substance abuse personal essay

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Essay on Drug Abuse in 250 and 500 Words in English for Students

• Updated on  
• Apr 2, 2024

Drug abuse refers to the excessive and frequent consumption of drugs. Drug abuse can have several harmful effects on our mental and physical health. Ronald Reagan, the 40th President of the USA, passed the Anti-Drug Abuse Act of 1986 and initiated the War on Drugs . He said, ‘Let us not forget who we are. Drug abuse is a repudiation of everything America is.’

Consuming drugs not only harms the individual himself but also affects society as a whole. Studies have shown that people who consume drugs become addicted to it. This addiction turns into substance abuse, resulting in self-damage, behaviour changes, mood swings, unnecessary weight loss, and several other health problems. Let’s understand what drug abuse is and how to fight it.

This Blog Includes:

Essay on drug abuse in 250 words, why do people consume drugs, why is drug abuse bad, laws in india against drug consumption, steps to prevent drug addiction, 10 lines essay on drug abuse.

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‘When people consume drugs regularly and become addicted to it, it is known as drug abuse. In medical terminology, drugs means medicines. However, the consumption of drugs is for non-medical purposes. It involves the consumption of substances in illegal and harmful ways, such as swallowing, inhaling, or injecting. When drugs are consumed, they are mixed into our bloodstream, affecting our neural system and brain functioning.

The Indian government has taken significant steps to help reduce the consumption of drugs. In 1985, the Narcotics Drugs and Psychotropic Substances Act came into force. This act replaced the Opium Act of 1857, the Opium Act of 1878, and the Dangerous Drugs Act of 1930. 

Drug abuse can lead to addiction, where a person becomes physically or psychologically dependent on the substance and experiences withdrawal symptoms when attempting to stop using it. 

Drug abuse can have serious consequences for the individual and society as a whole. On an individual level, drugs can damage physical health, including organ damage, infectious diseases, and overdose fatalities. Not only this, a person already suffering from mental health disorders will face more harmful aftereffects. Addiction disrupts our cognitive functioning and impairs our decision-making abilities.

To fight drug abuse, we need collective action from all sections of society. Medical professionals say that early intervention and screening programmes can identify individuals at risk of substance misuse and provide them with the necessary support services. Educating people, especially those who are at-risk, about drug abuse and its harmful effects can significantly help reduce their consumption.

Drug abuse is serious and it must be addressed. Drug abuse is killing youth and society. Therefore, it is an urgent topic to address, and only through sustainable and collective efforts can we address this problem.

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Essay on Drug Abuse in 500 Words

Drug abuse is known as frequent consumption. In time, these people become dependent on drugs for several reasons. Curiosity drives adolescents and teenagers, who are among the most susceptible groups in our society. Cocaine, marijuana, methamphetamine, heroin, etc. are some of the popular drugs consumed. 

The very first question about drugs is: why do people consume drugs? Studies have shown that more than 50% of drug addicts consider drugs as a coping mechanism to alleviate emotional or psychological distress. In the beginning, drugs temporarily relieve feelings of anxiety, depression, or trauma, providing a temporary escape from difficult emotions or life circumstances. 

Some consume drugs out of curiosity, some under peer pressure, and some want to escape the painful experiences. Some people enjoy the effects drugs produce, such as euphoria, relaxation, and altered perceptions. Recreational drug use may occur in social settings or as a form of self-medication for stress relief or relaxation.

The National Institute on Drug Abuse states that drugs can worsen our eyesight and body movement, our physical growth, etc. Marijuana, one of the most popular drugs, can slow down our reaction time, affecting our time and distance judgement and decreasing coordination. Cocaine and Methamphetamine can make the consumer aggressive and careless.

Our brain is the first victim of drugs. Drugs can disorder our body in several ways, from damaging organs to messing with our brains. Drugs easily get mixed into our bloodstream, and affect our neural system. Prolonged and excessive consumption of drugs significantly harms our brain functioning.

The next target of drug abuse is our physical health and relationships. Drugs can damage our vital organs, such as the liver, heart, lungs, and brain. For example, heavy alcohol use can lead to cirrhosis of the liver, while cocaine use can increase the risk of heart attack and stroke.

Here is an interesting thing; the USA has the highest number of drug addicts and also has strict laws against drug consumption. According to a report by the Narcotics Control Bureau, around 9 million people in India consume different types of drugs. The Indian government has implemented certain laws against drug consumption and production.

The Narcotic Drugs and Psychotropic Substances Act, 1985 (NDPS), prohibits the production, sale, purchase, and consumption of narcotics and other illegal substances, except for scientific and medical purposes.

Also, Article 47 of the Indian Constitution states that ‘ The State shall endeavour to bring about prohibition of the consumption, except for medicinal purposes, of intoxicating drinks and drugs which are injurious to health.’

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Several steps can be taken to prevent drug addiction. But before we start our ‘War on Drugs’ , it is crucial to understand the trigger point. Our social environment, mental health issues and sometimes genetic factors can play a role in drug abuse.

• Education and awareness are the primary weapons in the fight against drugs. 
• Keeping distance from people and places addicted to drugs.
• Encourage a healthy and active lifestyle and indulge in physical workouts.
• Watch motivating videos and listen to sound music.
• Self-motivate yourself to stop consuming drugs.
• Talk to a medical professional or a psychiatrist, who will guide you to the right path.

Drug abuse is a serious problem. The excessive and frequent consumption of drugs not only harms the individual but also affects society as a whole. Only a collective approach from lawmakers, healthcare professionals, educators, community leaders, and individuals themselves can combat drug abuse effectively. 

Quick Read: Speech About Life

Here is a 10-line essay on drug abuse.

• Drug abuse can significantly affect our physical growth
• Drug abuse can affect our mental functioning.
• Drug abuse may provide instant pleasure, but inside, it weakens our willpower and physical strength.
• Educating people, especially those who are at-risk, about drug abuse and its harmful effects can significantly help reduce their consumption.
•  Drugs easily get mixed into our bloodstream, and affect our neural system. 
• Prolonged and excessive consumption of drugs significantly harms our brain functioning.
• In 1985, the Narcotics Drugs and Psychotropic Substances Act came into force.
• The USA has the highest number of drug addicts and also has strict laws against drug consumption.
• Drug addicts consider drugs as a coping mechanism to alleviate emotional or psychological distress.
•  Adolescents and teenagers are the most vulnerable section of our society and are driven by curiosity.

Ans: Drug abuse refers to the excessive and frequent consumption of drugs. Drug abuse can have several harmful effects on our mental and physical health.

Ans: ‘When people consume drugs regularly and become addicted to it, it is known as drug abuse. In medical terminology, drugs means medicines. However, the consumption of drugs is for non-medical purposes. It involves the consumption of substances in illegal and harmful ways, such as swallowing, inhaling, or injecting. When drugs are consumed, they are mixed into our bloodstream, affecting our neural system and brain functioning.

Ans: Drug abuse is known as frequent consumption. In time, these people become dependent on drugs for several reasons. Adolescents and teenagers are the most vulnerable section of our society who are driven by curiosity. Cocaine, marijuana, methamphetamine, heroin, etc. are some of the popular drugs consumed.  The Narcotic Drugs and Psychotropic Substances Act, 1985 (NDPS), prohibits the production, sale, purchase, and consumption of narcotics and other illegal substances, except for scientific and medical purposes.

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Shiva Tyagi

With an experience of over a year, I've developed a passion for writing blogs on wide range of topics. I am mostly inspired from topics related to social and environmental fields, where you come up with a positive outcome.

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Substance Abuse and Public Health: A Multilevel Perspective and Multiple Responses

Substance abuse has been a thorny public health concern throughout human history. Manifestly, prevention and treatment are the two main strategies commonly adopted to tackle the problem of substance abuse. They are in fact cross-disciplinary, and they relate to the various domains of heredity, biology, psychology, cognitive science, family, social development and cultural structures. This special issue, “Substance Abuse, Environment and Public Health,” has published empirical studies from different regions and countries globally to enhance the international exchange of latest views and findings on the etiology, processes and influences of substance abuse across different domains, through which a multilevel perspective is considered more helpful for analyzing its complex nature, courses and consequences. This in turn suggests the possible need to employ multiple responses dynamically and integratively in the prevention and treatment of substance abuse.

