Substance Use/Misuse

Lifetime rates of substance use disorders in the Canadian population falls at about 20%.  Alcohol is by far the most common substance for abuse or dependence, although cannabis abuse or dependence is also widespread.  Other substances that may be abused include stimulants (amphetamines, cocaine, nicotine, etc.), depressants (valium, xanax, barbiturates, etc.), dissociatives (ketamine, PCP, etc.), hallucinogens (LSD, mushrooms, etc.), and inhalants (propane, nitrous oxide, etc.).

 

 

 

 

Substance abuse is defined as the use of alcohol or drugs to

the point of impairment in at least one of the following areas:

  • Significant role obligations are neglected as a result of the substance use.

  • The substance is used in physically hazardous situations (ie. driving a car, working on a construction site).

  • Legal problems result from the substance use.

  • The substance use is continued despite persistent interpersonal problems that are caused or worsened by the effects of the substance.

  • Note: substance abuse can occur, and often does, without any symptoms of tolerance, withdrawal, or a compulsive pattern to use, as seen in substance use dependence.

 

Substance use dependence is defined as a pattern of repeated

self-administration of the substance, in addition to three or more of

the following symptoms:

  • And increase in tolerance and the need for increased amounts to achieve desired effects.

  • Withdrawal symptoms.

  • Unintended increased in usage in terms of time period or quantity.

  • A persistent desire for the substance or an inability to control/cut-down the usage.

  • An increase in the amount of time spent obtaining, using, or recovering from the substance.

  • Limited or avoided social, occupational, or recreational activity due to substance use.

  • Continued use of the substance despite physical or psychological problems likely cause or exacerbated by the substance.

 

Some of the signs that substance use may

be a problem include:

  • Intense urges or cravings for the substance.

  • An increase in poor judgement and/or risky behaviours due to the substance use.

  • Increased isolation due to embarrassment, depression, paranoia, anxiety, or perceived stigma.

  • Financial trouble, particularly as it relates to the purchasing of the substance.

  • Physical signs such as tremors or shakes in the hands, feet, or head, deterioration of hygiene, nausea, excessive sweating, or irregular heartbeats.

  • Changes in overall attitude or personality, with no other identifiable cause.

  • Chronic dishonesty.

  • An excessive need for privacy.

  • Possession of a fake ID.

  • Difficulty paying attention or concentrating.

  • General lack of motivation, self-esteem, or energy, with no other identifiable cause.

© 2019 Trish Stephens, Psychotherapist - Ottawa, Canada