Substance Use

I often hear terms like substance, substance use, substance misuse, substance abuse and addiction. Do these words all mean the same thing or are they different?

• Substances: Substances refer to drugs or alcohol that have a psychoactive and/or physiological effect when ingested or introduced into the body. These substances alter mood and cognition and impact individuals in a variety of ways depending on the substance.
• Substance Use: Substance use refers to the consumption of any drugs or alcohol. Use is typically casual and limited, such as having a drink at dinner.
• Substance Misuse: Substance misuse refers to using substances for a purpose not consistent with legal or medical guidelines.  It often involves excessive use of substances, most often with prescription medications. For example, taking more medication than is prescribed.
• Substance Abuse: Substance abuse refers to the continuous use of drugs or alcohol even when it causes physical, mental, emotional, legal, economic, or social harms, or issues in someone’s personal life. Problems or issues that could result from this include missing work, violence and health issues such as liver disease or malnutrition.
• Substance Use Dependence or Addiction: Dependency or addiction occurs when someone is unable to stop using drugs or drinking alcohol. Individuals often experience physical withdrawal symptoms when stopping use. Daily use is needed in order to function or feel normal. 

Frequency and duration of substance use depends on the individual, and the substance itself. Individuals can use substances experimentally, in specific situations (e.g., bar), occasionally, or intensively.

There are four broad classifications that substances can belong to. These include:

• Stimulants: Stimulants increase activity of the central nervous system. Individuals may appear agitated, develop fast or loud speech, become sweaty or grind/clench their teeth. Examples of stimulants include methamphetamine, cocaine, ecstasy, caffeine and Ritalin.
• Depressants: Depressants decrease activity of the central nervous system. Individuals may appear sleepy, develop slow or slurred speech, have impaired coordination or slow breathing. Examples of depressants include alcohol, cannabis, and opioids such as codeine, heroin and fentanyl.
  • Hallucinogens: Hallucinogens are drugs that cause hallucinations, altered perceptions, and significant changes in thoughts, emotion and/or consciousness. Individuals often see, hear and feel things not there, develop paranoia, and feel out of control. Examples of hallucinogens include LSD (acid), ketamine, and magic mushrooms.
  • Anti-psychotics: Anti-psychotics control psychotic symptoms such as hallucinations, delusions, paranoia, and/or mania. Individuals may experience blurred vision, drowsiness or dizziness, and restlessness. Examples of anti-psychotics include Clozapine and Risperidone.

• Substance of choice (e.g., class of substance, strength, cost)
• Setting (i.e., location of where person uses substance, social and cultural norms)
• Personal characteristics (e.g., psychological state, physical size, health, tolerance, reason for use)