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What is substance abuse?

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Substance abuse or misuse is ‘the continual misuse of any mind altering substance which severely interferes with an individual’s physical and mental health, social situation and responsibilities’.

Alcohol dependence is the most common problem of this kind, but the misuse of any drug, including heroin, cocaine, crack and cannabis, comes into this category, as does the misuse of volatile substances such as glue and aerosols.

Substance abuse may also include smoking cigarettes or drinking excessive amounts of coffee. Although not strictly a form of substance abuse, the eating disorder bulimia nervosa does involve the misuse of food.

Most forms of substance abuse may give you a temporary feeling of well being or of being in control but all of them can ultimately damage your health.

The most severe forms of substance misuse are normally treated by specialist drug and alcohol rehabilitation services. For people with mental health problems who are also substance misusers, the mental health team normally encourages contact with a specialist substance misuse service for help. There is also a lot you can do to help yourself.

What leads to substance abuse?

There are many reasons why you may start to use and then go on to misuse any of these substances. You may begin because of curiosity, a sense of rebellion or influence from your peers. You may find the experience enjoyable and want to repeat it. It may start when you are unhappy or stressed or trying to cope with problems in your life. Drugs, alcohol, nicotine, solvents and even food can start as ‘props’ to help you get through difficult times. But the feelings of relief are only temporary, and as the problems don’t disappear, you may use more and more of these substances and risk becoming dependent on them – which in itself creates new problems.


Coffee, tea and chocolate all contain caffeine. It is also added to some soft drinks and energy drinks as well as being an ingredient in some painkillers and cold remedies. The amount of caffeine in different products depends on the product and on how they’re prepared. The average cup of coffee contains around 40mg per cup, a can of cola around 23mg,whereas some energy drinks have four times that amount. Plain chocolate has 40-mg caffeine per 100g – nearly three times as much as milk chocolate.

Dependent on caffeine

Caffeine stimulates the brain and nervous system. It can make you feel more alert and better able to concentrate, and it also increases acid production in the stomach, which helps digestion. If you regularly have large quantities of caffeine – say, five or more cups of coffee a day – you may find your tolerance has increased and you need to drink even more to get the same stimulant effect.

The disadvantages of caffeine are that it raises your heart rate and blood pressure and makes you pass more urine – so you may end up losing calcium if you have too much. Sensitivity to caffeine varies from person to person, but too much can make you anxious, restless, irritable, jittery and sleepless. It can also give you headaches, stomach pain, nausea, muscle twitching or palpitations.

Medicinal drugs, such as tranquillisers and sleeping tablets, are initially prescribed for very good reasons, but they can also cause health problems if used for long periods. Experts believe tranquillisers only really help anxiety for about a month and that sleeping tablets are only effective for a couple of weeks. After that time you may find you need a higher dose to get the same effect and even then your anxiety may increase or your sleeplessness return.

Street drugs, such as cannabis or ecstasy, are usually taken for recreational purposes. How they affect you will depend on the type of drug, the amount you use, your mood and surroundings. For some people, the first hit can cause problems, especially if the drug contains impurities. For other people, the problems may start as their bodies get used to the repeated presence of the drug, and they need higher and higher doses to maintain the same effect.

Types of drugs
All drugs can be divided up according to the main effect they have on users.

These include caffeine and tobacco as well as amphetamines, anabolic steroids, ‘poppers’, hallucinogenic amphetamines (ecstasy), cocaine and crack. They act on the central nervous system and increase brain activity. Users generally feel more confident and alert, are able to stay awake for longer or perform physical tasks for a long period of time. With all except tobacco, high doses can cause nervousness and anxiety. Apart from tobacco and caffeine, stimulants can cause temporary feelings of paranoia.

These include minor tranquillisers such as Valium, Librium, Mogadon and temazepam, solvents, glues, aerosols and gases. Depressants act on the central nervous system and slow down brain activity. They relax users, making them feel less tense and anxious, but at the same time impair mental and physical activity and decrease self-control.

Analgesics are painkillers and include heroin, opium, pethidine and codeine. They make users less sensitive to emotion and physical pain and produce feelings of warmth and contentment.

These include cannabis, LSD and ‘magic’ mushrooms. Hallucinogens act on the mind, heightening sensations and distorting the way users see and hear things.

Signs you may be becoming dependent on drugs

If you rely on drugs to help you feel less anxious or depressed or to improve your mood, you may be becoming psychologically dependent. If you rely on drugs to achieve certain physical effects or you can’t face the unpleasant physical effects of not taking the drugs, you may be becoming physically addicted. In fact most drug-related problems generally involve physical and psychological symptoms and sometimes it is difficult to separate the two.
Other signs that you could be becoming dependent on drugs:

  • If obtaining and taking drugs are more important than anything else in your life
  • If you use drugs to block out both physical and emotional pain
  • If you use drugs to distance yourself from problems such as loneliness, family or relationship problems, low self esteem, poverty or housing difficulties, unemployment or lack of opportunities.

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