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Substance Abuse Overview

Overview of substance abuse and alcoholism. Find out the difference between substance abuse and substance dependence and the characteristics of alcoholism.

What is Substance Abuse?

The use of various substances to modify mood or behavior is generally regarded as normal and acceptable in our society. Many people drink coffee or tea for the stimulant effects of caffeine, or engage in the social drinking of alcohol. On the other hand, there are wide cultural variations. In some groups, even the recreational use of alcohol is frowned upon, whereas in other groups the use of various legal or illegal substances for mood-altering effects has become widely accepted. In addition, certain over-the-counter and prescription medications may be medically recommended to relieve tension or pain or to suppress appetite.

But when regular use of these substances begins to interfere with normal functioning, creating behavioral changes that would be undesirable to people from any cultural background, substance use has turned to substance abuse. As psychiatrists define it, a person has a substance abuse problem when they continue to use a substance--some form of drug, medication or alcohol -- despite the recurring social, occupational, psychological or physical problems such use causes. Such behavior is indicative of a mental disorder which can turn an illegal or a legal substance into a "drug" and which requires psychiatric medical treatment.

Substance abuse, the misuse of alcohol, cigarettes and both illegal and legal drugs and medications and other mood-altering substances is, by far, the predominant cause of premature and preventable illness, disability and death in our society. According to the National Institute of Mental Health, nearly 17 percent of the U.S. population 18 years old and over will fulfill criteria for alcohol or drug or other substance abuse during their lifetimes. When the effects on the families of abusers and people close to those injured or killed by intoxicated drivers are considered, such abuse affects untold millions more.


 

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The annual cost of alcohol abuse is nearly $86 billion for treatment and indirect losses such as reduced worker productivity, early death and property damage resulting from alcohol-related accidents and crime each year. Alcohol intoxication is associated with approximately 50 percent of the nation's traffic fatalities and homicides every year. Drug abuse accounts for $58 billion a year in direct and indirect costs to business and the economy. Cigarette smoking has long been known to cause cancer and emphysema and heart disease, but quitting cigarettes is greatly complicated because most smokers declare that they would like to quit, but they have lost control of the habit. This is especially true of smokers who begin smoking when they are adolescents or young adults. The economic toll of these different forms of substance abuse amounts to over four times that of cancer and nearly a third greater than that of cardiovascular disease, according to a 1984 Research Triangle Institute report.

Among the disorders related to the misuse of these substances, a distinction is made between substance abuse and substance dependence. As related above, those whom psychiatrists and other mental health professionals would classify as "substance abusers" can't control their use of alcohol or other drugs. They become intoxicated on a regular basis--daily, every weekend or in binges--and often need the substance for normal daily functioning. They repeatedly try to stop the use but fail.

Those who are considered to be dependent on a substance suffer all the symptoms of drug abuse, with the addition that they have developed a physical tolerance for it, so that increased amounts are necessary for the desired effects. Opiates (such as heroin), alcohol and amphetamines (such as methamphetamine) also lead to physical dependence in which the person develops withdrawal symptoms when he or she stops use.

Alcohol Abuse

Overview of substance abuse and alcoholism. Find out the difference between substance abuse and substance dependence and the characteristics of alcoholism.While alcohol is considered by psychiatrists to be a "drug," for the purposes of this pamphlet its abuse is being discussed separately from that of other drugs.

The National Council on Alcoholism and Drug Dependence (NCADD) and the American Society of Addiction Medicine (ASAM) define alcoholism as: A primary, chronic disease...characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial." NCADD and ASAM further say that by "disease" they mean "involuntary disability," and that the symptoms of alcoholism may be continuous or may occur periodically. Further, the two groups say that the development of alcoholism in a person is influenced by genetic, psychosocial, and environmental factors, and that the disease of alcoholism is often progressive and fatal.

Social stigma has blocked the road to understanding of alcoholism more than with any other disease. Society has long viewed the affliction as a psychological problem alone--the sign of a ravaged soul devoid of discipline or morality. Physicians are inclined to ignore its symptoms and victims deny its existence.

Recent scientific breakthroughs, however, have begun to dramatically alter our views on alcoholism. The myth that alcoholism is a "psychological problem" is yielding under the weight of evidence that the disease has its roots in biological causes. This news holds significant hope for the estimated 15.4 million adult victims of alcohol, as well as the 56 million people directly affected by their alcohol abuse or addiction. Such discoveries may eventually lead to prevention or detection of the disease before its damage becomes irreversible.

continue: Characteristics of Alcoholism

Last Updated: 29 March 2017
Reviewed by Harry Croft, MD

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