Substance abuse occurs when a person uses an illegal or legal substance, such as alcohol, tobacco, or a prescription medication, either too much or in the wrong way, often for the pleasurable physical or mental experience that comes with it.
Usually, people abusing substances can stop their behavior before it has significant health effects. Substance abuse, which is behavioral in nature, is different from addiction, which is a disease. Medically known as substance use disorder, addiction affected more than 19.7 million American adults (ages 12 and older) in 2017.
Substance abuse and substance use disorder are both closely linked with mental illnesses like anxiety and depression. People who have anxiety and depression are more likely to abuse substances, and substance abuse can cause or exacerbate existing anxiety and depression.
Decreasing or even quitting the use of drugs and alcohol is crucial for health. With psychological support and, if needed, medical treatment, people can overcome substance abuse and addiction and in turn lessen their likelihood of experiencing detrimental health effects.
What Is Substance Abuse?
Substance abuse occurs when a person uses illegal drugs or legal substances that alter their behavior or mind—such as alcohol, tobacco, or prescription drugs—too much or the wrong way. Usually, substance abuse involves a pattern of someone using potentially harmful substances for the physiological outcome in spite of potential health or behavioral risks.
It’s important to differentiate substance abuse, a primarily behavioral problem, from addiction, which is a disease. Most people who abuse substances can stop, while people with addiction are generally unable to stop using harmful substances without medical intervention.
What is the difference between substance abuse and substance use disorder?
Substance use disorder is the medical term for addiction. Substance abuse is a behavior a person can change, while substance use disorder implies physiological dependence on a substance. Often, addicted individuals build a physiological “tolerance” for the substance they are abusing. This means that they need more and more of the substance to achieve the same effect, which leads to a spiral of increased substance use and can result in serious health problems over time.
In order to be diagnosed with an addiction, a person must meet certain diagnostic criteria that show physiological dependence on a substance. The National Institute on Drug Abuse (NIDA) uses the term “addiction” to describe compulsive drug seeking despite negative consequences.
For example, a person with an addiction who continues using detrimental substances for the rewarding, physiological outcome, in spite of harmful effects on their health, work, or relationships.
A substance use disorder is typically diagnosed and treated by a mental health professional such as a psychiatrist, psychologist, or licensed drug and alcohol counselor.
Common substance use disorders include:
- Alcohol use disorder
- Cannabis use disorder
- Opioid use disorder, including heroin and prescription pain medications such as oxycodone, codeine, and morphine
- Tobacco use disorder
- Sedative, hypnotic, or anxiolytic use disorder, which includes addiction to sleeping pills or anti-anxiety medications
If you think you may have a substance use disorder, talk with a mental health professional.
Commonly Abused Substances
People engage in substance abuse for a number of reasons. Their physiological and mental effects are a significant factor. Legal and illegal substances contain chemicals that can alter how a person’s mind and body work, often resulting in temporary feelings of relaxation or pleasure.
Substance abuse may include the following:
Alcohol abuse is defined differently for men and women. For men, heavy drinking is defined as more than four drinks in a day or 14 in a week. For women, due their lower body weight, heavy drinking means more than three drinks a day or seven drinks in a week.
One drink is quantified as:
- 12 ounces of regular beer
- 8-9 ounces of malt liquor
- 5 ounces of wine
- 1 1/2 ounces of distilled spirits like gin or vodka
People who abuse alcohol can easily consume less of the substance. The difference is that an alcoholic is a person who is physiologically dependent on alcohol and its effects.
Unfortunately, both alcoholism and alcohol abuse can result in liver damage. Although symptoms of liver disease may not occur until late in the course, some signs of liver damage to be aware of include:
- Abdominal pain and swelling
- Swelling of the legs or ankles
- Itchy skin
- Dark urine color
- Pale stool color
- Nausea and vomiting
- Chronic fatigue
- Skin and eyes that look yellow (jaundice)
- Loss of appetite
- Bruising easily
If you experience any of these symptoms, you should see your doctor right away.
Prescription and over-the-counter (OTC) medicine
At times, people may abuse prescription or over-the-counter medications for their mild altering effects. This can lead to a drug addiction. Abuse of legal medication occurs when when a person takes a prescription or OTC medicine:
- Prescribed for someone else
- More frequently than it’s supposed to be taken
- In a higher dose than it’s supposed to be taken
- For a non-medical reason
Some of the most common prescription drugs people abuse include:
- Opioids, such as hydrocodone (Vicodin), oxycodone (OxyConton or Percocet), morphine (Kadian or Avinza), and fentanyl
- Medicines used to treat attention deficit hyperactivity disorder (ADHD)
- Anti-anxiety medications, such as alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), and lorazepam (Ativan)
- Sleeping medications, such as zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta)
Commonly abused OTC drugs include:
- Cough and cold medicine that contain dextromethorphan, an opioid derivative
- Decongestants that contain pseudoephedrine, an ingredient in illegal methamphetamine (“meth”)
Illegal drugs can be dangerous with even occasional use. Many illegal drugs can alter a person’s thinking and judgment, resulting in risky behaviors. They also present significant health risks, including drug addiction, drugged driving, infectious disease, and adverse effects on pregnancy.
