What is the difference between drug use, misuse and abuse?
We use drugs daily in our lives. Whether it is drinking a cup of coffee to help us wake up or taking an aspirin to relieve pain, the important consideration is how and why people use drugs. Almost every drug created has a medicinal purpose. It is people who decide whether they are going to use drugs in a positive, healthy manner or misuse them. In presenting drug information, it is important to distinguish between the following terms:
Drug use: the use of a chemical for medicinal purposes under the supervision of a physician or as directed in the instructions provided by the manufacturers of over-the-counter drugs.
Drug misuse: chemical use without the supervision of a physician or not following manufacturer’s directions.
Drug abuse/chemical dependency: when an individual physically and/or psychologically cannot quit using specific chemicals. The individual’s drug use has become a disease. It is progressive, predictable, and treatable.
General Symptoms of Drug Misuse and Abuse
- Changes in school attendance and conduct
- Changes in academic performance and/or drop in grades
- Change in dress and personal hygiene; poor physical appearance
- Change in level of patience; short-tempered
- Wearing sunglasses at inappropriate times to conceal dilated or constricted pupils (Note: Allow for current fashion trends which promote the donning of sunglasses while indoors.)
- Routine wearing of long-sleeved shirts even in hot weather
- Change in peer group, particularly those labeled as drug users
- Finding a young person in unusual places for no apparent reason (i.e., closets, storage rooms, basements, attics, garages)
- Stealing small items
- Sudden change in personal finances and spending (either too much money or too little money)
Characteristics of Specific Drug Use
The Inhalent/Solvent Abuser
- Odor of the chemical inhaled is apparent on user’s breath and clothing
- Unusually frequent presence of plastic or paper bags in user’s possession
- Unusually excessive runny nose and watery eyes
- Poor muscular control and slurred speech (acts drunk)
- Drowsiness or unconsciousness
- Unusually recurring bad breath
The Depressant Abuse
- Symptoms of alcohol intoxication without any apparent odor on user’s breath (i.e., staggering, slurred speech, disorientation)
- Frequently sleeping at inappropriate times (i.e., school, work)
- Apathetic attitude towards school and/or work
- Displays difficulty in concentrating on work
- The Stimulant Abuser
- Unusually hyperactive
- Displays excessive behavior which is unusually irritable, argumentative, and/or anxious
- Dilated pupils
- Unusually talkative and excitable
- Goes long periods of time without eating and/or sleeping
- Possible displays of hallucinations and feelings of paranoia
- Chain smoking
- Chronic bad breath
- Dry mouth and nose which frequently cause the user to lick lips and rub and scratch nose.
The Narcotic User
- In early stages presence of empty bottles of paragoric and/or cough medicine containing codeine in wastebasket
- Unexplained scars on the arms or on the backs of hands, feet, or between toes (caused by injections)
- Constricted, fixed pupils
- Frequently scratches body
- Loss of appetite other than for sweet foods (candy, cookies, sodas)
- Unusually frequent runny nose, watery, red eyes, and cough
- Unexplained syringes, bent spoons, cotton, needles, metal bottle caps, and medicine droppers
- Unexplained white powder around the nostrils caused from inhaling heroin.
- Often lethargic and drowsy; may go on the “nod” which is an alternating cycle of dozing and awakening
- If withdrawing from-the drug, the user may be nauseated, vomit, and display flushed skin, frequent yawning, and muscular twitching
The Marijuana User
- In early stages, the user appears animated, displaying rapid, loud talking with frequent laughter
- In later stages, the user appears sleepy
- Dilated pupils, bloodshot eyes
- Sweet, mushy odor on hair and clothes
- Distortion of depth and time perception
The Hallucinogen Abuser
- Dilated pupils
- Users may sit or recline quietly in a trance of may appear paranoid
- Increase in blood pressure, heart rate, and blood sugar while under the influence
- Unexplained nausea, chills, flushes, irregular breathing, sweating, and trembling while under the influence
- The user may experience changes in sense of sight, hearing, touch, smell and time while under the influence
Drug addiction has clear characteristics
Some of these are:
- An adaptative alteration in the body such that the presence of the drug in the system is necessary to maintain normalcy
- Occurrence of withdrawal symptoms that usually do not occur when the drug is used appropriately and the drug is discontinued or decreased
- Craving for the effects produced by a drug; the user thinks it is necessary for his/her psychological well-being to continue its use
- Condition of anxiety, depression, and sometimes a psychotic state brought on by withdrawal
- Development of tolerance, i.e., the user has to increase the drug dosage in order to achieve the same effect.
