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Addiction is a word that’s used to describe a variety of conditions which are all characterized by an abnormally strong need to act in predictable ways to try to satisfy the intense driving forces that are felt by anyone with an addiction.

Substance abuse, which can also be called drug abuse, is one form of addiction. It involves the intense craving and need to consume, inject, sniff or smoke, one or more of a wide variety of psycho-active drugs. A psycho-active drug is any chemical which has the property of changing how the brain functions.

Examples of psycho-active substances which affect the brain in some way are heroin, cocaine, smack, ice, amphetamines, cannabis, ecstasy, alcohol, nicotine, and many others.

Some of these substances are illegal and others are not, but they can still be the substance involved in an addiction. This is because, at the heart of all addictions, is the one feature that defines addiction from anything else:

The person loses control over their use of the substance or behavior, and importantly, they are aware of that loss of control.

This loss of control is the hallmark of all addictions.

The abnormal drives and cravings for the substance, are so compelling, that even if they wish to stop consuming or doing them, people who have developed an addiction find that now, they cannot stop.

What’s the Difference between Substance Abuse and Addiction?

The broad, general term of Addiction, is subdivided into two separate subtypes of Addiction: Substance Abuse and Process Addiction. This sub division allowed health professionals to distinguish between

  • Addiction that involved chemicals that acted directly on the brain – the psycho-active chemicals such as heroin, amphetamines and alcohol etc. which was now Substance Abuse,
  • And behavioral addictions such as gambling and eating disorders which were now called Process Addictions.

That is why addiction and substance abuse are sometimes used to mean the same thing. In many people’s mind, they do mean the same thing, but this can also lead to confusion.

Substance Abuse is also sometimes called Drug Abuse.

Is there a Difference Between Addiction and Dependency?

In ordinary conversation, probably not, but here again, these labeling words can be confusing. The word Dependency is commonly used to describe Substance Abuse, which is commonly used to describe Addiction. The defining criteria of all these terms, is that the drives to continue are internally generated – and the affected person is increasingly unable to stop using the drug, even though it is causing damage to their bodies and lives.

In that sense, they are totally dependent on the drug, physically, but also psychologically. They have lost control over their ‘need’ for the drug and will go to almost any lengths to obtain it, with little regard to the harmful effects the drug is causing to themselves and others.

However there is also a more specific use of the word ‘dependency’ to refer to ‘physical only dependency’ that can develop, but which is not an addiction. The body and brain adapt to the drug, and tolerance to the drug is built up over time.

This tolerance means that larger and larger doses of the drug are required to produce the same physical or mental effects. Once this has happened, any sudden loss of the drug causes your body to react to the ‘withdrawal’ of that drug.

What’s the Difference between Recreational Drug Use and Substance Abuse?

Recreational, or non-medical use of a drug does not necessarily mean you have an addiction or that you will develop one. Some people are able to use psycho-active drugs and still keep control over how much, and how often, they ‘use’ them.

The problem is that many people gradually lose control over how much they use, and are overcome by the increasingly strong desire to consume more and more of the drug. That is when so called ‘Recreational Use’ turns into an addiction – when control is lost and the cravings take over and dominate a person’s life.

For example, many people can regularly drink limited amounts of alcohol, and their drinking remains under their control. Unfortunately, there are quite a few people who lose that control over time, and they develop uncontrollable cravings for alcohol. In other words, they become addicted – they now ‘need’ regular alcohol, just to feel normal. They have now become what is commonly known as an Alcoholic.

Using psycho-active drugs for recreational use always carries some risk that you may develop an addiction. This risk is increased if you have also inherited a genetic predisposition for addiction from your parents. But addiction can still happen to anyone, whether you have increased risk or normal risk – we are all potentially at risk. The good news is that even if you have inherited an increased risk for addiction from your parents, risk awareness and sensible choices can prevent you falling into the trap of addiction.

