What is substance use? What are the signs and symptoms of substance use problems? This is first in the series of content on substance use shared by the Addictions Research Group team at Sangath India.
Substance use refers to any consumption of psychoactive or mood-altering “substances''. These could be legal substances such as alcohol or tobacco, illegal substances such as marijuana or heroin, and also prescription or over-the-counter medications used for purposes other than those for which they are meant to be used, or in excessive amounts. Something as common as sharing a beer with friends over dinner is considered to be substance use.
Pleasure is a part of substance use. Substances can produce a “high”, give us energy, make us feel good, reduce stress, or aid sleep. People use alcohol and other substances in social settings such as bars, clubs, and parties to enhance their interactions with others through increased confidence, greater sociability, and less anxiety. People use substances for a wide variety of reasons and one’s use of substances is a personal choice. It is important to know what you are putting in your body, how it affects you, and why you are using it.
People may use substances for a wide variety of reasons, including but not limited to:
- Coping with stress or dealing with difficult emotions
- Co-occuring mental health conditions such as anxiety, depression, or trauma
- Family history of substance use
- Peer and social pressure
- For pleasure, recreation, or fun
- Curiosity about substance use or to experiment
In many instances, people can use substances responsibly, in a way that does not negatively impact their ability to go about their everyday life or cause any harm to themselves or others. At times though, substance use can cross over into misuse. Substance misuse typically refers to the use of any of the above mentioned psychoactive substances in a way that is harmful or hazardous to health. One should note that substance use is a spectrum and it’s not completely black or white or rather right or wrong. It’s important to identify when substance use transitions into substance misuse, so you can take a few precautions.
The substance use spectrum
This is what a substance use spectrum looks like.
- On one end, we have ‘no use’ while on the other there is ‘severe use’, characteristic of a substance use disorder.
- Experimental use is when one tries a drug once or twice out of curiosity. Social and recreational use refers to the use of a drug for enjoyment, particularly to enhance a mood or social occasion. Regular/Daily bingeing is when a person consumes a heavy amount of drugs over a short period of time, and/or uses continuously over a number of days or weeks. This is where it starts inching into drug misuse territory.
- On the other end of the spectrum, we have excessive use of substances, which can be classified as mild, moderate, and severe. Prolonged or heavy use over time, or a continuous need to take the drug consistently in order to feel normal or to avoid uncomfortable withdrawal symptoms, is indicative of a disorder.
For example, if you are drinking alcohol once or twice a week on a social occasion for pleasure, that could be categorised as “recreational use”; however, feeling an overwhelming “need” to consume alcohol through the week might be a sign that “use” is moving towards a “substance disorder”. The intention behind substance consumption might be one of the most important ways to recognize whether it is recreational use or addiction.
When should one seek help for substance misuse?
The presence of any of the following substance misuse signs indicates that one may need to reach out and seek help:
- Feeling that you have to use the substance regularly, and having intense urges to have the substance that block out any other thoughts.
- Not meeting obligations and work responsibilities, or being unable to engage in social or recreational activities because of substance use.
- Continuing to use the substance, even though you know it's causing problems in your life or causing you physical or psychological harm.
- Spending money on the substance, even though you can't afford it.
- Doing things to get the substance that you normally wouldn't do, such as stealing.
- Driving or doing other risky activities when you're under the influence of the substance.
- Failing in your attempts to stop using the substance.
- Experiencing distressing physical and behavioural symptoms when you attempt to stop taking the substance.
It can also cause:
- Changes in energy, such as being unexpectedly and extremely tired or energetic.
- Extreme mood changes, feelings of sadness and fear.
- Low self-esteem and poor motivation.
- Physical changes including bloodshot eyes, increased illness, and changes in weight and complexion.
- Sleeping a lot more or less than usual, or at different times of the day or night.
These are a few changes you can observe in a person who is misusing substances. Using substances is not explicitly a bad thing. When you use a substance to such an extent that you start to experience increasingly more problems than benefits, that should be your signal to cut back. If you have observed some of these warning signs and symptoms of substance misuse in a friend or loved one, you might feel uncertain about addressing the issue. It can be difficult to communicate your concern, especially if you are worried it might result in a conflict. Still, it is crucial to reach out, and provide the necessary resources so that they are out of harm’s way.
In the link here are some helplines you can contact for support.
In the next article in the series, read about the signs of substance misuse and the approach for recovery from a substance use problem.
Also read, How to Support Substance Use Recovery in a Loved One
This article is produced by the Addictions Research Group team at Sangath India. Our content production and editorial team includes Kyra Semelhago, Dr Abhijit Nadkarni, Urvita Bhatia, Kedar Mirchandani, and Shubhangi Kashyap.
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