Do you drink alcohol? Do you smoke cigarettes? Do you get your wakeup "fix" of caffeine every day? Chances are you use some substances on a regular basis. I wonder if you know
the difference between substance abuse, substance dependence, and substance addiction.
If you do have any of these behaviors, how do you classify yourself as to your use?
* Are you a responsible, occasional user who can take the substance or leave it?
* Are you using the substance primarily to alter your feelings?
* Are you dependent upon the substance to the point that using it has become habitual?
* Or, are you someone who can't stop using the substance, no matter how hard you try to quit?
Abuse, dependence, and addiction are distinct terms that require their own clear definitions. Although many people use them interchangeably, this practice contributes to misunderstanding the underlying causes of substance use. Through some simple research, you can increase your understanding of these states of usage and more precisely address drug issues.
William Cope Moyers, the son of journalist Bill Moyers, is the executive director of Hazelden's Center for Public Advocacy and vice president of their public affairs and community relations. He was once addicted to alcohol and crack cocaine, and he uses his own experiences to highlight the power of addiction and recovery. Moyers wrote Broken: "My Story of Addiction and Redemption" (2006) to improve people's understanding of alcohol and drug addiction.
"If we want the public and policymakers to understand addiction as an illness, we need to do a better job of differentiating between people who casually use those substances and those who are unable to stop using them on their own," says Moyers. "People like me never just abused those substances. We loved them. We protected them. And we would go to any lengths to get them."
(William Cope Moyers. "Clarifying addiction--helping define the disease of alcohol and other drug dependence." Hazelden Betty Ford Foundation. 2015.)
Most importantly, knowledge can help you identify problem behaviors in yourself or in your loved ones. It is also key to this discussion to remember that alcohol and nicotine can be very harmful substances and they should be included in the definitions of drug abuse, dependence, and addiction.
Abusing
Abusing a drug abuse simply means that a person uses the substance in a manner that does not conform to social norms; the motivation to use the substance may or may not be particularly strong compared with other motivators. But, usually, abusing involves an intense desire to use increasing amounts of a particular substance or substances to the exclusion of other activities.
Abuse can involve using a substance in maltreatment or it can involve excessive or habitual use of drugs not needed for therapeutic purposes, solely to alter one's mood, affect, or state of consciousness.
Natasha Tracy is an award-winning writer from the Pacific Northwest who specializes in writing about pharmacology, bipolar disorder, depression and other mental health issues. Tracy shares four common symptoms of drug abuse:
* Drug use has negatively impacted performance in work or school.
* Risky acts endangering the drug user or others are committed as a result of drug use, for example, drinking and driving.
* Continuation of drug use in spite of the negative consequences drug use is having on relationships.
* Legal or financial problems as a result of drug use.
(Natasha Tracy. "Signs of Drug Abuse - Symptoms of Drug Use and Drug Abuse."
healthyplace.com. January 16, 2012.)
Dependence
Drug dependence refers to a state where an individual is dependent upon a substance for normal physiological functioning. The National Institute on Drug Abuse says physical dependence reflects how the body adapts to the drug, requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal). Abstinence from the substance that produces these withdrawal reactions may constitute the only evidence for this dependence.
Dependence can result from the prolonged and usually intense (chronic) consumption of a drug or drugs. It can be a component of addiction, but it does not equal addiction.
The Addiction Science Network cites dependence signs ...
"Drug dependence can involve disturbances in general bodily (i.e., somatic) function such as vomiting, diarrhea, sweating, and the resulting symptoms indicate a physical dependence syndrome which is usually specific for a given class of drug.
"Drug dependence can also involve disturbances in psychological functioning, such as inability to concentrate, anxiety, depression, and the resulting symptoms indicate a psychological dependence syndrome which often shares common features with other abused drugs.
"It is important to note that psychological dependence has a physiological basis and thus it is preferable to use the term physical dependence to refer to disturbances in somatic function to avoid confusion."
