What is Substance Abuse?

From prescription pills to street drugs, some substances can quietly spiral into serious addiction before anyone notices.

Substance abuse refers to the harmful use of psychoactive substances, including drugs such as opioids, stimulants, hallucinogens, and sedatives. Abuse can lead to addiction, a chronic condition characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in brain function.

Unlike casual or experimental use, substance abuse often reflects a pattern that interferes with daily functioning, relationships, health, and overall well-being.

Substance Abuse Types

Cocaine

Cocaine is a powerful stimulant derived from the coca plant, and it is often abused for its euphoric and stimulating effects. Nicknames include snow, nose candy, sleet, coke, powder, or white. Cocaine works by increasing the levels of dopamine in the brain, leading to feelings of intense pleasure and energy. However, chronic use can cause serious cardiovascular issues, including heart attacks and strokes, and can also lead to anxiety, paranoia, hallucinations, and even violent behavior.

2. Heroin

Heroin an opioid drug derived from morphine, is known for its intense euphoric effects. Heroin is typically injected, smoked, or snorted, and it binds to opioid receptors in the brain, producing feelings of relaxation and pain relief. However, it is highly addictive, and prolonged use can lead to physical dependence and withdrawal symptoms, including muscle pain, nausea, anxiety, and vomiting. Overdose is a major risk with heroin use, as it can cause respiratory depression, leading to death. Heroin has many nicknames, including brown sugar, dope, horse, tar, or H.

3. Cannabis

Cannabis, often referred to as marijuana, is the most widely used illicit drug globally, though it is legal in some regions for medical or recreational use. The active compound in cannabis, THC, produces the drug's psychoactive effects. While cannabis use can induce feelings of euphoria and relaxation, it can also impair memory, concentration, and motor coordination. For individuals predisposed to mental health conditions, cannabis use can exacerbate symptoms of anxiety, paranoia, and psychosis. Common nicknames include weed, grass, Mary Jane, 420, pot, bud and skunk.

4. Meth

Methamphetamine (often referred to as meth or crystal meth) is a highly addictive stimulant that causes an intense rush of euphoria, increased energy, and heightened alertness. However, it also leads to harmful side effects, including severe dental problems (often referred to as "meth mouth"), extreme weight loss, and skin sores. Chronic meth use can lead to anxiety, paranoia, hallucinations, violent behavior, and long-term cognitive impairments. There are several nicknames for this substance, including ice, cookies, white cross, cotton candy, rocket fuel or scooby snax.

4. Hallucinogens

Hallucinogens such as LSD (lysergic acid diethylamide) and psilocybin mushrooms cause visual or auditory hallucinations, altered sense of time, and distorted reality. While not physically addictive, they can cause psychological distress, particularly in those with underlying mental health issues. Hallucinogen use can also lead to bad trips, characterized by extreme anxiety, paranoia, and delusions. Prolonged use may contribute to persistent changes in cognition and mood, including flashbacks or hallucinogen persisting perception disorder (HPPD).

5. Nicotine and Tobacco

Nicotine is the addictive substance in tobacco. Tobacco use, especially through smoking cigarettes, is the leading cause of preventable deaths worldwide. Nicotine is a stimulant that affects the brain, increasing dopamine levels and creating feelings of pleasure and relaxation. Nicotine dependence causes intense cravings, irritability, and anxiety, making it difficult for individuals to quit. Smoking also leads to yellowed teeth, skin aging, and a significantly reduced life expectancy.

6. Prescription Drugs

Prescription drug abuse involves the misuse of medications that are prescribed to treat specific medical conditions. Commonly abused prescription drugs include opioids (like oxycodone, hydrocodone, and fentanyl), benzodiazepines (like Xanax, Valium, and Ativan), and stimulants (like Adderall and Ritalin). Opioids, used for pain management, can produce feelings of euphoria. Benzodiazepines, prescribed for anxiety and insomnia, can also cause dependence, with withdrawal symptoms such as anxiety, tremors, and seizures. Stimulants, often prescribed for ADHD, can be misused for their energizing and focusing effects, but abuse can lead to increased heart rate, anxiety, and the risk of cardiovascular problems.

7. Ecstasy

Ecstasy is a synthetic drug that is chemically similar to both stimulants and hallucinogens, which is why it produces both energizing and mood-altering effects. Commonly used recreationally, especially in social or party settings, Ecstasy is known for enhancing sensory perception, increasing feelings of empathy, and creating intense feelings of euphoria. Side effects include dehydration, increase in body temperature, nausea, muscle tension and anxiety.

