Substance Abuse

Substance abuse definitions are like other diseases or ailments definitions.  Very precise and a little bit different depending on who you are talking to.

The National Institute on Drug Abuse (NIDA) says addiction is this:

Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her. Although the initial decision to take drugs is voluntary for most people, the brain changes that occur over time challenge an addicted person’s self control and hamper his or her ability to resist intense impulses to take drugs. NIDA

The World Health Organization (WHO) says substance abuse is:

Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. Psychoactive substance use can lead to dependence syndrome – a cluster of behavioral, cognitive, and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state.  WHO

That definitions sounds like they know what they are talking about but, what are “harmful or hazardous use”.

Wikipedia defines substance abuse as:

Substance abuse, also known as drug abuse, is a patterned use of a substance (drug) in which the user consumes the substance in amounts or with methods which are harmful to themselves or others.  Wikipedia

What does the Diagnostic and Statistical Manual (DSM) offer us on the subject.  It is about the same as WHO’s but rumor has it that the term will be changed.  According to The Fix the:

DSM V will no longer use the labels “substance dependence” and “substance abuse” but will instead classify addiction problems under the heading “Substance Use and Addictive Disorders. The Fix

That changes everything because the DSM is the gold standard for mental health diagnosis.

Substance Abuse

Substance abuse occurs when you use drugs, (any drug – alcohol, prescription medication, illegal drugs), to get a high or to escape the reality you live in.  When you begin abusing a substance it can, but does not have to, lead to dependence.

Using 2 vicodin when your doctor says use 1 is abuse (and illegal).  But that isn’t what we are talking about.  Using drugs to get high on any kind of regular pattern can be risky.  It is also substance abuse.  People are less addicted to the specific drug’s chemical makeup than they are to the high feeling they think they need.  So if you find yourself or someone else using drugs as intoxicants in any kind of weekly and predictable  pattern.  That is risky.  Getting drunk every New Years Eve is barely worth mentioning, feeling the need to get drunk every weekend is.  Look for people who like the high.


If you have a boyfriend/girlfriend who likes to smoke pot and for some reason they find they have to stop, such as for a new job interview.  Watch to see if their alcohol consumption goes up.  If it does, they are most likely substituting one drug for the other.  If you have noticed this in someone than you understand that THC is not the thing their body wants most.  Otherwise they would use it.  THC is just their preferred method of getting high.  They can substitute ETOH (ethyl alcohol) for the THC.  They are addicted to the high.  If their body really needed the drug THC it would demand THC.  For instance, we need oxygen and we cannot substitute anything else for it or our body will tell us to do anything to get it.  Addiction is not about your body needing a particular molecule.  It is about the high.  It is about increasing/decreasing the neurotransmitters in our brain.  THC and ETOH are just the way we manipulate our brains to give us what we really want.  Our neurotransmitters at a level we we find pleasurable.

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