DIFFERENT KINDS OF SUBSTANCE-RELATED BEHAVIOUR

The effects, risks, and dangers of psychoactive substances (also known as psychotropics) vary with the substance and the way that it is used. People’s reasons for using these substances also vary, depending on their personal history, health, family background, and social setting.

Psychoactive substances can provide immediate sensations of pleasure or relief. For example, people may:

  • drink a glass of wine because they enjoy the
    taste, or to relax, or to calm down after a
    frightening experience, or, alternatively, simply
    because they have become dependent on it;
  • smoke tobacco to imitate their peers, or to
    spend time with their friends or co-workers,
    or simply because they can't quit;
  • take ecstasy in the hope of experiencing
    intense sensations;
  • abuse substances for many other reasons— for example, to reduce feelings of uneasiness, to forget painful memories, or to escape difficult situations.

Whether the substance is licit or illicit, three types of substance use behaviours are distinguished: use, abuse, and dependence.

Each of these types of behaviours involves different risks. These risks depend on what substance is used, how much, how often, and by which method of use. The risks also depend on the vulnerabilities of the particular user and on various social, psychological, and cultural factors.
Whether the substance is licit or illicit, three types of substance-use behaviours are distinguished: use, abuse, and dependence


WHAT IS A PSYCHOACTIVE SUBSTANCE?

Alcohol, coffee, heroin, GHB, amphetamines, cocaine, and cannabis are all psychoactive substances, which means that they affect people’s mental processes. Psychoactive substances:

  • alter people’s perceptions, moods, thinking, behaviour, and various physical and psychological functions; using them exposes people to risks and health hazards and can have social consequences in their daily lives; it can also lead to dependence;
  • also cause bodily reactions that vary widely with the properties of each substance, its effects, and how harmful it is.

In Canada, all psychoactive substances are legally regulated

In Canada, drugs such as ecstasy, LSD, and PCP are all illicit (illegal) substances, and the federal Controlled Drugs and Substances Act prohibits and sets penalties for producing, possessing, importing, exporting, and trafficking them, unless authorized by virtue of specific Regulations.

Marijuana is also an illegal substance in Canada, but its use is sometimes authorized here within the very specific framework, of the Marihuana Medical Access Regulations.

Psychoactive medications (anxiolytics, analgesics, sedatives, hypnotics, antidepressants, antipsychotics, and mood stabilizers) are licit (legal) substances. They are prescribed by physicians to treat anxiety, agitation, insomnia, depression, pain, psychoses, and mood disorders. Their production, distribution and use are strictly controlled, and a prescription is needed to obtain them.

Alcohol and tobacco are legal substances that are consumed freely.

WHAT IS SUBSTANCE USE?

Use means using one or many psychoactive substances without giving rise to health or behavioural problems that might harm users themselves or anyone else.

Substance use is common among teenagers and young adults who may experiment with a psychoactive substance—most commonly, cannabis or alcohol—out of curiosity, for the fun of it, or because of peer pressure. Most of the time, this use seems to stop there, without escalating to increased use. Occasional, moderate use of to alcohol and cannabis also fits this definition.

WHAT IS SUBSTANCE ABUSE?

Substance abuse means using psychoactive substances in a way that may cause physical, psychological, economic, legal, or social harm to users themselves or to people directly or indirectly associated with them.

The risks of substance abuse relate chiefly to the specific dangers of the particular substance–the damage that it can do to users’ health and related social impacts.

Health risks

Substance use becomes substance abuse when it impairs the user’s physical or psychological health, aggravates certain illnesses, or even causes premature death.

Social risks

Substance use also becomes substance abuse when it endangers or harms the user or other people (for example, if someone drives a car while under the influence of alcohol or another drug).