The Main Addiction Risk Factors

  • the genetics you might have inherited

  • a parent with an addiction – because close exposure to addiction itself, is added to the inherited genetic risk

  • easy access to the desired substance or activity

  • your social environment

  • peer pressure

  • repeated exposure to potentially addictive behaviour - drinking, gambling, substance abuse, computer games, porn and others

  • your early childhood experiences

However, there are some things that don’t affect your risk of addiction:

It makes no difference if you are male or female, brainy or dumb, rich or poor – all sorts of people develop addictions. Being smart, or rich, does not change anything except your increased ability to fund your addiction. And it doesn’t matter if the activity, or substance involved, is legal or illegal – being legal does not mean you won’t develop an addiction. Alcohol and smoking are prime examples.

Easy Access

The question of having easy access is important. If you have easy access to a substance or activity that carries the risk of addiction, there’s an increased likelihood that you will try it out. Easy access also gives you the opportunity to continue with the activity, once started. Repeating the activity increases the risks of you continuing to do it as well – it becomes a habit. Frequently repeating the activity over time will also increase the risk of developing an addiction.

If it is also ‘affordable’ on whatever income you have, that will probably also increase your consumption.

Risky Environments

If you live in a neighborhood where drugs are easily available, you and your family are exposed to increased risk of substance abuse. If these drugs are also affordable, that increases the risk a well. Add peer pressure into the mix, and you can easily see how young people can get hooked into an addiction before they fully realize what is happening to them.

Peer Pressure – Choose your Friends Wisely

Choosing your friends is not always easy. Peer pressure is a really powerful influence over everyone’s behavior – not just young people. If you mix with a crowd who are regular drinkers, or smoke, gamble or take drugs, your exposure to this potentially addictive activity is obviously increased. This adds to your own risk of developing an addiction. Added to that, if your friends are themselves developing an addiction, they will almost always try to get you to join them in that activity.

They don’t do this because they want you to ‘enjoy’ the ‘pleasure’ of that activity. They do it because it makes them feel better about themselves. If you try to resist their push to get you involved, they will often try to ridicule and shame you, in order to pressure you do what they want. Don’t be fooled.

There’s an old saying that goes, ‘Misery loves company’ and this is also true with addiction. Maybe someone you know wants you to rob a store with them, or start selling drugs with them, or go to the pub every night and binge drink until you’re senseless. ‘Come on”, they say, “Are you scared or something?” Or they jeer and taunt, saying, “It’s only one more drink, can’t you hold your liquor??’

This is powerful pressure to try to resist! But, if you can see this behavior for what it is, you can see how pathetic they really are. They are trying to force you, and shame you, into doing what they do, because they haven’t got the guts to do it on their own. They are only trying to pressure you, because they want ‘backup’, and what feels to them, like moral reinforcement for their own risky behaviour. Don’t let them do that to you – or any of your friends.

So, if you are surrounded by family and friends who actively encourage excessive shopping, drinking alcohol, gambling or over eating, and you are a person who already has predisposing risk factors for addiction, such as an inherited genetic risk, you might become addicted when a less susceptible person, might not.


  • Knowing what the risk factors for addiction are, allows you to know if you might be at increased risk.

  • If you know you might be at increased risk, you have to take extra care not to fall into the trap of addiction.

  • Don’t ‘experiment’ with drugs, or start going every night to the pub or play the poker machines ‘because everyone else does’.

  • You can have control over what you do and the risks you take.

  • Anyone can develop an addiction – don’t let it happen to you.

  • Look after ‘your life’, and don’t throw away opportunity, just because you’ve made bad choices in your past.

  • If you already have a problem, honestly admit it to yourself, then get help for it before it ruins your life and your marriage.

  • Don’t expose your family to your untreated addiction, and increase their risks for developing an addiction.

  • Don’t be a bad example to your kids.

  • Don’t succumb to peer pressure to do what you know you should not do

  • If possible, look out for your friends and family, and help them avoid unwise friends or risky activities.

Even if other people in your family have an addiction, or everyone around you seems to be addicted to one thing or other, an understanding of the risks for developing an addiction can help you understand the need for you to avoid certain situations and risky behavior, and to choose your friends wisely.

And of course, some people develop addictions without any obvious predisposition at all. A predisposition just means that some people are more at risk than others.

There are no guarantees in this life.