People struggling with substance abuse generally:

Develop a tolerance and need more of the substance to feel the same effect
Feel anxiety, irritation, or physical symptoms (like headaches) when the substance use is reduced or stopped
Minimalize personal, social, or work problems cause by the substance
Have unsuccessful attempts to cut back or stop using
Withdraw from friends and family or lie about usage
Lose interest in hobbies, instead replaced with a focus on substance use

The Impacts of Substance Addiction

These impacts can vary depending on the substance being abused, the duration of the addiction, and the individual’s personal and environmental factors.

1. Physical Health

Opioid addiction can result in respiratory depression, overdose, and infectious diseases (e.g., HIV, Hepatitis C) if needles are shared. Methamphetamine abuse can cause severe dental problems (known as “meth mouth”), heart issues, and cognitive damage. Nicotine addiction leads to lung cancer, heart disease, stroke, and chronic obstructive pulmonary disease (COPD). Cocaine use can lead to cardiovascular problems, including heart attack and stroke, as well as neurological damage.

2. Mental and Emotional Health

Substance addiction often co-occurs with mental health disorders such as depression, anxiety, and post-traumatic stress disorder (PTSD). Substance abuse can both exacerbate these mental health issues and be used as a form of self-medication, creating a cycle that is difficult to break. For example, someone with depression may use cocaine to numb their feelings, but it worsens their depression over time. Many may feel intense guilt, shame, or worthlessness, which can further fuel their addiction as they try to cope with negative emotions.

3. Overdose Risk

One of the most immediate physical dangers of addiction is overdose, which can be fatal. Opioid overdoses, for example, are a leading cause of death due to drug abuse. Overdose symptoms can include slowed breathing, unconsciousness, and death. Other substances, such as alcohol and cocaine, can also result in fatal overdoses, particularly when mixed with other substances.

4. Cognitive Impairment

Long-term substance abuse can lead to lasting cognitive deficits, including memory loss, difficulty concentrating, and impaired decision-making. For instance, chronic alcohol or drug use can damage the brain's ability to process information effectively, leading to trouble in work, school, and day-to-day functioning.

5. Social and Relationships

Addicts may lie, steal, or behave erratically, causing mistrust and emotional pain. Over time, this can result in the breakdown of relationships, social isolation, and a lack of support. A person who is addicted may struggle with attendance at school, performance, and maintaining relationships with colleagues. In extreme cases, addiction may lead to job loss or expulsion from school. Legal consequences can include arrests, fines, imprisonment, and a permanent criminal record, all of which can further hinder a person’s ability to reintegrate into society.

So What Causes Addiction?

Several factors contribute to the development of substance addiction:

Genetics: Individuals with a family history of addiction are at higher risk, suggesting a hereditary component.
Brain Chemistry: Different substances can affects neurotransmitters like dopamine, creating a cycle of reward and reinforcement that can lead to dependence.
Mental Health: Anxiety, depression, trauma, and other psychological disorders often co-occur with alcohol addiction. Many individuals may turn to substances as a coping mechanism, leading to a dual diagnosis.
Environmental Influences: Peer pressure, cultural norms, stress, and early exposure to substances in adolescence all play significant roles.

A Note From PsychNest

Substance abuse is a serious challenge, but it's one that can be overcome with the right support, determination, and resources. While the journey to recovery may not be easy, countless individuals have reclaimed their lives and found strength they never knew they had. It's important to remember that help is always available, and no one has to face this struggle alone.

Check out these resources for some extra support:

Substance Abuse and Mental Health Services Administration (SAMHSA): https://www.samhsa.gov
National Institute on Drug Abuse (NIDA): https://www.drugabuse.gov
Narcotics Anonymous (NA): https://www.na.org

Sources

American Psychiatric Association. Addiction and Substance Use Disorder (https://www.psychiatry.org/patients-families/addiction-substance-use-disorders). Accessed 3/15/2025.
National Institute on Drug Abuse. Drug Misuse and Addiction (https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction). Accessed 3/15/2025.
National Institute on Drug Abuse. Understanding Drug Use and Addiction (https://nida.nih.gov/publications/drugfacts/understanding-drug-use-addiction). Accessed 3/15/2025.

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