Substance Abuse. Why Is It So Dangerous?  

By Brian McAlister

Whether you call it substance misuse, substance use disorder, plain old addiction or partying, there is one undeniable truth. People die.

Addiction is a progressive disease. Untreated, it leads to disability and death.

No one wants to be an addict. It is truly a miserable existence. Every natural instinct for self- preservation, health and happiness is hijacked. It is as if our brains are working against us. At some level the substance abuser recognizes he is injuring himself, yet he is unable to stop.

Substance Abuse Often Goes Undiagnosed

Addiction is a complex disease that often goes undiagnosed. In popular culture, substance abusers are often portrayed as downtrodden, homeless vagrants. Nothing is further from the truth. The vast majority of people suffering from substance abuse disorder are gainfully employed, have loving families and even two cars in the driveway. This outward appearance of normalcy often masks a serious illness.

Longtime heavy drinkers, for example, may dismiss the notion they have a problem. Aren’t they going to work every day and paying the bills? Indeed, amid certain professions, it is a source of pride to work hard and play hard. Heavy drinking and drug use is encouraged, and celebrated.

This is also true among college students. Many incoming freshmen are immersed immediately into a party culture, where they are advised by upperclassmen not to schedule classes on Fridays, where Thirsty Thursday events kick off a three-day weekend of drinking. Binge drinking is misuse, yet on some campuses, it is seen as the norm.

Opioid misuse is particularly dangerous. Mixing opioids with alcohol can be immediately life-threatening. And those who take too many pills before bed may never wake up. Opioids can have a euphoric effect that helps the user forget about problems but they also cause respiratory depression that results in the user forgetting to breath.

A checklist, included below, can help you identify the criteria that define misuse. The list, published by The National Institute on Drug Abuse, drives home the point that when substance use continues despite negative consequences, such as a DUI or loss of friendships, the person is in trouble. But before you evaluate the criteria, you should be aware the definition of misuse and know which drugs are commonly misused.

The Misuse of Prescription Drugs

Many people believe that prescription drugs are not dangerous. Indeed, many over-the-counter medications for common illnesses are advertised as “prescription-strength.” This is viewed as a positive attribute; presumably we will be relieved of our symptoms more quickly.

In addition, prescription drugs are common. Our medicine cabinets are filled, as are the medicine cabinets of our neighbors. We forget how potent these drugs can be.

When it comes to prescription drugs, the definition of misuse is simple and clear. The Substance Abuse and Mental Health Services Administration zeroes in with a description of misuse:

• Taking a drug without a prescription
• Taking a drug in a way other than prescribed (more frequently, for example, or combined with other drugs).
• Taking a drug simply for the experience or the feeling that it causes, rather than to address an illness or medical condition.

We know that alcohol and marijuana are commonly misused. Indeed, many experts, including those at the National Institute on Alcohol Abuse and Alcoholism, are now labeling the misuse of alcohol (which includes heavy drinking and binge drinking) as an alcohol use disorder. The criteria for alcohol use disorder is similar to the criteria outlined in the checklist below.

Which Prescription Drugs Are Commonly Misused?

What about prescription drugs? Adderall is bought and sold with ease on college campuses, especially during midterms and finals, when students want to stay alert and focused. Prescription-strength cough syrup is mixed with candy, a concoction that is celebrated in song lyrics and in social media. These are examples of prescription drug misuse.

Other prescription drugs are commonly misused, including:

• Opioids, such as Vicodin, OxyContin, morphine, codeine
• Stimulants, such as Ritalin, Dexedrine
• Depressants, such as Ambien, Valium, Xanax

When Does Substance Abuse Become A Problem?

Experts who study alcohol abuse note that more than 95 percent of the people who need treatment do not feel they need treatment. What this tells us is that alcohol abuse is prevalent, and most alcoholics are not seeking help.

The same is true for other substance abusers. Most people who are opioid dependent simply do not seek treatment, in part because they don’t recognize an addiction

No one strives to be an addict. Yet it’s often hard to define when things are getting out of hand. How do you know?

Experts have studied, and continue to study, the complex set of factors that determine when drug use crosses the line. They also note that certain circumstances put people at higher risk for addiction. Introducing a drug, or continuing to use a drug, amid one of these high-risk circumstances creates a perfect storm.

At-risk circumstances include:

• Family history of substance abuse or addiction
• Trauma
• Stress
• Unemployment
• Depression

Learn to Identify a Problem of Substance Abuse

This list of criteria, published online by the National Institute on Drug Abuse will help you define the difference between use and misuse. A problem exists if, in the last 12 months, just two of these criteria apply.

• You take the drug in larger amounts or over a longer time period than intended
• You have a persistent desire to cut back, or you try unsuccessfully to quit or control your us
• You spent a lot of time and effort to acquire the drug, or recovering from Persistent desire to cut back, or unsuccessful effort to control use of the drug
• You have strong craving
• Your use causes problems at school, at work, at home.
• Your use continues despite the social difficulties it causes
• You give up your hobbies or recreational activities
• You use even when it’s dangerous to do so (drinking and driving, for example)
• You use despite knowing you have a condition or illness caused by the substance
• Your tolerance for the substance changes, meaning you need more to create the same effect
• You suffer withdrawal symptoms

Even with all definitions and checklists and risk criteria, you may still be unsure whether use has morphed into misuse and whether that misuse is problematic. Indeed, experts are still trying to figure that out, and continue to study the web of complexities that define dependency and addiction.

Nevertheless, you should also know this: Studies show that early intervention makes a real difference. My goal is to convince you to act early. A difficult situation isn’t likely to improve on its own. The Freedom 365 Virtual Recovery System offers individuals a free assessment to help them know if they have a problem. The assessment is secure and respects your anonymity.

Freedom 365™ aims to put addiction recovery support and strategy in reach of everyone who needs help, no matter where they and on any device. Find out more here.

Brian McAlister is the President and CEO of Freedom 365 Virtual Recovery System™ and Full Recovery Wellness Center. He is Best-selling author of Full Recovery, The Recovering Person’s Guide to Unleashing Your Inner Power. Sober date: August 2, 1990.