Commonly abused illegal drugs include:
- Heroin, the organic version of prescription opioids
- Marijuana, which is illegal in most U.S. states and the most widely used illegal drug in the world
- Hallucinogens, such as ketamine, LSD, PCP, psilocybin, salvia, DMT, and ayahuasca
Tobacco contains a highly addictive chemical called nicotine. Tobacco products people may abuse include:
- Pipe tobacco
- Tobacco smoked via a water pipes, also known as hookah
- Smokeless tobacco, or e-cigarettes
- Chewing tobacco
What Causes Substance Abuse?
At the most basic level, substance abuse is caused by using drugs or alcohol more often or in a higher dose than needed. A number of external and biological factors can also contribute to alcohol abuse and drug abuse, including:
- A genetic predisposition to addiction or abuse
- A history of mental illness, including depression and anxiety
- Childhood trauma or neglect
- Lack of social support
- Peer pressure
- The belief that drug abuse or alcohol abuse aren’t harmful
While these are some of the most common causes of substance abuse, not everyone with substance abuse has experienced these things. No matter what the cause, it’s important to seek the support of a health provider if you’re abusing substances.
Identifying Substance Abuse
Signs of substance abuse can vary from person to person. Common red flags that you may have a problem with substance abuse include:
- Using drugs or alcohol more often than you used to
- An emotional need for drugs or alcohol to get through an experience
- Lack of interest in things you normally enjoy
- Symptoms of depression or anxiety
- Friends and family noticing or commenting on your behavior
- Changes in how you take care of yourself
- Changes in your sleep routine
- Increased irritability or aggression
- Problems at work or with loved ones
- Involvement in illegal or risky behavior
- Frequent mood changes
If you’re experiencing any of the above, or you need support in overcoming substance abuse, schedule an appointment with a medical provider who can help you pinpoint next steps for reducing your drug and alcohol abuse.
How to Treat Substance Abuse
Treating substance abuse, including drug abuse and alcohol abuse, involves helping people learn how to decrease their substance use or stop it altogether. Seeking mental health treatment, such as psychotherapy or a drug and alcohol support group, is one way to overcome substance abuse.
Often, people with substance abuse problems also have anxiety and depression. Treating those disorders with therapy and/or medication can prevent substance abuse.
Learning other ways to cope with stress can also be helpful in reducing substance use. Stress-reducing methods may include:
- Exercising more frequently
- Practicing mindfulness, meditation, or yoga
- Getting ample sleep
- Eating a nutritious diet
- Seeking social support from loved ones
It can be overwhelming to face substance abuse, but with positive lifestyle changes and social support, people can often overcome unhealthy substance use.
Since it’s a disease, and since many substances can lead to withdrawal, treating drug addiction and alcohol addiction generally requires more medical intervention.
Sobriety is the first step. Many people who recover from substance use disorder manage to abstain from the substance they were previously addicted to. To help reduce symptoms of withdrawal, doctors sometimes prescribe medications. This may happen in an in-patient setting like a hospital or drug and alcohol treatment center. Other people may seek out-patient treatment.
Other medications can help maintain sobriety by reducing cravings or causing a person to feel sick when a substance like alcohol enters the body.
Many approaches are known to be successful in treating substance use disorders, such as:
- Behavioral counseling
- Medical devices that treat withdrawal symptoms
- Treating co-occurring mental illnesses, like anxiety and depression
- Long-term follow up
- Social support, including groups such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA)
If you or someone you know is suffering from substance abuse, call the SAMHSA (Substance Abuse and Mental Health Services) National Helpline at 1-800-662-HELP (4357). SAMHSA can connect you with local treatment facilities, support groups, and other organizations. The hotline is available 24/7, and it’s confidential and free.
Risk Factors and Complications
Anyone can abuse substances, but people may be more likely to do if they experience the following:
- Emotional stress
- Major life transitions, like a job loss, divorce, or death of a loved one
- A hereditary predisposition to addiction or mental illness
Substance abuse can come with a number of physical, emotional, and social complications. Some of the health problems stem from the substance itself, while lack of judgment related to substance use can cause a number of social problems.
Some of the most common complications related to substance abuse include:
- Drug overdose or alcohol poisoning
- Brain damage
- Increased risk of disease, like cirrhosis (liver failure), cancer, or heart disease
- Sexual dysfunction
- Unwanted pregnancy
- HIV or AIDS
- Sexually transmitted infections (STIs)
- Anxiety and depression
- Domestic violence
- Child abuse
- Vehicle crashes
- Physical fights
If you or someone you know is facing complications related to substance abuse or a substance use disorder, you’re not alone. A physician can help get you on the right path for better health.
When to See a Doctor
If you’re concerned you’re abusing a substance or substance abuse is interfering with your life, it’s important to talk to a medical provider who can help you determine the best course of treatment.
Withdrawal from substances can be a medical emergency. If you or someone you know experience any of the following withdrawal symptoms, seek medical help right away:
If you have a diagnosed substance use disorder and a history of withdrawal symptoms, talk to a doctor before you quit.
How K Health Can Help
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K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.