Individuals who suffer from alcoholism experience slightly different symptoms.
- Loss of control over alcohol intake
- Presence of physiological, psychological, economic, familial, and/or social problems
- Use of alcohol as a “crutch” in order to keep his/her life from falling apart
- Increased tolerance (need for more to produce effects) and repeated withdrawal symptoms when alcohol is not consumed.
Factors that determine drug effects
It is important to remember that there are three basic rules concerning the action of drugs on the human body. First of all, the action of a drug is always mediated by a naturally occurring process of the body. A drug can minimize, facilitate, or antagonize a normally occurring biological action. Secondly, a drug has one of three basic effects on body cells. It can increase, decrease or disrupt a cell’s normal activity. There are many factors that influence an individual’s response to a drug. No one factor determines how a drug will affect an individual. The factors to consider are as follows:
Type of drug used - Different types of drugs bring on different responses in the body. Every drug has its own specific action on the body which is distinct from other drugs. Every drug also has potential side effects.
How a drug is taken – The way a drug is taken into the body will greatly affect its speed, intensity, and length of the effects. A drug that is taken by intravenous injection will produce effects within 15 seconds since the drug enters the circulatory system directly. A drug that is taken orally takes longer to take effect because it has to be broken down in the stomach and intestines before it can be absorbed into the bloodstream. The method by which a drug is taken depends a great deal upon the desired action and the chemical and physical properties of the drug. Some drugs do not lend themselves to be taken orally but work well if given by injection.
Dosage – Dosage is very important in determining drug effects. For example, if aspirin is taken in appropriate doses (1-2 tablets), it may relieve pain. Taken in larger doses, aspirin may cause adverse effects, such as tinnitus, stomach distress, bleeding, belching, and delay in clotting time.
Body weight – The body weight of the user has much to do with the effects of a drug. People who are heavier than average may be able to take a greater amount of a drug. People lighter than average may be adversely affected by the same amount.
Age - The age of the user oftentimes determines his/her sensitivity to a drug. Children are more sensitive to any drug than an adult even if their body weight is the same. With some drugs it takes only one-fourth the adult dosage to be fatal to a child. The elderly are also more sensitive to drugs.
Mind-Set – When a person takes a drug, his/her psychological expectations have an influence on the effects of the drug. The emotional state of the user can also affect the reactions he/she has, especially with hallucinogens.
Setting – The environment in which a person takes a drug has a substantial influence on its effects. The user’s feelings of discomfort, the temperature, and the altitude of the surroundings can affect the drug activity in the body and the way a person reacts physically to the chemical.
Sex – Anatomically, men’s and women’s bodies have differences in fat and water content. Since some drugs are fat-soluble while others are water- soluble, there are often different drug effects in men and women. For example, most women are more affected by alcohol than men even if their weight is the same.
Tolerance – If a person uses a drug continuously over a period of time, the dosage has to increase in order to achieve the same desired effects. Some of the drugs that a person can develop a tolerance to are Demarol, Percodan (both painkillers), Seconal, Nembutal (both depressants), Benzedrine, Dexedrine (weight control pills), caffeine, nicotine, and alcohol. Even some overthe-counter drugs, such as sleep-aid preparations, carry a potential for tolerance if used long enough.
Absorption and metabolism rates – Individual metabolic rates and food can alter the rate at which a drug is absorbed and how effective it is in the body.
General health - Any disease, allergy, or medical problem can interfere with the body’s ability to deal with the problems that might come about by taking certain drugs. A person who is very nervous can be resistant to high doses of tranquilizers or sedatives. A patient who is running a fever may experience stimulation rather than pain relief when morphine is administered.
Mental health - If a drug user has a mental disorder, the drugs that he/she uses can have a different effect other than what is the normal effect. For example, an opiate may ease the delusions of a person suffering from paranoia.