1. Introduction

It is apparent that substance abuse is a cross-disciplinary topic of research and concern [ 1 , 2 ], which involves the need to employ concomitantly various theoretical explications and empirical evidence in collaborative efforts to strive for more optimal solutions to limit its contagiousness, and to curb any direct and indirect harm [ 3 , 4 ]. Substance abuse has been described as a “chronic relapsing disease”, with extremely high relapse rates that range from 56.8% to 81.8% [ 5 , 6 ]. Recently, the United Nations reported that “(i)n 2017, an estimated 271 million people, or 5.5 per cent of the global population aged 15–64, had used substances in the previous year” ([ 7 ], p.7). This is 11.5% higher than the estimated number of substance-using people in 2012 [ 8 ]. Due to the nature of recurrence and the rising number of substance users globally, a continuing upsurge in human, social, health and economic costs in the form of substance-related violence, criminal acts, health care needs, legal orders, rehabilitative services, reduced labor productivity and judicial expenditure is evident [ 4 , 6 , 9 ]. Undoubtedly, prevention and treatment are two main intervention approaches that have been commonly adopted to tackle substance abuse [ 2 , 10 ], in which the former focuses primarily on enhancing public awareness of the dangers of substance misuse and addiction, and the latter mainly emphasizes helping substance abusers to attain complete abstinence and avoid relapse. Both prevention and treatment of substance abuse are pertinent to public health, as the two approaches need to employ a multilevel perspective to conceptualize and solve fallout generated from drug trafficking, misuse and harm [ 11 , 12 ]. This points to the need to investigate human hereditary, biological, and psychological needs, cognitive and mental conditions, social development and cultural structures simultaneously and interactively.

For a comprehensive understanding of the nature, processes and impact of substance abuse on human individuals and societies as a whole, an international exchange of the latest scholarly views and empirical research findings is needed. This special issue, “Substance Abuse, Environment and Public Health,” aims to promote international exchange of empirical academic works on substance abuse and its related concerns. It includes 14 empirical research articles and one intervention paper from Bosnia, Croatia, Hong Kong, Italy, mainland China, Norway, Poland, Singapore, South Korea, Spain, Slovenia, Sweden and the United States, and covers the topics of substance misuse and addiction amongst various social groups, different types and forms of illicit and legally approved substances and multiple research methods and designs. Importantly, the scholarly works published in this special issue are expected to present an opportunity to enhance the international exchange of cross-disciplinary research and academic inquiries in the prevention and treatment of substance abuse.

2. Substance Abuse and Different Social Groups

When researching substance abuse and its harmful effects, researchers predominantly focus on certain social groups with a higher tendency towards substance taking and misuse, such as adolescents and male adults [ 13 , 14 , 15 , 16 , 17 , 18 ]. This is valid, as they may encounter various demanding life and social challenges, expectations, interpersonal alienation and biological impulses, all of which are relevant to the triggering of their initiation into drug experimentation as a form of self-medication. Substances may also act as a comforting “soul mate” to help users evade hard realities [ 19 , 20 ]. In this special issue, Zubak et al. [ 21 ] examined the effects of scholastic factors—for example, grade point averages, school and other unexcused absences and poor behavior—in relation to illicit drug misuse (IDM) and its initiation among adolescents in Bosnia and Herzegovina. Jee et al. [ 22 ] investigated the trajectories of different smoking groups of young South Korean male adults and the implication of the habit in their atherosclerotic cardiovascular disease (ASCVD) in middle age. However, substance takers are never restricted to any specific social groups; they can be found in communities of professionals, social talents, elders and university students. Devcic et al. [ 23 ] examined socio-demographics, sports-related factors, factors of hesitation, doping-related factors, consumption of dietary supplements, knowledge of doping and predictors of doping behavior in terms of misusing performance-enhancing substances among high-level competitive swimmers in Slovenia. Wang et al. [ 24 ] investigated how gender, residential areas and study majors were related to misconceptions about antibiotic use among Chinese university students, which in turn linked to their antibiotic misuse behavior. Through the use of a community-based participatory research design, Walter et al. [ 25 ] inquired how work-related musculoskeletal disorders (MSDs) and injuries among US fishing industry workers affected their use of prescription opioids to treat their pain, which in turn exposed them to increased risk of developing substance disorders. Apparently, different social groups are equally susceptible to the risk of substance abuse and addiction [ 3 , 4 , 12 ], and this is likely to be affected by their specific personal characteristics and environmental conditions. Hence, there is a need for researchers to discover both common and unique precursors germane to different social groups which lead to their substance using behavior.

3. Substance Abuse and Its Types and Forms

Substances that are misused or abused can be categorized into two forms. These include illicit and legally approved substances of various types. The most common illicit types of substances include cannabis, amphetamines, ketamine, methamphetamines, cocaine, ecstasy and heroin [ 2 , 6 ], which are largely banned in most countries. However, marijuana products have recently been legalized and commercialized in some northern American and Western states and regions under the umbrella of “control of reasonable use,” which casts a contemplative doubt over the original intent of reducing cannabis-related criminality and public health problems; hence, more research is needed on this subject [ 26 , 27 , 28 ]. Tobacco and alcohol are two legally approved types of substances that have been widely used by different social groups across different societies and cultures [ 6 , 11 , 29 ]. Some legally prescribed drugs, such as cough medications and the antibiotics mentioned above, can also be easily misused and abused by the general public, and these too merit the further attention of researchers [ 2 , 30 ].

In this special issue, Lo et al. [ 31 ] explored how far using illicit drugs, smoking cigarettes and drinking alcohol predicted sexual misconduct among Macau youths, while simultaneously adjusting for the effects of susceptibility to peer influence and school attachment/commitment. Assari et al. [ 32 ] attempted to assess the impact of subjective and objective socioeconomic status on the cigarette smoking and alcohol use of older African Americans by controlling the effects of pertinent covariates, which included demographic factors (age and gender), living arrangement and family type, health insurance status, chronic medical conditions, self-rated health, sick days, depression and chronic pain. Muller et al. [ 33 ] investigated changes in exercise and nicotine use among 1464 Norwegian prison inmates by classifying them into harmful and non-harmful substance use pre-incarceration groups, according to the Drug Use Disorders Identification Test (DUDIT) and the Alcohol Use Disorders Identification Test (AUDIT), both of which are commonly used by healthcare practitioners and researchers to assess the severity of illicit drug and intoxicant use. Wang et al. [ 34 ] analyzed the sources of antibiotics leftovers in the home and the risk factors of keeping them in relation to antibiotic self-medication among Chinese university students. Taken together, the relationships between the use of illicit drugs and legally approved substances are complex and intertwined or mutually reinforcing [ 35 , 36 ]. They may be affected by the personal circumstances and environmental conditions of the abusers, and may cause other forms of behavioral maladjustment [ 17 , 37 , 38 ]. Nevertheless, our current understanding of this complicated phenomenon of substance abuse is limited, and so more cross-disciplinary research is again recommended.

4. Researching Substance Abuse: Methods and Designs

As has been mentioned, substance abuse is a public health concern that involves human biological and physical needs, psychosocial demands, cognitive and spiritual fulfillment, and environmental formulations. Therefore, cross-disciplinary research using different methodologies and designs is much needed to scrutinize substance abuse in respect of etiology, maintenance, consequences, abstinence and relapse. Generally speaking, empirical studies using quantitative methods are more common than research involving qualitative inquiry, analysis of secondary data and/or documentary inspection [ 16 , 39 , 40 ]. In fact, research based on a range of methods and designs is useful in enhancing our comprehension of the nature and impact of substance abuse from different perspectives. This special issue incorporates empirical studies conducted by quantitative, qualitative and documentary methods. For quantitative research designs, study findings based on a representative sample or any of the random sampling procedures are desirable, and can strengthen empirical evidence and provide greater external validity [ 41 ]. For example, Oh et al. [ 42 ] investigated whether those who had current or previous experience of facial flushing would drink for different primary reasons, compared with those who had no experience of facial flushing. The sample comprised 4590 college students who were recruited by stratified random sampling procedures proportionately in 82 colleges in South Korea. There are other empirical studies in this special issue that similarly used a representative sample [ 21 , 24 , 31 , 34 ]. However, using quantitative methods to survey empirically the attitudes and behaviors of certain health and human service professional groups is less likely to require a representative sample, and so it is necessary to use non-probabilistic sampling procedures such as quota, purposive or snowballing sampling designs. Molina-Mula et al. [ 43 ] analyzed the attitudes and perceptions of emergency and mental health nurses with regard to alcoholics. Their findings will hopefully help to develop appropriate professional and clinical responses to substance abuse.

Qualitative research methods can help reveal in-depth and formative information related to the processes and development of substance abuse. For their qualitative study, Chan et al. [ 44 ] interviewed 67 drug abusers to explore how their psychological experiences—with special emphasis on interpersonal relatedness—affected their drug taking and relapse behaviors. Walter et al. [ 25 ] used qualitative interviewing to examine knowledge of and attitudes towards opioid use among 21 fishing industry workers in the US. In addition, use of secondary data or documentary information can efficiently and objectively assist in the transition processes of substance users. For example, Asharani et al. [ 45 ] employed and analyzed recorded data from the Registry of Birth and Death, Immigration and Checkpoint Authority of Singapore to investigate the unnatural deaths of 42 treatment seekers of substance addiction between 2011–2015. Their findings provide evidence of the lethal consequences of substance abuse in an unobtrusive manner. Moreover, Chmielowiec et al. [ 46 ] examined the relationship between the mesolimbic dopamine system and addiction in a group of 299 addicted subjects and another group of 301 non-addict controls by analyzing two polymorphisms in their genes (a variable number of tandem repeats in DRD4 and DAT1), which are mainly responsible for dopaminergic transmission, representing a human reward system that is closely related to substance abuse and misuse. It is clear that research using different methods and designs is useful in fortifying and enhancing currently established concepts and knowledge of substance abuse. Therefore, more novel research methods and designs should be encouraged, so that patterns of substance abuse can be more efficiently dissected.

