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  • Ernesto L. Brea

Understanding Substance Abuse


Although illicit drug use is a major category of substance abuse, it is not the only one.  Alcohol, inhalants, adhesives, nicotine, prescription medicines, and solvents are also subject to abuse. Recent news reports about teenagers using liquid hand soap to “get high” demonstrate the lengths to which people will go to satisfy an unquenchable desire for the abused substance.

Often substance abusers are blamed for their own illness. They are labelled as irresponsible or weak or unwilling to change. These views are not only outdated, but they actually stand in the way of positive outcomes. More and more, the evidence is clear that addiction is based in the chemistry of the brain, and not in the personality.

With continual drug use, the abuser’s brain undergoes changes that increase their desire for the substance, and the brain’s ability to avoid or resist it is actually damaged. Substance abusers may have chosen to use the substance in the first instance, but it is largely out of their control after that. It is not fully understood why some people become addicted to substances that others are able to use in moderation, or to avoid completely.

What other factors contribute?

Genetics and environment play a role in increasing an individual’s vulnerability to substance abuse. It is known that addictions can be inherited, and the combination of biological tendencies and behavioural modelling is a combustible mix. Of course, other factors can contribute as well. Survivors of sexual or physical abuse often become substance abusers, as do those who are mentally ill, or have suffered poverty, crime, or neglect. That said, substance abuse is an illness that knows no social, racial, or economic bounds.


Therefore, recovery from substance abuse poses a number of challenges. It is a chronic illness, which means that it never completely goes away, and it tends to reappear under periods of stress, even when there has been a long stretch of remission. It is helpful to understand that the healing process does not proceed in a straight line. It can be a life-long struggle to remain free from the substance that is doing so much harm.

What can I do next?

If you suspect substance abuse in yourself or in someone else, there are steps you can take in identifying the problem and knowing when to seek help. Some signs to look for include such obvious ones as increased use of the substance more, and in larger amounts, neglecting school, work, or social activities in order to use the substance, and blacking out or experiencing loss of memory. Other changes may include impaired performance at work or in daily activities, depression, and loss of interest in socializing and using the substance alone or in hiding. More severe signs include suicidal thoughts, risky behaviours such as stealing or reckless driving, unsafe sex, and other dangerous or criminal activity.


As scientists begin to better understand the biological aspects of substance abuse, a brighter future may lie ahead as new treatment modalities are created. In the meantime, substance abuse is too serious an illness to ignore or evade.

Images on Creative Commons license courtesy of xJason.Rogersx, CarbonNYC, Alan Cleaver

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