Substance abuse

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Substance abuse, or drug abuse, happens when a person uses a drug over and over again, in ways that are harmful to their health. The person is using the drug to change his or her mood or to feel better, not for any healthy reason. Sometimes when the person uses the drug for a long time, they will start to act differently. Some of the drugs are illegal to have or use, or can have certain limits that the person does not follow. Someone who thinks that they need a drug is called an addict.

Is it substance abuse?[change | change source]

Substance abuse can have different symptoms in different people. “Drug abuse” is not used in the DSM or ICD. In the DSM, the term “substance abuse” is used instead to mean the misuse of one of ten different types of drugs.  A person can also become dependent on drugs.[1] Repetitive use of a drug can cause dependence as well as tolerance. Tolerance happens when it takes more of a drug to produce the same effect than a previous time.

The term “drug misuse” is sometimes used when the drug being used is a prescription medication that are classified as sedatives (medicines that make someone calm), anxiolytics (medicines that make someone less worried or anxious), analgesics (medicines that reduce pain), or stimulants (medicines that give someone more energy).[2] Someone who abuses there drugs may have to illegally buy them from someone who gets them from a doctor.

Not everyone agrees on the definition of substance abuse. Different countries have different rules for what is a drug and what drugs are illegal. People also do not agree about what is abuse. In most Western countries, one glass of wine is acceptable, but drinking more than one bottle at once is abuse. To some people, any drinking can be seen as abuse. In the United States, any use of marijuana is illegal, except in a few states where marijuana can be given by a doctor.

What causes people to abuse substances?[change | change source]

In many cases, when a person is using drugs, their thinking and behaviors change. Sometimes, they commit crimes while using drugs. They may do things that are not safe, like drive a car while drunk. When people abuse drugs over a longer time, their personalities often change as well. The people who abuse drugs are often addicted. Since many of these drugs are illegal, very often drug abusers have problems with the law.

There are two major ideas about why people abuse drugs.[3] One is that a person’s genes cause them to be likely to become dependent on drugs. In this case, the drug abuse is learned from someone else, usually a family member or friend. The other major idea is that drug use is a habit that becomes harmful. In this case, if a person becomes addicted, they begin to abuse the drug.

What kind of drugs are abused?[change | change source]

People abuse drugs in many different ways, including:

Illegal drugs[change | change source]

Some of the most commonly abused illegal drugs are:[4]

Legal drugs and medicines[change | change source]

Some of the most commonly abused legal drugs and medicines are:[4]

Substance abuse, depression, and suicide[change | change source]

People who abuse drugs have a high rate of suicide. This is because of the changes in the brain caused by drugs, both when they are being used and the changes they cause over time. Another cause is the loss of family and friends because of the drug abuse. In the United States, about 30% of all people who perform suicide have abused alcohol at some point.[5]

This table explains more about how some commonly abused drugs relate to depression and suicide:

Substance abused Effects related to suicide
Alcohol People who misuse alcohol are more likely to have a number of mental health disorders. Alcoholics have a very high suicide rate. Suicide from alcoholism is more common in older adults.[6] If a person drinks 6 or more drinks per day, they are six times more likely to commit suicide.[7][8] Many heavy drinkers have major depressive disorder, and heavy drinking itself can cause major depressive disorder in a lot of alcoholics.[9]
Benzodiazepines People are more likely to be depressed, and have a higher risk of suicide, if they have been abusing benzodiazepines (like Xanax) or using them for a long time.[10] Depressed adolescents who were taking benzodiazepines were much more likely to hurt themselves or kill themselves.[11]
Cigarette smoking Many studies have shown a link between smoking, thinking about suicide, and suicide attempts.[12][13] In studies done with 50,000 nurses and 300,000 male U.S. Army soldiers, the people who smoked between 1 to 24 cigarettes per day had twice the suicide risk, and people who smoked 25 cigarettes or more had 4 times the suicide risk, as compared with those who had never smoked.[14][15]
Cocaine Misuse of drugs such as cocaine often has a link with suicide. When cocaine's effects wear off, people go through cocaine withdrawal. During this time, many people feel very bad. Suicide is most likely to happen during this time in people who use a lot of cocaine or are addicted. In younger adults, suicide more commonly happens when two or more drugs are taken together.
Crystal meth Crystal meth use has a strong link with depression and suicide, as well as a range of other bad effects on physical and mental health.[16]
Heroin 3% to 35% of deaths among heroin users are thought to be from suicide. Overall, heroin users are 14 times more likely than people who do not use heroin to die from suicide.[17]

Treating substance abuse[change | change source]

Treatment of substance abuse can include both therapy and medicine. Therapy for substance abuse helps people not use drugs when they feel they need to. For children and young adults, both the child and the family may have therapy. The child will learn how to not abuse, and the family will learn how to help the child. The organization Alcoholics Anonymous helps people with alcohol abuse.[18]

For some kinds of substance abuse, medicine can be used to help.[19] Some of these medicines, such as methadone, stop the drug from working in the brain. Other medicines can cause people to feel ill if they use the substance that they abuse.