("Why Distinguishing between Drug Dependence and Drug Addiction is Important." Addiction Science Network. addictionscience.net. 2015)
A number of substances produce dependence without producing an addiction. For example, the therapeutic uses of certain steroids, antidepressant medication of the SSRI class, and even some antihistamines can all produce characteristic withdrawal syndromes when their use is abruptly discontinued. However, there is no strong motivation to continue the use of these substances for most patients; some patients even refuse to resume treatment with such drugs because of their adverse experience during unsupervised withdrawal.
Other substances like coffee can produce a notable psychological dependence without producing an exceptionally strong motivation to avoid abstinence. Caffeine has desirable stimulating effects that involve general arousal accompanied by a mild mood elevation for many daily coffee drinkers. The motivation to moderate or stop this condition is far below the level produced by highly addictive drugs such as cocaine and heroin.
Addiction
Drug addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use. Addiction is manifested via behavioral symptoms, most notably continued use of the substance in spite of clear harmful effects on the individual and their family. It is considered a brain disease because drugs change the brain; they change its structure and how it works. These brain changes can be long lasting and can lead to many harmful, often self-destructive, behaviors.
Addiction involves a behavioral syndrome where the procurement and use of a drug seem to dominate the individual's motivation and where the normal constraints on the individual's behavior seem largely ineffective. An addict has an overwhelmingly powerful motivation to obtain and self-administer his substance.
"Every time I hear people say that they're addicted to something, I feel like shaking my head," says Carlton Erickson, Ph.D., director of the Addiction Science Research and Education Center at the University of Texas at Austin. "When the word is used so loosely, it detracts from the seriousness of problems with heroin, cocaine, alcohol and nicotine."
These are additional drug addiction symptoms in a user:
* Consumes large and even dangerous amounts of the drug
* Makes certain to maintain a supply of the drug
* Spends money on the drug, even though he can't afford it
* Does things to get the drug that he normally wouldn't do, such as stealing
* Becomes unable to stop using the drug even after repeated attempts to do so
Summary
The Addiction Science Network has a helpful summary of distinctions ...
"Drug abuse describes the misuse of a substance without explicit reference to motivational strength; drug dependence describes the necessity of using a substance to maintain normal psychological and/or somatic functioning without reference to the motivational strength of the substance use or to whether the substance use violates cultural norms; and drug addiction describes the motivational strength of substance use."
Carlton Erickson adds this helpful distinction:
"To summarize, drug dependence is unintentional and involuntary, while drug abuse is intentional and voluntary. This distinction is already being made in the medical literature, including the International Classification of Diseases from the World Health Organization.
Telling a person who is dependent on alcohol to "just say no" is like telling a person with clinical depression to just cheer up," Erickson says. He adds, "If we avoid the imprecise language of addiction, we can avoid such ineffective responses."
(Carlton Erickson, Ph.D. "Clarifying addiction--helping define the disease of alcohol and other drug dependence." Hazelden Betty Ford Foundation. 2015.)
There exists a lack of understanding about drugs, drug use, and drug abuse in Scioto County. From the top of government down, we must re-educate ourselves in order to improve the general health of the citizenry. Knowledge is power, and strong activism is the dominant force that induces needed change. In my opinion, improving the drug problem is Priority Number One.
We do not need common rumors, half-truths, and lies to add to the significant confusion that thwarts effective drug education, drug treatment, drug legislation, and drug enforcement. In my opinion, anyone who believes substance abuse is a problem that can simply be solved by adding more and more "handcuffs" and "arrests" needs to wake up, discover actual sources for the problem, and dedicate themselves to finding real, research-based solutions.
This significant endeavor takes open-minded people willing to suspend their prejudices and their long-held stereotypes about drug abuse to allow themselves to view anew something most simply detest -- something they prefer to ignore in stolid indignation because they are sure they and their loved ones will never become addicted.
And, I need to say this: If leaders refuse to prioritize substance abuse in Scioto County, they are ignoring the major contributor to health problems (physical and psychological wellness), job procurement, and financial independence in our area.
Just complaining about addiction exacerbates frustration while doing nothing to improve the quality of life that remains horribly low. Blame without commitment to proven, effective strategies is counterproductive. But, oh, I fear the old views will remain because stating anything other than utter distaste for an issue involving the words drug abuse is liable to jeopardize the standing of a person in the eyes of others.
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