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    • Things That Come Pg 2

Substance Use, vs. Substance Dependence, vs. Substance Abuse


See the section 'Psychoactive Substances' for a review of the following references;

NEUROSCIENCE OF PSYCHOACTIVE SUBSTANCE USE AND DEPENDENCE
http://www.who.int/entity/substance_abuse/publications/en/Neuroscience.pdf  286 pages; from the World Health Organization (WHO), published 2004.
.
http://www.who.int/substance_abuse/publications/en/Neuroscience_E.pdf ; a 40 page summary of the same.

Definitions of use, abuse and dependency; here again you have Wikipedia for a baseline;

Wikipedia

'...A substance related disorder is a condition in which "an individual uses or abuses a substance to the point where it leads to maladaptive behaviours, manifested by at least one symptom that interferes with normal life functioning within a 12 month period.". In order to be diagnosed with substance dependence an individual must display at least three of the following for a 12 month period: "development of tolerance to the substance, withdrawal symptoms, persistent desire/unsuccessful attempts to stop using the substance, ingestion of larger amounts of substance, declined life functioning, and persistent use of substance."
'...Substance abuse, also known as drug abuse, refers to a maladaptive pattern of use of a substance (drug) that is not considered a dependency. Substance abuse/drug abuse is not limited to mood-altering or psycho-active drugs. Activity is also considered substance abuse when inappropriately used (as in steroids for performance enhancement in sports). Therefore, mood-altering and psychoactive substances are not the only drugs of abuse. Substance abuse often includes problems with impulse control and impulsivity.
'...The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts. The terms have a huge range of definitions related to taking a psychoactive drug or performance enhancing drug for a non-therapeutic or non-medical effect. All of these definitions imply a negative judgment of the drug use in question (compare with the term responsible drug use for alternative views). Some of the drugs most often associated with this term include alcohol, amphetamines, barbiturates, benzodiazepines,...cocaine,... and opioids. (My note-Please notice that all of these have been prescribed by licensed physicians for what was seen to be legitimate purposes. The med doesn't change. The person doesn't change. The efficacy may in fact be just as beneficial. But now it is termed 'drug abuse') Use of these drugs may lead to criminal penalty in addition to possible physical, social, and psychological harm, both strongly depending on local jurisdiction.'


Use versus abuse
The progression from use to abuse is analogous to the progression of thought an identity from 'having' a disease to 'becoming' the disease. 'I am vs I have'- 'becoming' the condition.

Wikipedia;
'...According to the current  (DSM-IV), substance dependence is defined thus:
'...When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed. Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped. This, along with substance abuse are considered 'substance use disorders'
'...In 1964, a new WHO committee found these definitions to be inadequate, and suggested using the blanket term "drug dependence":
The Expert Committee recommends substitution of the term "drug dependence" for the terms "drug addiction" and "drug habituation".
'...The committee did not clearly define dependence, but did go on to clarify that there was a distinction between physical and psychological ("psychic") dependence. It said that drug abuse was "a state of psychic dependence or physical dependence, or both, on a drug, arising in a person following administration of that drug on a periodic or continued basis." Psychic dependence was defined as a state in which "there is a feeling of satisfaction and psychic drive that requires periodic or continuous administration of the drug to produce pleasure or to avoid discomfort" and all drugs were said to be capable of producing this state:
'...There is scarcely any agent which can be taken into the body to which some individuals will not get a reaction satisfactory or pleasurable to them, persuading them to continue its use even to the point of abuse – that is, to excessive or persistent use beyond medical need.'

   One needs to establish, beyond any doubt, that dependence on a legal, prescribed medication is none the less 'drug dependence' The potential for positive or negative effects on the body and the mind is the same. It is only the legal terminology that differs.

   Why does the world (governments, judicial systems, communities) feel the need to make dependency, use and abuse of certain substances illegal, and to incarcerate and otherwise marginalize those of the population found guilty of such activities? It is not so much because of the intoxication per se , although there are statutes prohibiting 'public intoxication' in most localities. Rather, it is the presumed or observed sequelae of the use of these substances; 

'...Toxic and other biochemical effects, chronic and acute social problems, accidents, injuries, acute disease, chronic disease.' (WHO 2004) In other words, if you just drank alcohol at home, or for that matter took oxycodone, smoked marijuana or crack, and otherwise were a model citizen; if your health and your relationships weren't affected, the social concern might be less. But if you go out and rob pharmacies, kill your girlfriend or neighbor, drive to endanger, contract HIV or Hepatitis b, develop Cirrhosis, become disabled secondary to your activities and the public has to pay huge bills for your ongoing care- including frequent visits to the emergency room for intoxication or overdose- then, it's not just your problem any more.


(See also writings under 'Conspiracy Theory')
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