In the vast majority of cases, occasional use does not result in escalation


TELLTALE SIGNS OF SUBSTANCE ABUSE

You know someone is abusing a substance if they are:

  • using it in situations where it can be dangerous (for example, if it makes them less alert while driving a motor vehicle or operating a dangerous piece of equipment);
  • having repeated run-ins with the law in connection with their use of the substance (for example, committing crimes or getting into accidents while under its influence);

  • experiencing personal or social problems (such as financial difficulties or deteriorating family relationships, etc.) caused or aggravated by the substance’s effects on their behaviour;

  • having trouble in meeting or failing to meet their obligations at school, work, or home because of their substance use (for example, being absent repeatedly, receiving poor marks or poor performance evaluations, absenteeism, isolating themselves from other people, or shirking their responsibilities);

  • showing an inability to go without the substance for several days in a row;

  • threatening someone else’s health or safety through their substance use (for example, when a pregnant woman takes a drug that poses health risks for her baby).

DEPENDENCE: WHEN DOES IT START?

Suddenly or gradually, depending on the substance, substance dependence occurs when someone can no longer stop using a particular substance without experiencing physical or psychological distress.

There are two types of substance dependence: physical dependence and psychological dependence. They can occur either together or separately.

When daily life revolves largely or solely around getting and using a substance, then one is dependent on it.

Addiction is characterized by the following general symptoms:

  • inability to resist the need to take the substance;

  • increased inner tension or anxiety before taking the substance at the usual time;

  • an experience of relief after taking the substance;

  • a feeling of loss of control while taking the substance.

PSYCHOLOGICAL DEPENDENCE

Psychological dependence, also called psychic dependence, means that if someone suddenly starts taking less of a drug, or stops taking it completely, he experience psychological symptoms characterized by an emotional and mental preoccupation with the effects of the drug and a craving to take it again.

Drug deprivation causes uneasiness, anxiety, and sometimes even depression. Once they stop using the drug, people may need time to adjust to life without it. All of their old habits will be gone, leaving a void that may sometimes cause them to start re-experiencing the same feelings that led them to take the drug in the first place. That in turn may cause relapses, sometimes repeatedly; this is part of the slow process that may eventually lead to a life without drug abuse.

PHYSICAL DEPENDENCE

Some substances create a physical dependence, in which the body has adapted to the continuous presence of the drug. When the concentration of the drug falls below a certain level, the body demands more of it by displaying various physical symptoms known withdrawal symptoms or simply withdrawal.

Deprivation of some substances such as opioids, tobacco, alcohol and some psychoactive medications causes physical uneasiness that may vary according to the substance: pain in the case of opioids; trembling and convulsions in the case of alcohol, barbiturates and benzodiazepines.

These physical symptoms may be accompanied by behavioural symptoms (e.g., anxiety, irritability, agitation).

Withdrawal occurs when someone suddenly or even progressively stops taking a drug. To help such people break their drug dependencies without suffering too much from the physical symptoms of withdrawal, public and private centers are available in Canada that provide medical and psychosocial assistance. The treatments that these facilities offer may include medically assisted withdrawal, personalized rehabilitation programs, and substitution treatment. The medical follow-up and psychosocial support that these facilities provide can be invaluable in overcoming withdrawal problems and facilitating rehabilitation. In general, this support encourages and reinforces the desired results.

POLYSUBSTANCE USE: MULTIPLE SUBSTANCES, MULTIPLE DANGERS

When someone takes several different substances, the problems can get more complicated.

When someone takes one psychoactive substance, they may end up taking others along with it. For example:

  • cigarettes with alcohol

  • cocaine with heroin (a combination known as a speedball)

  • tobacco and alcohol with cannabis

  • cannabis laced with PCP (“killer weed”)

  • psychoactive medications with ecstasy

Such behaviour is called polysubstance use. Its dangers are often misunderstood. Combining multiple substances can amplify their harmful effects, sometimes posing serious health risks.

There is a close correlation between use of cigarettes and use of other psychoactive substances. In particular, use of alcohol, sedatives, heroin, and amphetamines is associated with increased cigarette smoking.

Several studies have also shown a relationship between the degree of dependence on alcohol and dependence on tobacco. Alcoholics tend to smoke more and to experience less success when they try to quit.





 Drug deprivation causes uneasiness, anxiety and sometimes even depression Withdrawal occurs when someone suddenly or even progressively stops taking a drug Polysubstance use can lead to polyaddiction