There is no certainty of susceptibility, or immunity, for anyone – only degrees of risk for Addiction in every person’s personal background and history.

Take care of yourself and those around you.

You only have one life – make the most of it.

What happens when you drink

It all depends on what you mean by `a drink’. A small amount of alcohol does you no harm and can be enjoyable. But if it is more than a small amount and if it is a regular thing, maybe it is not quite as harmless as you think it is. Drinking too much alcohol or even drinking a little at the wrong time can cause serious damage to your health, to your family and to your self-esteem, not to mention your pocket. Whenever you drink you are affected by alcohol. But if you only drink a little and if you don’t drink very frequently, the risks are very small. However, the more you drink and the more frequently you drink, the higher the risks. That is why it is important to look carefully at your drinking habits.

“Drinking is a classy way to commit suicide.”

If you have to know the amount of alcohol that you consume in a day or a week, you have to have some idea about the amount of alcohol in your drink. The beers that are usually available in India contain about 3 to 6 percent alcohol content by volume, which can be about 3 - 6 units of alcohol per bottle. The wines that are available contain 11 - 16 percent alcohol content by volume, having about 11 - 16 units of alcohol per bottle. The spirits that are available commonly contain about 40 percent alcohol content by volume, and the approximate availability of alcohol is 40 units per bottle. Women who consume more than 14 units and men who take more than 21 units of alcohol in a week are likely to enter the zone of risk for ill-health. If the consumption goes beyond 35 units for a woman and 50 units for a man it is definitely considered harmful.

Some of the early signs of problem drinking are `tolerance’ (increasing level of alcohol is needed to achieve the same effect or same amount of alcohol gives decreasing effect), drinking more alcohol for longer periods, presence of withdrawal symptoms, spending a great deal of time and effort to obtain alcohol, persistent desire and unsuccessful attempts to curb abuse, avoiding important social, occupational, or recreational events because of alcohol use, and continued use of alcohol despite exacerbation of health problems. People who abuse alcohol tend to develop chronic fatigue, poor nutritional status, poor appetite, sleep disturbance, fits, and failure to fulfil major obligations at work and home. They may also have interpersonal problems, recurrent legal problems, accidents and suicide attempts. They may use alcohol during work.

Alcohol affects many organs in the body. The brunt of the damage is however borne by the brain, liver, heart and gastro-intestinal system. It causes an array of illnesses related to these organs, often requiring help from different specialists simultaneously. When alcohol is withdrawn, it results in a period of hyper-excitability, the severity and duration of which varies from person to person.


During the initial stages of treatment for alcoholism, your doctors are generally controlling your withdrawal symptoms and taking care of the medical damages to your body. This stage is difficult and has high risk. The long-term treatment for alcoholism starts after the initial stage is successfully completed. This stage is prolonged and lasts about a year. Most alcoholics are treated as outpatients during this phase. Many strategies of treatment have to be evaluated before the most suitable strategy is identified for the individual’s requirements. During this stage, success of treatment often depends on the extent of support from your family to assist your doctor in maintaining your abstinence. A vast majority of alcoholics who relapse after detoxification, start drinking again before six months are over. A lesser number of people relapse during the second six months. Very few, who have been abstinent during the entire year, relapse after the year is over.

Disulfuram is a medicine, which is sometimes used to help stop your drinking. This medicine is used in the treatment of some people, whom your doctor finds fit for the purpose. However, there are certain precautions to be taken when you are taking Disulfuram.

  • Avoid taking syrups or tonics that contain alcohol.

  • If you get a reaction with after-shave lotions or colognes do not use them.

  • Before taking any food or drink, check whether it contains alcohol.

If you take alcohol while on Disulfuram, you will develop distressing symptoms such as flushing, sweating, breathlessness, headache, nausea and vomiting. These reactions will make the idea of drinking averse to you, but also produce a drop in your blood pressure. Therefore you are strongly advised to:

  • Totally abstain from drinking.

  • Do not stop Disulfuram and drink, since the reaction occurs even 5 days after you stop Disulfuram.

  • Report to the nearest hospital immediately, if you develop any reaction.