised based on their propensity for abuse. The use of certain medicines is strongly linked.

For example, the consumption of seven illicit drugs (amphetamines, cannabis, cocaine, ecstasy, legal highs, LSD, and magic mushrooms) is correlated, and the Pearson correlation coefficient r>0.4 in every pair of them; cannabis consumption is strongly correlated (r>0.5) with nicotine (tobacco) usage, heroin consumption is correlated with cocaine (r>0.4) and methadone (r>0.45), and crack consumption is strongly correlated (r>0.5).

Abuse of drugs

In the United States, prescription medication use is quickly approaching criminal drug use. In 2010, 7 million people were consuming prescription medicines for nonmedical purposes, according to the National Institute on Drug Abuse. Nonmedical prescription drug use is now second only to cannabis among 12th students. In 2011, “almost one in every twelve high school seniors reported nonmedical use of Vicodin; one in every twenty reported such use of OxyContin.” Both of these medications contain opioids.

According to a 2017 study of 12th students in the United States, 2.7 percent overuse OxyContin, compared to 5.5 percent at its peak in 2005. Misuse of the hydrocodone/paracetamol combination was at its lowest level since 2003, when it peaked at 10.5 percent. This drop could be attributed to public health activities and a reduction in availability.

Law enforcement is increasingly holding physicians accountable for prescribing banned narcotics without fully establishing patient controls, such as a “drug contract” with the patient. Concerned doctors are learning how to recognize medication-seeking behaviour in their patients and are getting acquainted with “red flags” that would alert them to potential prescription drug addiction.



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Several evidence-based approaches have evolved from the applied behaviour analytic literature, behavioural psychology, and randomised clinical trials: behavioural marital therapy, motivational interviewing, community reinforcement approach, exposure therapy, and contingency management. They aid in the suppression of cravings and mental worry, the improvement of concentration on treatment and new learning behavioural skills, the alleviation of withdrawal symptoms, and the reduction of the likelihood of relapse.

For the treatment of substance misuse disorders in children and adolescents, cognitive behavioural therapy (CBT) and family therapy currently have the most research evidence.

Furthermore, brief school-based treatments have been shown to be successful in reducing teenage alcohol and cannabis use and misuse. Motivational interviewing can also be used to treat teenagers with substance abuse disorders.


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A number of drugs have been licenced for the treatment of substance dependence. These include buprenorphine and methadone replacement therapy, as well as antagonist drugs like disulfiram and naltrexone in either short or long acting forms. Several other drugs, many of which were first used in different situations, have also been proved to be beneficial, including bupropion and modafinil. Methadone and buprenorphine are sometimes used to treat opiate addiction. These medicines are used as alternatives for other opioids and still cause withdrawal symptoms, but they help with the tapering off process in a regulated manner.

Antipsychotic drugs have not been found to be effective. Acamprostate is a glutamatergic NMDA antagonist that helps with alcohol withdrawal symptoms since alcohol withdrawal is connected with a hyperglutamatergic system.

Dual diagnosis

Individuals with a substance use disorder are likely to have other psychological issues. The terms “dual diagnosis” or “co-occurring disorders” relate to having both a mental health and a substance use disorder at the same time. According to the British Association for Psychopharmacology (BAP), “symptoms of mental illnesses such as sadness, anxiety, and psychosis are the rule rather than the exception among individuals who misuse drugs and/or alcohol.”


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Policymakers attempt to understand the relative costs of drug-related measures. An acceptable drug policy is based on an assessment of drug-related public expenditure based on a classification system in which expenses are appropriately identified.

Drug-related expenditures are defined as direct planned spending that demonstrates the state’s voluntary participation in the sector of illicit substances. Direct public expenditures expressly designated as drug-related can be easily tracked back by thoroughly analysing official accounting documents such as national budgets and year-end reports. Unlabeled expenditure is unplanned spending that is estimated using modelling tools and a top-down budgetary procedure. This approach estimates the fraction of overall aggregated spending that is causally due to substance addiction (Unlabeled Drug-related Expenditure = Overall Expenditure Attributable Proportion).

To estimate the jail drug-related expenses in a certain country, for example, two components would be required: the overall prison expenditures in the country for a given period, and the attributable fraction of inmates due to drug-related concerns. The result of the two will be an approximate estimate that may be compared across countries.

Manifestations and symptoms

Drug misuse, including alcohol abuse, can result in health problems, social problems, morbidity, injuries, unprotected sex, violence, deaths, motor vehicle accidents, homicides, suicides, physical dependency, or psychological addiction, depending on the compound.

Alcoholics and other drug addicts commit suicide at a high rate. Long-term alcohol and other drug misuse, which causes physiological brain chemical distortion, as well as social isolation, are thought to raise the risk of suicide.

Suicide is also quite common in teenage alcohol drinkers, accounting for one in every four suicides in adolescents. In the United States, alcohol misuse is responsible for around 30% of suicides. Alcoholism has also been linked to an increase in the likelihood of committing criminal offences such as child abuse, domestic violence, rapes, burglaries, and assaults.

Drug misuse, including alcohol and prescription pharmaceuticals, can cause symptoms similar to mental illness. This can happen when drunk as well as during withdrawal.
Substance-induced psychiatric illnesses, such as persistent psychosis or depression after amphetamine or cocaine misuse, might remain long after abstinence in some circumstances. A protracted withdrawal syndrome can also develop, with symptoms lasting months after the drug has been stopped.

During intoxication, cannabis may produce panic attacks, and long-term use may result in a state comparable to dysthymia. Researchers discovered that both daily cannabis usage and high-potency cannabis use are independently linked to an increased risk of developing schizophrenia and other psychotic diseases.

Sustained alcohol addiction frequently causes severe anxiety and sadness. Even modest alcohol use might induce anxiety and depression in some people. In most cases, these drug-induced psychological illnesses resolve with prolonged abstinence. Similarly, while substance misuse causes many changes in the brain, there is evidence that many of these changes are reversed after periods of sustained sobriety.

Evaluation and screening

The screening and assessment of substance use behaviour is critical for diagnosing and treating substance use disorders. Screeners are used to detect people who have or may be at risk of developing a substance use disorder. They are usually quick to administer. Assessments are performed to help determine the right treatment by clarifying the nature of the substance use behaviour. Assessments typically necessitate specialised knowledge and take more time to administer than screeners.

Given that addiction causes structural changes in the brain, non-invasive magnetic resonance imaging may one day be used to help identify addiction.

A Thought from Very-well

Image via Shilpa Sarkar

Is your substance abuse causing you harm? If you believe this is the case for you, you are not alone. According to the most recent estimates, around 27.1 million Americans—roughly one in every ten people—misuse substances.
In 2015, an estimated 21.7 million people required substance abuse treatment, but only three million received it.

Talk to your doctor about your treatment choices if you use substances for recreational purposes, misuse prescription medications, or take substances to become inebriated.