Substance Abuse

A single definition for drug dependence is impossible. The term drug dependence of a specific type emphasizes that different drugs have different effects. Addiction refers to a style of living that includes drug dependence. Usually this dependence is both physical and psychological. Dependence usually is considered to be a compulsive use and overwhelming involvement with a drug. In addition, addiction implies the risk of harm and the need to stop use whether the addict agrees or not.

Drug or substance abuse is defined only in terms of society’s disapproval and involves different kinds of behavior.

Drug abuse can include:

  1. Experimental and recreational use of drugs
  2. Use of drugs to relieve problems or symptoms
  3. Use of drugs to relieve problems or symptoms which leads to a dependency

Recreational drug use has increasingly become a part of our culture even though it is not sanctioned by our society. Recreational users tend toward sporadic drug use involving relatively small doses and they apparently do not suffer harm from their exposure. Recreational use is seldom practiced alone. Most drugs used in this manner are used to obtain a “high” rather than to relieve distress. For this reason, depressant drugs are seldom used for the “recreational” user.

Two general aspects are common to most types of drug dependence:

  1. Psychological dependence involves feelings of satisfaction and a desire to repeat the use of the drug in order to produce pleasure or avoid pain. The mental state is a powerful factor involved in chronic use of certain drugs.
  2. Physical dependence is a state of addiction to a drug accompanied by development of tolerance displayed by a withdrawal or abstinence syndrome. Tolerance is a need to increase the dose progressively in order to produce the effect originally achieved by smaller amounts. A withdrawal syndrome is characterized by physiological changes that occur when the drug is discontinued, such as convulsions, violent shaking and twisting, sweating, vomiting, delirium, etc.

Drugs that produce dependence act on the Central Nervous System and produce one or more of the following effects: reduced anxiety or tension; elation, euphoria, or other pleasurable mood changes; feelings of increased mental and physical ability; altered sensory perception; and changes in behavior. These drugs can be divided into two categories: those which cause psychological dependence and those which cause both a physical and psychological dependence. Drugs which cause primarily a mental dependence include: cocaine, marijuana, amphetamine, bromides and the hallucinogens, such as LSD, MDA, and mescaline.

The development of drug dependence is complex and unclear. At least three components require consideration: the addictive drugs, predisposing conditions, and the personality of the user. The psychology of the individual and drug availability determine the choice of the addicting drug and the pattern and frequency of use.