5. Conclusions

Substance abuse has been an issue of public health for hundreds of years [ 47 ]. Nevertheless, professionals and researchers of different domains tend to adopt a one-dimensional view based on their particular expertise when examining, explaining and trying to find solutions to this complex problem [ 10 , 48 , 49 ]. Thus, various and often competing perspectives rooted in the paradigms of heredity, biology, psychology, cognitive science, family, social development and cultural structures can exist simultaneously, thereby unwittingly compounding the problem [ 1 , 2 , 39 , 50 ]. However, as substance abuse is composed of layers of individual development, family and social influences, cultural values and environmental conditions, a multilevel perspective is needed to analyze its etiology, maintenance and consequences. Various theories and models from different scholarly paradigms at different levels of social systems should be employed concomitantly to help examine and resolve the issues as part of a dynamic and comprehensive process [ 2 , 3 , 12 ]. Employing such a multilevel perspective requires researchers and practitioners to explore the interaction of hereditary, physical, psychological, cognitive, mental, family, social, cultural and environmental factors, and to show exactly how such synergy leads to and/or maintains substance use and addiction. Doing so will help in the design of improved multiple responses to the fallout from substance abuse.

As substance abuse is never limited to particular social groups in human societies, it is essential to understand the unique psychological, personality, cognitive, socioeconomic, familial and cultural differences of various social groups, and to explore what common and unique characteristics they hold in terms of the initiation, processes and consequences of substance abuse [ 4 , 6 ]. If researchers, service practitioners, educators and policy makers were able to understand the common and unique etiological causes and stimulants that incur experimentation and the subsequent maintenance of substance abuse, more effective prevention and treatment strategies and programs could be introduced. Furthermore, because each society or nation is comprised of multiple differing social groups, a knowledge and understanding of their unique cultural and ethnic structures would be empirically useful for researchers trying to unearth the common and distinct etiological causes and stimulants of substance use and abuse. This is a largely unchartered area of research.

The abuse of different types and forms of substances may generate different levels of addiction and harm [ 2 , 51 ], which in turn may trigger distinct social maladjustment and craving behaviors [ 12 , 52 ]. Therefore, future research should discern and clarify the effects of different types and forms of substances on the progress, abstinence and relapse of addicts; this would lead to a better comprehension of the nature and impact of substance abuse. Quantitative methods and designs should be adopted to this end, in addition to other methods and designs that will broaden our perspectives on the topic. In other words, future addiction research should consider the employment of mixed-method designs to investigate the nature of different types and forms of substances and their effects on different social groups. Furthermore, the interaction between the biological, individual, family, social and cultural factors that lead to substance abuse is worthy of research, but will require more advanced methodological designs and mathematical and statistical procedures.

The processes and consequences of substance abuse can be seen to evolve in step with social, technological and cultural developments [ 4 , 39 ]. The patterns and forms of substance abuse can vary according to different social groups. Therefore, comparative and longitudinal research is more useful and insightful in helping to reveal its precarious and dynamic influences. In fact, polysubstance abuse—in which substance addicts expect to achieve higher substance-synergy effects of enjoyability by simultaneously abusing multiple types of drugs and substances—has become more common in the past decade [ 53 , 54 ]. This apparently presents an even greater challenge to treatment and healthcare services. In the face of this new phenomenon, the role of empirical research becomes more pivotal in helping to configure effective approaches and solutions.

In conclusion, substance abuse has long been a thorny public health problem, and it continues to evolve. Multiple responses supported by the employment of a multilevel research perspective are needed. Cross-disciplinary collaboration and concerted research are urgently required if we are to optimize our current strategies and remediation.

Author Contributions

T.W.L., J.W.K.Y., and C.H.L.T. conceived the topic for the Special Issue and were the guest editors. All authors have read and agreed to the published version of the manuscript.

This research received no external funding.

Conflicts of Interest

The authors declare no conflict of interest.

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• April 01, 2024 | VOL. 181, NO. 4 CURRENT ISSUE pp.255-346
• March 01, 2024 | VOL. 181, NO. 3 pp.171-254
• February 01, 2024 | VOL. 181, NO. 2 pp.83-170
• January 01, 2024 | VOL. 181, NO. 1 pp.1-82

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Substance Use Disorders and Addiction: Mechanisms, Trends, and Treatment Implications

• Ned H. Kalin , M.D.

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The numbers for substance use disorders are large, and we need to pay attention to them. Data from the 2018 National Survey on Drug Use and Health ( 1 ) suggest that, over the preceding year, 20.3 million people age 12 or older had substance use disorders, and 14.8 million of these cases were attributed to alcohol. When considering other substances, the report estimated that 4.4 million individuals had a marijuana use disorder and that 2 million people suffered from an opiate use disorder. It is well known that stress is associated with an increase in the use of alcohol and other substances, and this is particularly relevant today in relation to the chronic uncertainty and distress associated with the COVID-19 pandemic along with the traumatic effects of racism and social injustice. In part related to stress, substance use disorders are highly comorbid with other psychiatric illnesses: 9.2 million adults were estimated to have a 1-year prevalence of both a mental illness and at least one substance use disorder. Although they may not necessarily meet criteria for a substance use disorder, it is well known that psychiatric patients have increased usage of alcohol, cigarettes, and other illicit substances. As an example, the survey estimated that over the preceding month, 37.2% of individuals with serious mental illnesses were cigarette smokers, compared with 16.3% of individuals without mental illnesses. Substance use frequently accompanies suicide and suicide attempts, and substance use disorders are associated with a long-term increased risk of suicide.

Addiction is the key process that underlies substance use disorders, and research using animal models and humans has revealed important insights into the neural circuits and molecules that mediate addiction. More specifically, research has shed light onto mechanisms underlying the critical components of addiction and relapse: reinforcement and reward, tolerance, withdrawal, negative affect, craving, and stress sensitization. In addition, clinical research has been instrumental in developing an evidence base for the use of pharmacological agents in the treatment of substance use disorders, which, in combination with psychosocial approaches, can provide effective treatments. However, despite the existence of therapeutic tools, relapse is common, and substance use disorders remain grossly undertreated. For example, whether at an inpatient hospital treatment facility or at a drug or alcohol rehabilitation program, it was estimated that only 11% of individuals needing treatment for substance use received appropriate care in 2018. Additionally, it is worth emphasizing that current practice frequently does not effectively integrate dual diagnosis treatment approaches, which is important because psychiatric and substance use disorders are highly comorbid. The barriers to receiving treatment are numerous and directly interact with existing health care inequities. It is imperative that as a field we overcome the obstacles to treatment, including the lack of resources at the individual level, a dearth of trained providers and appropriate treatment facilities, racial biases, and the marked stigmatization that is focused on individuals with addictions.

This issue of the Journal is focused on understanding factors contributing to substance use disorders and their comorbidity with psychiatric disorders, the effects of prenatal alcohol use on preadolescents, and brain mechanisms that are associated with addiction and relapse. An important theme that emerges from this issue is the necessity for understanding maladaptive substance use and its treatment in relation to health care inequities. This highlights the imperative to focus resources and treatment efforts on underprivileged and marginalized populations. The centerpiece of this issue is an overview on addiction written by Dr. George Koob, the director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and coauthors Drs. Patricia Powell (NIAAA deputy director) and Aaron White ( 2 ). This outstanding article will serve as a foundational knowledge base for those interested in understanding the complex factors that mediate drug addiction. Of particular interest to the practice of psychiatry is the emphasis on the negative affect state “hyperkatifeia” as a major driver of addictive behavior and relapse. This places the dysphoria and psychological distress that are associated with prolonged withdrawal at the heart of treatment and underscores the importance of treating not only maladaptive drug-related behaviors but also the prolonged dysphoria and negative affect associated with addiction. It also speaks to why it is crucial to concurrently treat psychiatric comorbidities that commonly accompany substance use disorders.

