The journey from substance Use to Abuse and why spiraling happens?

Dr. Satyen Sharma

Sr. Consultant Psychiatrist | Mental Health & Substance Use Disorder

Addiction is another taboo topic that no one wants to talk about without prejudice.

It has been extremely downplayed for several years by the media and Bollywood. Our association of addiction is very biased, dark, and almost criminal-like. No, I am not just talking about drug addiction here.

It goes beyond drugs and habits.

The mere fact that addiction as a word is solely associated with drugs also shows how mislead and uninformed we are. Addictions are of various types, and the drug is just one type. For Example; India as a country consumes tons of tea every year, so much so that the Indian ‘chai’ has become a part of our culture whereas it was never meant to be of any cultural significance. It was just another refreshing beverage.

The point being, people are addicted to chai. It almost acts like a drug substitute and gives you a high. So would you call a chai addict a criminal? Most of you would say NO.

Similarly one does not become an addict or user overnight. It has a long process and takes a toll on the said person’s mental health. The use could be an escape mechanism or a temporary relief to start with but unconsciously or consciously becomes a habit, leading to addiction.

At the same time, it is extremely necessary to not associate a person’s addiction to their entire life and personality trait. It’s a cycle, an unhealthy one.

The multiple stages of addiction can occur over a short period of time, or they can take months or even years to develop. A person for example who has only occasionally had a casual drink may, over years, develop a habit that can turn to alcoholism.

Initial Use

It can be as seemingly benign as getting a prescription to manage pain or a mental health issue. Regardless of how the initial use occurs, it is the first step toward addiction. Whether or not that initial use is more likely to lead to addiction is often a matter of individual circumstances.

Abuse

The next stage of the addiction cycle is substance abuse. This is the point at which the person is using the substance on a recurring, improper basis; more simply, the World Health Organization simply defines substance abuse as using a substance in a way that is harmful. Perhaps the individual who is taking a prescription painkiller decides to take higher doses or use the medication more frequently.

Tolerance

The most dangerous phase where the usage is slowly saturating and tolerance for the substance sets in. When a person has been using a prescription drug or abusing other substances over a long period of time, the substance can cause changes in the brain that result in intolerance. Tolerance is an indication that the brain has changed in response to the drug.

Dependence

At a certain point, the body or brain becomes dependent on having the substance to be able to function properly. For example; in the film Kabir Singh. The character becomes so dependent on cocaine that he has to be high in order to perform high-functioning surgeries on his patients.

Final Stage. Addiction.

Addiction is a specific, chronic mental health disorder that results in defined symptoms and behaviors that can be used to diagnose the condition. Using more of the substance than the person originally planned and being unable to stop using the substance are some of the prevailing symptoms.

On a positive note, an individual may go through multiple attempts to stop using a substance before realizing that addiction is a factor. However, when addiction is diagnosed, it is possible to interrupt this cycle of addiction, abstinence, and relapse by getting professional treatment that is backed by research showing its ability to help.

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