Dr.Lipi Dhar

MBBS, DFW&CH (Delhi) PG Dip in PH (Aus, distinction) MPH (Aus)

What is ‘Substance abuse’?

There is no universally accepted definition of substance abuse. It can simply be defined as a pattern of harmful use of any substance (drug) for mood-altering purposes. According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) issued by the American Psychiatric Association- substance abuse is used to describe a pattern of substance use leading to significant problems or distress such as failure to attend work or school and poor work performance, drug use in dangerous situations such as driving a car or operating a machine, substance-related legal problems such as arrests for substance-related disorderly conduct , or continued substance use that interferes with friendships and or family relationships.

Commonly, when most people talk about substance abuse, they are referring to the use of illegal drugs. Illegal drugs are not the only substances that can be abused. Alcohol, prescription and over-the-counter medications, inhalants and solvents, and even coffee and cigarettes, can all be used to harmful excess.

Misuse or abuse of alcohol, tobacco, commonly used medicine (e.g. cough, cold, sleep, and diet medications), inhalants, stimulants (e.g. smokeable form of cocain), marijuana, heroin, steroids and club drugs (e.g. ectasy) are now widespread among adolescents internationally and cause significant health problems ¹. Alcohol consumption typically begins in adolescence. In United Kingdom, approximately 40% of young people report binge drinking; the main reason given for this is enjoyment. Young people believe that alcohol helps them to be more sociable ². Alcohol use is also rising rapidly in some developing region along with large increases in cigarette smoking. There are also growing incidences of injecting drug uses (opiates) in Eastern European Countries and South and South Asian countries ³

Cannabis is the most common drug of misuse in Western countries. a majority of young people in the United Kingdom, United States, New Zealand and Australia now use cannabis recreationally ⁴ . Cannabis use usually starts at about 16-17 years old. In England, about 30-50% of this age group reporting that they have at least tried cannabis. Regular use, however, is less common, with about 10% of adolescents reporting weekly use and about 3% daily use ². About one half of the people in the United States have used marijuana and the average age of first marijuana use is 14 ¹.