Insights Into Mechanisms Related to Cocaine Addiction Using a Novel Imaging Method for Dopamine Neurons

Cassidy et al. ( 3 ) introduce a relatively new imaging technique that allows for an estimation of dopamine integrity and function in the substantia nigra, the site of origin of dopamine neurons that project to the striatum. Capitalizing on the high levels of neuromelanin that are found in substantia nigra dopamine neurons and the interaction between neuromelanin and intracellular iron, this MRI technique, termed neuromelanin-sensitive MRI (NM-MRI), shows promise in studying the involvement of substantia nigra dopamine neurons in neurodegenerative diseases and psychiatric illnesses. The authors used this technique to assess dopamine function in active cocaine users with the aim of exploring the hypothesis that cocaine use disorder is associated with blunted presynaptic striatal dopamine function that would be reflected in decreased “integrity” of the substantia nigra dopamine system. Surprisingly, NM-MRI revealed evidence for increased dopamine in the substantia nigra of individuals using cocaine. The authors suggest that this finding, in conjunction with prior work suggesting a blunted dopamine response, points to the possibility that cocaine use is associated with an altered intracellular distribution of dopamine. Specifically, the idea is that dopamine is shifted from being concentrated in releasable, functional vesicles at the synapse to a nonreleasable cytosolic pool. In addition to providing an intriguing alternative hypothesis underlying the cocaine-related alterations observed in substantia nigra dopamine function, this article highlights an innovative imaging method that can be used in further investigations involving the role of substantia nigra dopamine systems in neuropsychiatric disorders. Dr. Charles Bradberry, chief of the Preclinical Pharmacology Section at the National Institute on Drug Abuse, contributes an editorial that further explains the use of NM-MRI and discusses the theoretical implications of these unexpected findings in relation to cocaine use ( 4 ).

Treatment Implications of Understanding Brain Function During Early Abstinence in Patients With Alcohol Use Disorder

Developing a better understanding of the neural processes that are associated with substance use disorders is critical for conceptualizing improved treatment approaches. Blaine et al. ( 5 ) present neuroimaging data collected during early abstinence in patients with alcohol use disorder and link these data to relapses occurring during treatment. Of note, the findings from this study dovetail with the neural circuit schema Koob et al. provide in this issue’s overview on addiction ( 2 ). The first study in the Blaine et al. article uses 44 patients and 43 control subjects to demonstrate that patients with alcohol use disorder have a blunted neural response to the presentation of stress- and alcohol-related cues. This blunting was observed mainly in the ventromedial prefrontal cortex, a key prefrontal regulatory region, as well as in subcortical regions associated with reward processing, specifically the ventral striatum. Importantly, this finding was replicated in a second study in which 69 patients were studied in relation to their length of abstinence prior to treatment and treatment outcomes. The results demonstrated that individuals with the shortest abstinence times had greater alterations in neural responses to stress and alcohol cues. The authors also found that an individual’s length of abstinence prior to treatment, independent of the number of days of abstinence, was a predictor of relapse and that the magnitude of an individual’s neural alterations predicted the amount of heavy drinking occurring early in treatment. Although relapse is an all too common outcome in patients with substance use disorders, this study highlights an approach that has the potential to refine and develop new treatments that are based on addiction- and abstinence-related brain changes. In her thoughtful editorial, Dr. Edith Sullivan from Stanford University comments on the details of the study, the value of studying patients during early abstinence, and the implications of these findings for new treatment development ( 6 ).

Relatively Low Amounts of Alcohol Intake During Pregnancy Are Associated With Subtle Neurodevelopmental Effects in Preadolescent Offspring

Excessive substance use not only affects the user and their immediate family but also has transgenerational effects that can be mediated in utero. Lees et al. ( 7 ) present data suggesting that even the consumption of relatively low amounts of alcohol by expectant mothers can affect brain development, cognition, and emotion in their offspring. The researchers used data from the Adolescent Brain Cognitive Development Study, a large national community-based study, which allowed them to assess brain structure and function as well as behavioral, cognitive, and psychological outcomes in 9,719 preadolescents. The mothers of 2,518 of the subjects in this study reported some alcohol use during pregnancy, albeit at relatively low levels (0 to 80 drinks throughout pregnancy). Interestingly, and opposite of that expected in relation to data from individuals with fetal alcohol spectrum disorders, increases in brain volume and surface area were found in offspring of mothers who consumed the relatively low amounts of alcohol. Notably, any prenatal alcohol exposure was associated with small but significant increases in psychological problems that included increases in separation anxiety disorder and oppositional defiant disorder. Additionally, a dose-response effect was found for internalizing psychopathology, somatic complaints, and attentional deficits. While subtle, these findings point to neurodevelopmental alterations that may be mediated by even small amounts of prenatal alcohol consumption. Drs. Clare McCormack and Catherine Monk from Columbia University contribute an editorial that provides an in-depth assessment of these findings in relation to other studies, including those assessing severe deficits in individuals with fetal alcohol syndrome ( 8 ). McCormack and Monk emphasize that the behavioral and psychological effects reported in the Lees et al. article would not be clinically meaningful. However, it is feasible that the influences of these low amounts of alcohol could interact with other predisposing factors that might lead to more substantial negative outcomes.

Increased Comorbidity Between Substance Use and Psychiatric Disorders in Sexual Identity Minorities

There is no question that victims of societal marginalization experience disproportionate adversity and stress. Evans-Polce et al. ( 9 ) focus on this concern in relation to individuals who identify as sexual minorities by comparing their incidence of comorbid substance use and psychiatric disorders with that of individuals who identify as heterosexual. By using 2012−2013 data from 36,309 participants in the National Epidemiologic Study on Alcohol and Related Conditions–III, the authors examine the incidence of comorbid alcohol and tobacco use disorders with anxiety, mood disorders, and posttraumatic stress disorder (PTSD). The findings demonstrate increased incidences of substance use and psychiatric disorders in individuals who identified as bisexual or as gay or lesbian compared with those who identified as heterosexual. For example, a fourfold increase in the prevalence of PTSD was found in bisexual individuals compared with heterosexual individuals. In addition, the authors found an increased prevalence of substance use and psychiatric comorbidities in individuals who identified as bisexual and as gay or lesbian compared with individuals who identified as heterosexual. This was most prominent in women who identified as bisexual. For example, of the bisexual women who had an alcohol use disorder, 60.5% also had a psychiatric comorbidity, compared with 44.6% of heterosexual women. Additionally, the amount of reported sexual orientation discrimination and number of lifetime stressful events were associated with a greater likelihood of having comorbid substance use and psychiatric disorders. These findings are important but not surprising, as sexual minority individuals have a history of increased early-life trauma and throughout their lives may experience the painful and unwarranted consequences of bias and denigration. Nonetheless, these findings underscore the strong negative societal impacts experienced by minority groups and should sensitize providers to the additional needs of these individuals.

Trends in Nicotine Use and Dependence From 2001–2002 to 2012–2013

Although considerable efforts over earlier years have curbed the use of tobacco and nicotine, the use of these substances continues to be a significant public health problem. As noted above, individuals with psychiatric disorders are particularly vulnerable. Grant et al. ( 10 ) use data from the National Epidemiologic Survey on Alcohol and Related Conditions collected from a very large cohort to characterize trends in nicotine use and dependence over time. Results from their analysis support the so-called hardening hypothesis, which posits that although intervention-related reductions in nicotine use may have occurred over time, the impact of these interventions is less potent in individuals with more severe addictive behavior (i.e., nicotine dependence). When adjusted for sociodemographic factors, the results demonstrated a small but significant increase in nicotine use from 2001–2002 to 2012–2013. However, a much greater increase in nicotine dependence (46.1% to 52%) was observed over this time frame in individuals who had used nicotine during the preceding 12 months. The increases in nicotine use and dependence were associated with factors related to socioeconomic status, such as lower income and lower educational attainment. The authors interpret these findings as evidence for the hardening hypothesis, suggesting that despite the impression that nicotine use has plateaued, there is a growing number of highly dependent nicotine users who would benefit from nicotine dependence intervention programs. Dr. Kathleen Brady, from the Medical University of South Carolina, provides an editorial ( 11 ) that reviews the consequences of tobacco use and the history of the public measures that were initially taken to combat its use. Importantly, her editorial emphasizes the need to address health care inequity issues that affect individuals of lower socioeconomic status by devoting resources to develop and deploy effective smoking cessation interventions for at-risk and underresourced populations.

Conclusions

Maladaptive substance use and substance use disorders are highly prevalent and are among the most significant public health problems. Substance use is commonly comorbid with psychiatric disorders, and treatment efforts need to concurrently address both. The papers in this issue highlight new findings that are directly relevant to understanding, treating, and developing policies to better serve those afflicted with addictions. While treatments exist, the need for more effective treatments is clear, especially those focused on decreasing relapse rates. The negative affective state, hyperkatifeia, that accompanies longer-term abstinence is an important treatment target that should be emphasized in current practice as well as in new treatment development. In addition to developing a better understanding of the neurobiology of addictions and abstinence, it is necessary to ensure that there is equitable access to currently available treatments and treatment programs. Additional resources must be allocated to this cause. This depends on the recognition that health care inequities and societal barriers are major contributors to the continued high prevalence of substance use disorders, the individual suffering they inflict, and the huge toll that they incur at a societal level.

