In every developed country people come into contact with alcohol. A minority of the population also comes into contact with other narcotics. Some people develop an addiction, others do not. Someone has an addiction when they have difficulty controlling substance use, when they are consuming large amounts at a time and/or when they continue to use the drug even though they know that this may cause problems (such as violence).

To feel the effect of narcotics time and time again, the person needs more and more of the substance in question: one becomes tolerant of the effect of the substance. Abrupt discontinuation of substance use leads to withdrawal symptoms. People with a substance problem have issues such as:

• A strong urge to consume the product.

• Difficulty controlling substance use.

• Problems regarding health, behavior and social relations caused by substance use.

What is a drug?

A drug is defined as a chemical agent that influences the biological functioning of humans and animals (food excluded). Psychotropic drugs act in the brain to influence mood, the thought process or behavior. Substance abuse is recognized as a disorder by the DSM-IV.

What are the effects of drugs?

Every type of drug has immediate and long-term effects. Some of these are shown in the table:

The biggest reason for using drugs is because they want to feel better.

What causes problems with substance abuse?

Researchers have different ideas about the cause of substance abuse: is it a chronic disease or is substance use more learned by the environment? Many former substance abusers see it as a chronic illness. The only way to recover would be through total abstinence.

Modern learning theories consider addiction as a result of constant substance abuse. This substance abuse is caused by a combination of genetic vulnerability and by their environment. When the person abuses drugs, the chance of addiction increases.

To give a good idea of ​​the cause of addiction, this term must first be defined. In the DSM (1994) dependency/addiction is defined as the tendency to take a drug which is not medically necessary. The drug must thereby lead to reduced health or reduced social functioning.

How to diagnose?

To classify psychological disorders, the DSM-IV is used worldwide. To diagnose substance abuse, the following criteria must be considered:

A. A maladaptive pattern of substance use that leads to clinically significant problems within twelve months. One or more of the following points must be addressed:

• Failure to perform important school, home or work activities.

• Repeated substance use in situations where physical damage can occur (for example when driving a car).

• Problems with the law through substance use.

• Use of substance continues to persist despite repeated social or interpersonal problems.

B. The symptoms must never have met the criteria for addiction for this type of product.

To diagnose substance dependency, the following criteria must be considered:

A. A maladaptive pattern of substance use that leads to clinically significant problems within twelve months. Three or more of the following points must be addressed:

• Tolerance (need increasing amounts of the product or experience a reduced effect with the same amount of product).

• Withdrawal.

• The product is taken in larger quantities or over a longer period of time than originally intended.

• A persistent desire or unsuccessful attempts to reduce substance abuse.

• A large amount of time spent on obtaining the drug, the use of the drug and the recovery of substance use.

• Important social, recreational and/or occupational activities are discarded as a result of substance use.

• The person knows that his or her physical or psychological problems are caused by the drug and continues to use the drug.

Note from summarizer: consult the DSM-V that has been issued for the current criteria for establishing substance abuse and substance dependency.

The substance use not only affects the individual, but also the people in his or her environment. The amount of substance use that is permitted depends on the culture. Many countries have drawn up guidelines for safe alcohol use.

What are the cultural factors and attitudes towards drugs?

There are huge cultural differences, especially in alcohol consumption: alcoholic may not be permitted in some countries, while in a country like France you are considered an outlier when you do not drink.