Addiction Awareness Week: Continuum of Substance Misuse

by Neseret on November 15, 2011

One Drop: Re-edit
The use of mood and consciousness altering substances is a universal human culture since the dawn of human history.

Substance use refers to the ingestion or administration of any substance that is psychoactive, meaning it alters mood and consciousness. Psychoactive substances include caffeine, alcohol, tobacco, illegal drugs, and some prescription medications. It is quiet common and culturally accepted to use legal drugs such as caffeine, nicotine and alcohol without much thought.

Substance use can range from beneficial to problematic depending on the quantity, frequency, method and context of use. Substance misuse refers to instances or patterns of use that has the potential to cause physical, psychological, economic and social problems.

Substance misuse can have negative impact on a person’s functioning, security, health and wellbeing.

Ultimately substance misuse has impact on families and communities at large. A recent Canadian cost study, based on 2002 data, estimated the overall social cost of substance misuse to be 39.8 Billion, representing a cost of $1267 for every Canadian. Substance misuse is everyone’s concern. Education and awareness about substance misuse are key factors in prevention, health promotion as well as in eliminating stigma.

Substance misuse falls within the continuum of varying degrees of substance use. Here are some of the ranges and types of use


Person using for social, health and or spiritual reasons. Use may or may not have positive health, spiritual and social impact. Substances used here are typically tea/coffee, red wine, ceremonial use of tobacco and some pharmaceuticals.

No use

An individual may choose not to use any substances as a personal choice or because of religious and or cultural beliefs or due to health related concerns.


An individual maybe curious about substances or maybe using due to peer pressure. Use is often on limited occasions and person typically experiences minimal consequences. They may have occasional hangover, gain status with their friends and easily rationalize their use.

Regular use

Use becomes an integral part of a person’s life. Friendships develop with people who use. Use becomes more frequent – maybe weekly or daily. Sometimes occurs during and before work, at lunch or during breaks. Person spends less time with non- using friends. May experience minor negative impact in work and interpersonal relationships.

Abuse or problematic use

Use becomes a lifestyle. Person uses to cope with stress, feelings, responsibilities, relationship conflicts etc. Use becomes excessive and person may need higher doses due to tolerance. Person also maybe trying stronger drugs and or combining drugs to get the same effect. Everything else in the person’s life revolves around their habit or pattern of use. Typically at this point a person’s work, school performance and attendance is affected. There maybe legal and financial problems due to their substance use. People here at great risk for compromising their health and personal values.

Addiction or Dependency

Substance use becomes a preoccupation and the centre of most if not all interactions. Person has lost control of their substance use. Extreme intoxication is common. Previously unthinkable methods of using substances become possible. Person may feel like they are unable to function. The person maybe using to medicate a mental illness. They may also be using to avoid the physical and psychological pain of withdrawal.

Series negative consequences arise in many areas of the person’s life. Person may suffer from physical problems such as weight loss, blackouts, and other illnesses. They may also exhibit behaviors such as aggression, guilt and self hate. They may avoid work, family and friends. At this point people tend to isolate themselves and maybe too ashamed to seek help. In addition they may have difficulty understanding and accepting that their substance use is causing many of their problems.

Depending on the drug of choice individuals may move rapidly through the different stages of use. The younger the person is when they choose to use the greater the risk of abuse and dependency. As drug use progresses there is a definite loss of control and ultimately choice.

The American Psychiatric Association defines substance dependence as an individual persisting in use of substances despite problems related to use of the substance. It is also defined as a “maladaptive pattern of substance use leading to clinically significant impairment or distress.”

Please take time to share your thoughts, ideas and experiences below.

Peace, Love & Gratitude,


{ 1 comment… read it below or add one }

Dominic Mando May 10, 2015 at 1:15 pm

I’m glad of the distinction you made between substance use and misuse. Quite surprising actually that a lot of people equate those two! There are a lot of misconceptions here, that’s why it’s very hard to find middle ground


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