Disclosures of Editors’ financial relationships appear in the April 2020 issue of the Journal .

1 US Department of Health and Human Services: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality: National Survey on Drug Use and Health 2018. Rockville, Md, SAMHSA, 2019 ( https://www.samhsa.gov/data/nsduh/reports-detailed-tables-2018-NSDUH ) Google Scholar

2 Koob GF, Powell P, White A : Addiction as a coping response: hyperkatifeia, deaths of despair, and COVID-19 . Am J Psychiatry 2020 ; 177:1031–1037 Link ,  Google Scholar

3 Cassidy CM, Carpenter KM, Konova AB, et al. : Evidence for dopamine abnormalities in the substantia nigra in cocaine addiction revealed by neuromelanin-sensitive MRI . Am J Psychiatry 2020 ; 177:1038–1047 Link ,  Google Scholar

4 Bradberry CW : Neuromelanin MRI: dark substance shines a light on dopamine dysfunction and cocaine use (editorial). Am J Psychiatry 2020 ; 177:1019–1021 Abstract ,  Google Scholar

5 Blaine SK, Wemm S, Fogelman N, et al. : Association of prefrontal-striatal functional pathology with alcohol abstinence days at treatment initiation and heavy drinking after treatment initiation . Am J Psychiatry 2020 ; 177:1048–1059 Abstract ,  Google Scholar

6 Sullivan EV : Why timing matters in alcohol use disorder recovery (editorial). Am J Psychiatry 2020 ; 177:1022–1024 Abstract ,  Google Scholar

7 Lees B, Mewton L, Jacobus J, et al. : Association of prenatal alcohol exposure with psychological, behavioral, and neurodevelopmental outcomes in children from the Adolescent Brain Cognitive Development Study . Am J Psychiatry 2020 ; 177:1060–1072 Link ,  Google Scholar

8 McCormack C, Monk C : Considering prenatal alcohol exposure in a developmental origins of health and disease framework (editorial). Am J Psychiatry 2020 ; 177:1025–1028 Abstract ,  Google Scholar

9 Evans-Polce RJ, Kcomt L, Veliz PT, et al. : Alcohol, tobacco, and comorbid psychiatric disorders and associations with sexual identity and stress-related correlates . Am J Psychiatry 2020 ; 177:1073–1081 Abstract ,  Google Scholar

10 Grant BF, Shmulewitz D, Compton WM : Nicotine use and DSM-IV nicotine dependence in the United States, 2001–2002 and 2012–2013 . Am J Psychiatry 2020 ; 177:1082–1090 Link ,  Google Scholar

11 Brady KT : Social determinants of health and smoking cessation: a challenge (editorial). Am J Psychiatry 2020 ; 177:1029–1030 Abstract ,  Google Scholar

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Home — Essay Samples — Nursing & Health — Substance Abuse — The Impact of Substance Abuse

The Impact of Substance Abuse

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Published: Mar 16, 2024

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When Substance Abuse and Psychiatric Issues Collide

Co-occurring disorders have taken a toll on celebrities and regular folk alike..

Updated April 5, 2024 | Reviewed by Hara Estroff Marano

• What Is Psychiatry?
• Find counselling near me
• Many people have a substance use disorder (SUD) and serious psychiatric issue at the same time.
• Experts and the public have struggled with whether drugs caused psychiatric illness or vice versa.
• Carrie Fisher and Matthew Perry may have self-medicated over distress, or SUDs triggered psychiatric ills.
• Sexual, physical, or emotional traumatic events in childhood increase risks for co-occurring disorders.

Often starting in adolescence or young adulthood, many individuals have both a substance abuse disorder and at least one psychiatric disorder, although which diagnosis came first is frequently unclear. This “double trouble” problem is also called “co-occurring disorders (CODS),” as well as “concurrent disorders” and “dual diagnosis.”

The combination of disorders has been discussed in speculative articles about celebrities like Charlie Sheen, Demi Lovato, Justin Bieber, Jhene Aiko, Britney Spears, and Russell Brand. More in-depth scientific and biographic articles about Ernest Hemingway, Carrie Fisher, and Kurt Cobain have helped explain the complexity of CODs. Some of us were mesmerized and sad watching their struggles. Kurt Cobain’s lyrics, performance, and even some of his songs (like “Lithium” and “All Apologies” ) come to my mind as both a fan and a psychiatrist.

But it’s not just celebrities who are suffering from both substance abuse and mental health issues. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2022 , 21.5 million people in the United States had both a substance abuse disorder and a mental illness.

In the past, experts believed it was best to treat one disorder (usually the substance issue) and assumed any psychiatric issues would sort themselves out. However, if the psychiatric issue persisted, it was eventually treated.

In contrast, current thinking is both disorders should be treated in about the same time frame, because ignoring either could be problematic for the patient. If someone is severely depressed, anxious, or has another psychiatric disorder, it may be possible for them to detoxify from a substance, but it’s very hard to develop longer-term control over substance dependence and any accompanying mental illnesses when both issues are not addressed.

For adolescents and young adults with underlying psychiatric disorders, abusing substances provides an unfortunate early opportunity for incorporating bad learning. For example, if they struggle with anxiety , teens may discover that alcohol calms their nerves, making them less anxious about meeting new people or engaging in social interactions. Early self- medication of psychiatric symptoms is double trouble, as alcohol causes brain changes and effects that can trigger alcohol use disorder (AUD.) Some people describe the first drink as magical, that first taste feeling like the key to previously locked-out relief.

More Intense Treatment Is Needed with SUDs Combined with Psychiatric Diagnoses

Individuals diagnosed with co-occurring disorders often need more intense treatment than others due to the complexity of their cases. They also may face greater consequences from their substance abuse compared to patients diagnosed with a mental illness only. Examples of such possible consequences may include a greater exacerbation of their psychiatric symptoms, hallucinations and/or suicidal thinking, an increase in aggressive and violent behaviors, concurrent medical, nutritional, and infectious issues, more emergency room visits than other patients, and a greater number of falls and injuries.

Those with CODs are also more likely to experience head injuries and physical fights with others as well as sexually transmitted infections (STIs). Some have a greater frequency of involuntary inpatient psychiatric placements. These patients need a psychiatric assessment and treatment from experts in both addictions and psychiatry.

Possible Causes of CODs

One theory to explain CODS, the self-medication theory, was developed by the late Harvard psychiatrist and psychoanalyst Ed Khantzian, M.D. He assumed anhedonia (the inability to experience pleasure) or suffering in general was the driving force behind addiction. This theory hypothesizes that underlying psychological disorders compel individuals to self-medicate their feelings with alcohol and/or drugs. In addition, patients are sometimes distinguished by their drugs of choice. For instance, patients with an alcohol use disorder might have been battling social anxiety and self-medicating with alcohol for performance anxiety, shyness, or nervousness in social settings; stimulants such as cocaine or methamphetamine often are used by those with depression or untreated attentional disorders like attention deficit hyperactivity disorder (ADHD).

The self-medication hypothesis was first put forth in a 1985 cover article in the American Journal of Psychiatry. It focused on how and why individuals are drawn to and become dependent on drugs. The self-medication hypothesis was derived from clinical evaluation and treatment of thousands of patients spanning five decades and remains a credible theory.

As I have stated in the American Journal of Psychiatry , it is one of the most “intuitively appealing theories” about addiction. But drugs of abuse and addiction can also cause psychiatric illnesses by targeting the brain’s mood and pleasure systems and inadvertently undermining them.

Neuroscientist Kenneth Blum developed the theory of reward-deficiency syndrome (RDS) as the cause for co-occurring addictive disorders and psychiatric diagnoses. In many ways, RDS is a natural extension of Khantzian’s theory, but it’s an update, attributing the cause to an underlying dopamine deficiency or neurochemical dysfunction that supports drug-seeking/self-medication.

People with RDS, which may be inherited, are miserably unhappy and their lives may be intolerable due to their inability to gain satisfaction from work, relationships, or their accomplishments.

An emerging, newer approach of “preaddiction” as an early or moderate stage of substance abuse is championed by leaders of the National Institute on Drug Abuse (NIDA), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and the National Institute of Mental Health (NIMH). Preaddiction is conceptually analogous to prediabetes, a risk factor for type-2 diabetes. Prediabetes has contributed to a quantum leap in early detection of people at risk for type-2 diabetes, shortened delays between symptom onset and treatment entry before the onset of diabetes, and overall been a remarkable success in halting progression to diabetes. Similarly, the earliest possible detection of substance abuse will save more lives as experts develop and focus on the evolving concept of preaddiction.

