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.

They are:

    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.