Use of substances such as alcohol, nicotine has been on a steady rise since few decades now.
Substance use has a strong correlation with social and cultural context. While in some cultures, it is
acceptable for friends or even family members to have an occasional drink together, in others, it is a
complete taboo. Young adults are using alcohol and smoking as a social lubricant increasingly and a
fair number of them are able to use it without any harm to their physical health or academic or work
performance. Millions of people (including teenagers and old ladies) happily chew on various forms
of tobacco with alarming regularity without being frowned upon, whereas even a single use LSD or
heroin can cause distress in the family. So where do we draw a line and say that the substance use is
veering towards dangerous territory? Is it to do with the kind of substance consumed, the amount or
the frequency? The answer is, all of the above. Substance use can be classified into use, abuse and
dependence. In this article, I will write about what kind of use constitutes dependence and ways to
deal with it.
When is a person considered to be ‘addicted’ or dependent on a substance?
– There is a strong desire or a compulsion to take the substance.
– There is difficulty in controlling the substance use in terms of how much substance is
consumed (in increasing or very high quantities that are above medically safe limits), how
frequently it is consumed or when it is consumed.
– He/she might experience withdrawal symptoms on reducing or stopping use. People
dependent on alcohol might experience tremors, agitation, restlessness, sleep disturbance,
irritability or even severe symptoms like confusion, disorientation or seizures. People with
nicotine dependence most prominently complain a strong craving as well as irritability or
constipation. Symptoms vary as per the substance consumed.
– There is ‘tolerance’ to the substance i.e., increasing quantity or frequency of use is required
to experience the same ‘high’.
– There is a gradual neglect of other interests and eventually even responsibilities (work,
family, academic) as priority is given to substance use above everything else.
– The person finds it very difficult to reduce or stop using substance. Even though continued
use might be resulting in failing health, deterioration at work or academics or interpersonal
problems at home, the person is unable to give up the substance. This is often the stage at
which patients themselves or family members seek medical help.
Management of addiction
– The user needs to undergo complete medical evaluation to rule out any physical
complications of substance use e.g., blood tests, ultrasound etc.
– Consulting a mental health professional to rule out any underlying emotional or
psychological problems. Often stress factors can lead to beginning or continuation of
substance use. People often resort to substance use to cope with conditions such as anxiety,
depression.
– Medications for deaddiction or anti-craving agents along with therapy such a motivational
enhancement therapy, group therapy or cognitive behaviour therapy to reduce unwanted
behaviour.
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