A Possible Environmental Cause: Adverse Childhood Events (ACEs)

In the late twentieth century, a large insurance provider in California worked with researchers to identify adverse childhood experiences (ACEs) that later reverberated in the lives of adults. The researchers found that individuals who reported the greatest numbers of ACEs—such as physical abuse, sexual abuse , loss of a biological parent, witnessing physical violence, and other severely traumatic childhood events—were significantly more likely than those with no ACEs to have psychiatric problems and substance abuse issues in adulthood. They were also at greater risk for suicidal behaviors.

Nirvana's Kurt Cobain was a person with bipolar disorder , substance use and a heroin habit, according to a cousin who described their family history in detail and noted that two uncles had killed themselves with guns. Cobain, who suicided in 1994, purportedly had at least four ACEs, including witnessing domestic violence , experiencing psychological abuse , being neglected, and suffering from his parents’ divorce . Such a score markedly increased Cobain’s risk for suicide as an adult.

Treatment of CODs Should Not Be Delayed

Although an extensive description of how CODs should best be treated is beyond the scope of this article, the key point is to not delay treatment of one disorder in favor of the other. Instead, as much of a simultaneous approach as possible is best. This often means a team of experts is needed, including a psychiatrist, psychologist, therapists, and others to assess the problem, determine whether inpatient, residential, or outpatient treatment is best, and develop a cohesive treatment plan for the patient.

In opioid use disorder treatment, the current standard of care is to focus on prevention of overdose and replacement of opioids with medication-assisted treatments (MATs.) However, detoxification from opioids or maintenance on a MAT would provide little symptomatic relief for a person with opioid use disorder, suicidal ideas, and bipolar illness.

It is also recommended to evaluate individuals for past or recent trauma and co-occurring psychiatric and medical illnesses and treat patients accordingly. Often this means psychotherapy is needed as well as psychiatric treatments. Psychotherapy may include cognitive behavioral therapy (CBT), motivation enhancement therapy (MET), dialectical behavior therapy (DBT), and other forms of therapy. Trained and experienced therapists are crucial. Depending on the substance on which patients depend, medication treatment for their detoxification, relapse prevention, and craving may or may not be available. Currently, medication treatments exist for tobacco use disorder, alcohol use disorder, and opioid use disorder.

Summing It Up

Not only celebrities but many people with a substance use disorder have at least one other psychiatric problem, and when this situation occurs, all disorders need to be identified and treated. I recommend professional help in checking for substance use disorders in psychiatric patients and also looking for psychiatric illness and a history of trauma in people with substance use disorders.

Future breakthroughs in genetic and other scientific research should make clearer why some individuals are more prone to such disorders, as well as lead experts toward the best medications, therapies, and other treatments to alleviate much more of this terrible suffering.

Cross, Charles R. Heavier than Heaven : a Biography of Kurt Cobain. New York :Hyperion, 2001.

Gold MS. Dual disorders: nosology, diagnosis, & treatment confusion--chicken or egg? Introduction. J Addict Dis. 2007;26 Suppl 1:1-3. doi: 10.1300/J069v26S01_01. PMID: 19283969.

Buckley PF, Brown ES. Prevalence and consequences of dual diagnosis. J Clin Psychiatry. 2006 Jul;67(7):e01. doi: 10.4088/jcp.0706e01. PMID: 17107226.

Mark S. Gold, M.D., is a pioneering researcher, professor, and chairman of psychiatry at Yale, the University of Florida, and Washington University in St Louis. His theories have changed the field, stimulated additional research, and led to new understanding and treatments for opioid use disorders, cocaine use disorders, overeating, smoking, and depression.

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Personal Experience With Addiction

As a college student, I have come across many addicted people; hence, I have honed my knowledge about addiction. Based on past knowledge and experiences, I knew addiction was a social ill that lowered the quality of life that people lived. Therefore, in this paper, I will delve into a personal experience I have had with addiction. Addiction is a concept that almost everyone has first-hand, second-hand, or third-hand knowledge of. Before this assignment, I had not given much thought to my own personal or professional experience with drug abuse. Before becoming a social work student, I tended to avoid situations that I perceived as undesirable. Addictions were eluding me, whether in my personal life or professional career. My mother separated my brothers and me from my grandma because she was a drug user. At the age of eleven or twelve, I finally met my grandmother for the first time. I did not have any feelings for her because I was no well acquainted with her at that period to form any opinions about her. I was largely unaffected by my grandmother’s drug use behavior. My mother would have allowed her to be a part of my life from the beginning if she had been sober or had never been an addict before I was born.

Besides, I am aware that my grandfather was addicted to heroin, but had already recovered by the time I was born. Perhaps, our relationship would be different if he had not overcome his alcoholism behavior before I was born. My father is quite protective of me, and I am sure he would have kept me away from my grandfather if he was still using drugs. My grandfather and I had a cordial relationship right up to his passing. Because he was my only grandfather, I am happy that his addiction did not affect my life. After reflecting on my own and my colleagues’ personal and professional experiences with addiction, I identified the event that impacted my life most. As a result of reflecting on that period – thanks to this assignment, I have recently become appreciative of some of the effects my mother’s relationship with an alcoholic user had on me. An alcoholic mother is the subject of the next section of this work, which I will describe.

The alcoholic user my mother dated was the first person I met; I use the term alcoholic since he is still addicted to alcohol. I remember meeting him. My mother first discussed her ex-boyfriend with my brothers and me to properly introduce us. When my mother informed us that she would be living with a new spouse in a few days, we were surprised. My mother’s ex-boyfriend arrived already drunk, and he continued to imbibe for the rest of the afternoon. I was instantly appalled and horrified by his actions, and I realized then that I did not want to build a relationship with him. I doubted my mother’s judgment based on my first impression on the man. “A man who behaves in this manner attracts my mum; why? These are some of the questions that flashed through my mind. I could not help but wonder. It is hard to imagine what kind of mom would allow a man like this to be around her children. To avoid any more misunderstanding, I immediately broke off contact with my mother’s ex-boyfriend. When he became an alcoholic, I was only fourteen or fifteen years old, so I had no understanding of what had led to his drinking problem. Initially, I wondered why this man could not control his drinking behavior and why he had to drink till he was intoxicated every time he did so.

Deliberating on my personal history and what you have learned from the course, addiction is a process marked by dependency on drugs and substances in day-to-day human activities. Psychology research and literature have effectively established that addicted people cannot control their feelings, emotions, and feelings towards drugs and other essential aspects in human life (Van Benthem et al., 2020). I believe addicts have a strong urge to continuously engage in drug abuse, a feeling that addicts cannot control. For example, my mother’s new spouse could not resist the urge to drink despite the fact that alcoholism undermined the overall well-being of the entire family. Her drinking was marked by constant and numerous wrangles that negatively affected our psychological development. Research shows that addicts lack the free will to control their cravings (Van Benthem et al., 2020). I find this argument convincing, specifically because addicts cannot quit using the drugs and regulate their urges voluntarily. This assertion is supported by the brain-disease model that I came across as I was researching for the paper. The model argues that addiction affects the neuroscience perspective and reduces the attributes of free will because it relocates the brain function and diminishes any blame attributed to addiction (Van Benthem et al., 2020).

Addicts lack control over their behavior which forms the basic definition of addiction. Research has demonstrated that addiction overcomes people’s capacity to believe in free will; hence, addicts have lack meaningful control over their behavior (Van Benthem et al., 2020). The inability to control a person’s behavior explains why alcohol addicts show adverse withdrawal symptoms when they try to avoid using their drugs. Alcoholism weakens the brain capacity and overall ability to act freely throughout the day. I remember my mother would condemn her alcoholic behavior when she was sober but soon find herself in the drinking den. The behavior would repeatedly occur even though she knew her behavior while under alcohol was quite bad. My mother’s ex-boyfriend would go out drinking with his friends and end up in jail for causing disturbances while under alcohol. Since moving in to stay with us, I have lost track of how many times he is has been arrested for intoxicated-related offenses. Addiction is often tantamount to the specific system, creating disbelief in free will (Van Benthem et al., 2020). Addicts are never in full control over their behavior. This argument stretches back to the antique notions that associate addiction with demonic possessions and divine command. Some people tend to argue that addiction leads to a system of supernatural volitions. Addiction in modern society is associated with reduced responsibilities and the inability to account for their actions (Silvers et al., 2019). Addicts have often cited external provocation as a major factor that compels them towards continuously engaging in addiction. While addiction has been associated with ideas of the demonic procession, I believe that lack of free will amongst the addicts is the leading cause of the belief that addiction is a form of association with demonic possessions. My argument is based on the DSM tool kit analysis and definition of the term addiction. According to the DSM kit, addition is associated with the substance being taken in larger amounts or over a longer period than intended.

