Frequently Asked Questions
Q: What is meant by use, misuse, abuse, addiction and dependency?
Substance misuse according to reading and personal experience is not taking a prescribed medication at the proper dosage. Examples are opiates taken for the high rather than for their pain relieving properties or taking medicines more often than prescribed (i.e.: prescribed 2 tablets every 4 hours…misuse is taking 4 tablets every 2 hours).
Substance use becomes substance abuse when alcohol or drug use is harmful to the health of the individual as well as the health of others. Abuse is used to describe a pattern that leads to significant problems or trouble Causing marked distress in social and / or occupational areas as well as health. (driving while under the influence), substance-related legal problems, or continued substance use that interferes with friendships and or family relationships. As a disorder, substance abuse refers to the abuse of illegal substances or the abusive use of legal substances, the overindulgence in and dependence on a stimulant, depressant, chemical substance, herb (plant) or fungus leading to effects that are detrimental to the individual's physical health or mental health, or the welfare of others, and dependency or addiction .Alcohol is the most common legal drug of abuse.
Addiction is a primary, chronic, relapsing, neurobiological disease with genetic, psychosocial, and environmental factors affecting its development. Manifestations include compulsive drug seeking behavior and abuse causing long-lasting chemical changes in the brain. One or more of the following characterizes addiction: impaired control over drug use, compulsive use, continued use despite harm, craving, and a strong emotional and /or psychological dependence. (Fields)
Dependency is defined as a lack of independence or self-sufficiency. In the case of chemical dependency there is such a strong reliance on the substance that it becomes necessary to have this substance just to function properly. The need of a substance is developed from abusing it, which leads to a requirement of the substance for survival . Signs of dependency include: increased tolerance or need for increased amounts of substance to attain the desired effect, withdrawal symptoms with decreased use, unsuccessful efforts to decrease use, increased time spent in activities to obtain substances, withdrawal from social and recreational activities, and continued use of substance even though physical or psychological problems are continually encountered. (DSM) (Fields)
Q: Diagnostic criteria for dependency?
The differences between psychologically dependent and physical dependence is a person who is psychologically dependent is preoccupied with taking the drug to reach his/her optimal high, and person who is physically dependent continues to take the alcohol or drug to avoid a negative consequence or withdrawal. Zuckerman states (pg 273) although cocaine and heroin are said to be drugs to produce dependence, but a study comparing daily use showed a smaller percentage of cocaine users ever felt the dependence of other users such as alcohol and heroin users. Only 13% of the cocaine users Zuckerman stated ever reported feeling withdrawal compared to the 75% of heroin users. Cocaine users particularly crack users, showed more distress, depression, temper, suspicious behavior, hallucinations and violent outburst compared to heroin users. (Zuckerman)
The DSM reflects the following criteria for Abuse and dependency:
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