Many substances can cause withdrawal. Withdrawal is a group of things that happen when someone who regularly takes a drug stops using that drug. For someone to have withdrawal, they must be addicted to the drug. Different drugs cause different things to happen during withdrawal. They can also cause different amounts of trouble for the person in withdrawal. Withdrawal for some drugs, like heroin and other opiates, can be dangerous and should be done with someone taking care of the person in withdrawal.

Likelihood[change | change source]

About 9% of Americans have a substance abuse issue. Young people are the most likely to experiment with and abuse drugs. Drug abuse affects about 5% of adolescents.[20] More men than women have substance abuse disorder, though women are more likely to have an issue with abusing prescription medication. Children who have parents with substance abuse issues are more likely to have a substance abuse issue when they grow up.

Special populations[change | change source]

Certain groups of people are more likely to develop substance abuse issues. One group is immigrants or other people who have left their home country. They often have issues in their new country, and some use drugs as a way to feel better.[21]  Another group that is at risk is homeless children. They will use drugs to become closer to each other.[22] A third group that is at risk is musicians. They may use stimulants to make themselves more active and happy. Singers can also hurt themselves if they use drugs that are inhaled.[23]

History[change | change source]

The first official definition for substance abuse was made in 1932 by the American Psychiatric Association. This definition was only used for when the substance was illegal and not being used as medicine.[24] In 1966, the American Medical Association defined abuse as the drug being given by someone to themselves without a doctor.

The first edition of the Diagnos[25]tic and Statistical Manual of Mental Disorders (DSM) had drug abuse as a symptom of other psychological issues. In the third edition, substance abuse was made its own issue. The DSM also has drug abuse as a different issue than drug dependence, which is defined as compulsive use of a drug.

Society and culture[change | change source]

Most countries have laws that make having or using certain drugs illegal. The rules for these drugs can be different between countries or in different parts of the same country. Many drugs that are illegal in several places are sold to make money for groups known as drug cartels.

Drug abuse can also cause issues in a country’s economy. According to the European Union, about 2.5 billion dollars are lost each year because of people abusing drugs. This loss comes from people not going to work or having to go to the hospital because of side effects of the drug. In the United Kingdom, about 29 billion dollars a year are lost.[26] This number does not include the cost of police or other law enforcement. In the United States, the cost was 181 billion dollars in 2002. This number includes costs because of health issues, loss of work, law enforcement, and welfare programs.

Related pages[change | change source]

References[change | change source]

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  2. Barrett SP, Meisner JR, Stewart SH (November 2008). "What constitutes prescription drug misuse? Problems and pitfalls of current conceptualizations" (PDF). Curr Drug Abuse Rev 1 (3): 255–62. 
  3. "Addiction is a Chronic Disease". http://archives.drugabuse.gov/about/welcome/aboutdrugabuse/chronicdisease.
  4. 4.0 4.1 "Commonly Abused drugs Charts". DrugAbuse.gov. National Institute on Drug Abuse. October 2015. http://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs-charts. Retrieved December 24, 2015.
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  16. Darke, S.; Kaye, S.; McKetin, R.; Duflou, J. (May 2008). "Major physical and psychological harms of methamphetamine use". Drug Alcohol Rev 27 (3): 253–62. doi:10.1080/09595230801923702. PMID 18368606.
  17. Darke S, Ross J (November 2002). "Suicide among heroin users: rates, risk factors and methods". Addiction 97 (11): 1383–94. doi:10.1046/j.1360-0443.2002.00214.x. PMID 12410779. http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0965-2140&date=2002&volume=97&issue=11&spage=1383.
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  19. The California Evidence-Based Clearinghouse: Current Pharmacological Treatment Available for Alchhol Abuse. Copyright 2006-2013.
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  26. http://drugs.homeoffice.gov.uk/drug-strategy/drugs-in-workplace