The DSM is a vital diagnostic tool developed and published by the American Psychiatric Association. The acceptability and applicability of the kit show how much faith is bestowed on the kit. DMS identifies addiction as a substance use disorder which means that the condition can be grouped as a psychiatric condition (Silvers et al., 2019). Usually, psychiatric conditions such as stress and chronic depression affect a person’s normal thinking process; hence, addiction undermines the normal thinking processes. DSM-5 (the latest version of the diagnostic kit) does not identify addiction as a vague condition but emphasizes the various symptoms that characterize a person’s addiction (Silvers et al., 2019). The kit identifies addiction as an involuntary action and process that compels people to engage in hazardous habits and use. The tool, therefore, categorically identifies addiction as a mental condition which means that the impact of the condition on the physiological and psychological process is similar to that of other mental conditions (Jalali et al., 2019). This argument thus shows that addiction can influence mental processes, and addicts have no willpower over the addiction processes. Addiction is characterized by the desire to overcome substance use, but addicts cannot overcome the behavior. Addicts experience intense cravings and a strong urge to use the addictive substance, and finally, an addict desires more of the addictive substance. If these desires are not met, an addict will likely experience mood swings and other withdrawal symptoms, which indicates an inability to manage their willpower and addiction.

I firmly support the argument that addiction can cause the violation of free will and intentions. Addicts show similar signs to people affected by mental disorders that undermine the capacity and ability to make sound decisions. My rationale for comparing addiction to mental disorders such as depression is founded on the fact that addiction affects a person’s decision-making processes as noted by Van Wormer and Davis (2016). Addiction leads the addict to make an unconscious decision, as illustrated by my example. I have never understood the idea of engaging in alcoholism only to engage in abusive behavior that compromises our public image. However, unconscious decision-making can be explained through several scientific theories on the human body and conscious decision-making processes (Jalali et al., 2019). While some people try to embrace these theories, on the contrary, scientific theories explain that decisions originate from the brain. The brain coordinates the flow of information and decisions between human life’s cognitive and motor aspects (Van Wormer & Davis, 2016). However, drugs and substances affect the part of the brain responsible for making decisions. An addict portrays behavior similar to a mentally compromised person, which includes making unnecessary and irrelevant comments that the people cannot remember moments later (Gavriel-Fried et al., 2020). Addicts cannot control their actions, especially when under alcohol. There is also the argument that addiction comes with a strong urge to consume a specific substance (Van Wormer & Davis, 2016). Addicts rely on drugs to indulge in other pleasures to the point that some of these behaviors are destructive and harmful. However, the fact that an addict lacks control over the destructive behavior shows that addiction undermines conscious decision-making and free will.

Research by Narcotics Anonymous demonstrates that addicts lack the free will and capacity to make decisions while consciously being responsible for their decisions (Woehler et al., 2018). While the twelve steps of Narcotics Anonymous are not medically proven, the argument presented by the first of the twelve steps clearly illustrates the supremacy of addiction over free will. The first step is founded on the argument that humans are powerless over addiction and that an addict’s life becomes unmanageable (Woehler et al., 2018). While some scholars have argued that being powerless is hard to grasp, there is sufficient literature to demonstrate that addicts are powerless over what happens within and outside their bodies (Gavriel-Fried et al., 2020). Many addicts may not admit to being powerless over alcohol and drugs, but it is evident that addiction is a sign of being powerless. By being powerless, the first step illustrates addiction as a state where no amount of self-control will change how the drugs affect the brain (Van Wormer & Davis, 2016). The argument forms a foundation and basis of my argument that addicts are unconscious in their approach to drug management. Some studies have suggested that alcoholism is like living with a disease that changes the normal functioning of the human brain (Woehler et al., 2018). A person suffering from a disease does not have any control over the effects of the disease on their bodies. Usually, addiction acts like a chemical that leads to a lack of willpower to control the internal and external environments. While an addict may not inherently lack values and good character, addiction makes the person weak and cannot dictate their needs and wants.

According to Step 1 of the 12 steps for Narcotics Anonymous, admitting to being powerless over addiction means that a person has no control over what happens with their behavior, urges, and needs, even though a person may desire to overcome addiction (Galanter et al., 2019). It is common that many addicts believe that they have control over their addiction and that alcohol consumption happens out of free will. However, people find it difficult to avoid alcoholism when they enroll in therapy sessions. “It’s only a few drinks. I could stop if I wanted to,” it is such a statement that drives the belief that an alcoholic has control over their drug dependency levels. However, the journey to recovery is never easy, with many people finding it challenging. People have to accept that addiction makes them powerless and lack control over their lives. An analysis of the historical experience with my mother illustrates the paradox of being powerless. However, being powerless in addiction and recovery does not mean that a person is hopeless but rather addicts cannot control their decisions, actions, and relationships (Galanter et al., 2019). In this case, therefore, the argument that a person is powerless refers to the fact addiction means that a person is likely to live a life where they depend on certain drugs for their normal day-to-day lives. It is common for addicts to experience signs of chronic headache, severe sweating, and lack of motivation to work until a time when the person has consumed the drug (Galanter et al., 2019). The fact that the drug seems to stabilize their decision-making shows that the people are powerless over the drugs .

Step 1 of the 12 steps for Narcotics Anonymous states that “We admitted that we were powerless over our addiction, that our lives had become unmanageable.” This statement got me thinking over the overall implications of addiction on the family and society as a whole. While addiction may not directly affect the entire family because it is confined to the active abuser only, it is irrational to presume that a family can escape the implications of having one member go deep into an addiction to the point of admitting to being powerless over the addictive substance (Woehler et al., 2018). While admission is the first step in the overall recovery process, the implications of addiction are usually too deep into the family, and recovery may be a lifelong process. Step one of the recovery processes provides presenting insights into the healing process. Woehler et al. (2018) asserts that step one of the recovery processes is the hardest to achieve as people rarely want to admit to addiction. However, reaching the step is critical as it comes with realizing that a person needs to recover and find therapy for the addict. The affected member and entire family opt to find a recovery plan and therapy for the patient (Woehler et al., 2018). Some addicts are expected to experience shocks regarding the state of their addiction. For example, a patient may experience a medical crisis since drugs have the potential to cause underlying infections. Nonetheless, while it may be difficult to admit to being powerless in the alcoholism process, the first step in the twelve-step recovery process is the greatest step an addict can take towards the recovery process.

Addiction has a devastating effect on people in the first, second, and third-degree. I am aware of this fact. I have stated that drug users have not harmed me throughout this paper. An alcoholic user was the only individual I came into contact with. Alcohol, as we all know, has various implications. “Alcohol is involved in 34 percent of drowning cases, 42 percent of fire injuries, 23 percent of suicides, 16 percent of child abuse cases, and 47 percent of homicides (American Addiction Centers, 2022). I did not allow one bad experience with an alcoholic user affect my view of people who are addicted to substances. To help others in my personal and professional lives, I aim to use this initiative in the future.

In conclusion, based on my historical knowledge and information from the course, addiction has huge implications on the life of an addict. Addiction affects brain function and lowers a person’s independency levels which leave a person overwhelmed by uncontrollable desires; hence, addicts have insufficient control over their lives. Due to addiction, a person’s intention, volition, and free will are mentally compromised, therefore insufficient to control the quantity and frequency of substance use. Addicts lack the free will and capacity to make decisions while consciously being responsible for their decisions. Also, addicts rely on drugs to indulge in other pleasures to the point that some of these behaviors are destructive and harmful. My rationale for comparing addiction to mental disorders such as depression is founded on the fact that addiction affects a person’s decision-making processes. Addicted people cannot control their feelings, emotions, and feelings towards drugs and other essential aspects in human life. Addicts have a strong urge to continuously engage in drug abuse, a feeling that addicts cannot control. The inability to control a person’s behavior explains why alcoholic users show adverse withdrawal symptoms when they try to avoid using drug substances.

American Addiction Centers. (2022).  Drug & Substance Abuse Addiction Statistics:  Retrieved 6 May 2022, from https://americanaddictioncenters.org/rehab-guide/addiction-statistics.

Galanter, M., White, W. L., & Hunter, B. D. (2019). Cross-cultural applicability of the 12-Step model: A comparison of Narcotics Anonymous in the USA and Iran.  Journal of Addiction Medicine ,  13 (6), 493.

Gavriel-Fried, B., Moretta, T., & Potenza, M. N. (2020). Associations between recovery capital, spirituality, and DSM–5 symptom improvement in gambling disorder.  Psychology of Addictive Behaviors ,  34 (1), 209.

Jalali, R., Moradi, A., Dehghan, F., Merzai, S., & Alikhani, M. (2019). Exploring factors related to treatment retention in Narcotics Anonymous members: a qualitative study.  Substance abuse treatment, prevention, and policy ,  14 (1), 1-9.

Silvers, J. A., Squeglia, L. M., Rømer Thomsen, K., Hudson, K. A., & Feldstein Ewing, S. W. (2019). Hunting for what works: Adolescents in addiction treatment.  Alcoholism: Clinical and Experimental Research ,  43 (4), 578-592.

Van Benthem, P., Spijkerman, R., Blanken, P., Kleinjan, M., Vermeiren, R. R., & Hendriks, V. M. (2020). A dual perspective on first-session therapeutic alliance: a strong predictor of youth mental health and addiction treatment outcome.  European child & adolescent psychiatry ,  29 (11), 1593-1601.

Van Wormer, K., & Davis, D. R. (2016).  Addiction treatment . Cengage Learning.

Woehler, E. S., Giordano, A. L., & Hagedorn, W. B. (2018). Moments of relational depth in sex addiction treatment.  Sexual Addiction & Compulsivity ,  25 (2-3), 153-169.

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Ontario's top doctor calls for decriminalization, limits on legal substances

Dr. kieran moore also wants province to explore value of raising legal drinking age from 19 to 21.

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Ontario's top doctor is calling on the province to decriminalize possession of unregulated drugs for personal use and make available safer supply, as well explore raising the legal drinking age from 19 to 21.

Dr. Kieran Moore, the province's chief medical officer of health, is also calling on the province to immediately enact policy that will limit access to alcohol, vapes and cannabis as the number of people who have died or visited a hospital due to using multiple substances has spiked in recent years.

Moore said more than 2,500 people have died in Ontario each year in the past few years due to a toxic drug supply. And the number of opioid-related deaths among teens and young adults in Ontario tripled between 2014 and 2021. Research has found a safer drug supply is the solution to immediately prevent thousands more from dying in the coming years, he said.

"The system must first take urgent steps to keep people alive, such as creating safe spaces where people can use unregulated drugs and providing regulated pharmaceutical alternatives," the medical officer wrote in an annual report released this week.

"With these harm reduction responses in place, people who are using opioids may be in a position to benefit from offers of education and treatment, and to make choices that enable them to reduce or even stop their opioid use," he wrote in the report. 

"When we see preventable threats, like substance use, that harm too many people too young, devastate families, destroy communities, and reduce life expectancy, we must act."

Moore's research suggests his "multi-pronged" recommendations can help officials prevent fatal overdoses and stop people, especially youth, from dangerously and increasingly using multiple legal substances.

Hannah Jensen, a spokeswoman for Ontario's minister of health, said in an email on Thursday the government appreciates Moore's "recommendations to restrict legal substances while decriminalizing hard drugs."

• Toronto wants to expand drug decriminalization to cover all ages and substances

But Jensen said they "ignore the unintended consequences and significant public safety concerns experienced by other jurisdictions that have implemented similar proposals," though she did not provide examples.

As for decriminalization, Moore said it "allows the justice and enforcement systems to focus their resources on stopping the organizations and individuals profiting from unregulated drug sales rather than on people who use substances whose needs would be better met in the health system."

'Disturbing trend' of binge drinking, vaping

He noted Ontarians, especially youth, have also been a part of a "disturbing trend" in recent years of binge drinking and vaping.

The report, citing recently released data from the Canadian Institute for Health Information, found 33 per cent of adults said they used cannabis in 2020, an eight per cent increase from 2019. And when it released its cannabis survey in 2022, Health Canada reported the number of Ontarians who died of alcohol toxicity rose 16 per cent between 2018 and 2021.

"We have also seen concerning changes in substance use patterns and harms more broadly, including higher rates of vaping among non-smokers, increased unintentional poisonings in children from cannabis ingestion, and an ongoing high burden of hospitalizations and cancers caused by alcohol," Moore said in the report.

He said that's why efforts need to be made to "shift social norms by making Ontarians more aware of new evidence on alcohol-related harms."

He suggested in the report, for example, that more restrictions on how legal substances are marketed can be implemented to educate people on the harms of substance use.

"The province does prohibit advertising of alcohol to minors on traditional media outlets like television, radio or print, but neither the federal nor the provincial government limits advertising on social media platforms, which is where youth get most of their information," Moore said.

Make sure people know the risks: Moore

He also recommended Ontario "explore the value of increasing the legal minimum drinking age from 19 to 21" and 'work with the federal government to require that all alcohol products have warning labels and signage that describe the risks and harms of drinking booze.

He said it's common knowledge that Ontarians will continue to use the legal substances.

"The challenge is to help people understand the risks, and moderate or stop their use," he said.

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"In 2020, the harms associated with substance use cost Ontario about $18 billion – or $1,234 per person – in health care, social and legal/policing costs," the report reads.

Moore argued his recommendations need to be implemented with the understanding that societal burdens, such as the affordability crisis, are driving more Canadians to use substances. 

That's why he said Ontario needs to implement his recommendations while working with all levels of government in developing affordable housing policies, programs for families that reduce the risk of adverse childhood experiences and domestic violence, and initiatives to improve social circumstances.

"This report calls for an all-of-society approach to improve health and reduce substance use harms: one that recognizes the complexity of human experience with substances, the factors that drive substance use, and the policy environment where public health policies may conflict with economic policies, and with public attitudes and perspectives," he wrote.

• Ontario's top doctor warns of potential measles outbreaks as cases increase abroad

Drug and Alcohol Abuse Analytical Essay

Introduction, works cited.

For along time now, drug and alcohol abuse in the society has been a problem that affects the youth and the society at large. The youth in the society get engaged in abusing substances that they feel all help them forget their problems. This paper highlights the problems of drug abuse and alcohol drinking among the youth in the society.

Alcohol is a substance that contains some elements that are bring about physical and psychological changes to an individual. Being a depressant, alcohol affects the nervous system altering the emotions and perceptions of individuals. Many teenager abuse alcohol and other drug substances due to curiosity, the need to feel good and to fit in their different groups. Drinking alcohol should not be encouraged because it usually affects the health of the youth.

It puts their health at a risk. Drinking youth are more likely to engage in irresponsible sexual activities that may result in unexpected pregnancies and sexually transmitted diseases. Additionally, teenagers who drink are more likely to get fat while complicating further their health conditions. Moreover, the youth drinking are at a risk of engaging in criminal activities hence being arrested (Cartwright 133).

According to the Australian Psychological Society, a drug can be a substance that brings about physical or psychological changes to an individual (2). Youngsters in the in the community take stuffs to increase enjoyment or decrease the sensational or physical pain. Some of the abused drugs by the youth in the society include marijuana, alcohol, heroine and cocaine.

The dangers of drug abuse are the chronic intoxication of the youth that is detrimental to their societies. Much intake of drugs leads to addiction that is indicated by the desire to take the drugs that cannot be resisted.

The effect of alcohol and other hard drugs are direct on the central nervous system. Alcohol and drug abuse is linked to societal practices like, partying, societal events, entertainment, and spirituality. The Australian Psychological Society argues that the choice of a substance is influenced by the particular needs of the substance user (3).

However, the effects of drug abuse differ from one individual to another. The abuse of drugs becomes a social problem whenever the users fail to meet some social responsibilities at home, work, or school. This is usually the effect when the substances are used more than they are normally taken. Additionally, when the use of substances is addictive, it leads to social problems (Cartwright 135).

Drug and alcohol abuse among the youth in the society should be discouraged and voided at all costs. The youth are affected and the society is affected. The productive young men and women cannot perform their social duties. One way in which the abuse of drugs and alcohol can be avoided in the society is through engaging the youth in various productive activities. This will reduce their idle time while keeping them busy (Cartwright 134).

They will not have enough time for drinking. Additionally, they will have fewer problems to worry about. They should also be educated and warned about the dangers of drug and alcohol abuse both to their health and to the society. Since alcohol and substance abuse is related to increased crime in the society, its reduction will lead to reduced crime rates and economic growth.

The Australian Psychological Society. Alcohol, and Other Drugs . Australian Psychological society. Web.

Cartwright, William. Costs of Drug Abuse to the Society. The Journal of Mental Health Policy and Economics , 1999. 2, 133-134.

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IvyPanda. (2023, December 18). Drug and Alcohol Abuse. https://ivypanda.com/essays/drug-and-alcohol-abuse/

"Drug and Alcohol Abuse." IvyPanda , 18 Dec. 2023, ivypanda.com/essays/drug-and-alcohol-abuse/.

IvyPanda . (2023) 'Drug and Alcohol Abuse'. 18 December.

IvyPanda . 2023. "Drug and Alcohol Abuse." December 18, 2023. https://ivypanda.com/essays/drug-and-alcohol-abuse/.

1. IvyPanda . "Drug and Alcohol Abuse." December 18, 2023. https://ivypanda.com/essays/drug-and-alcohol-abuse/.

Bibliography

IvyPanda . "Drug and Alcohol Abuse." December 18, 2023. https://ivypanda.com/essays/drug-and-alcohol-abuse/.

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