Drug and Alcohol Abuse Spectrum

Drug and alcohol abuse is not an all-or-nothing problem. We can put it on a continuum, a spectrum that ranges from total abstinence to dependence. The purpose of this article is to explain that spectrum.

Abstinence--This means that the person does not use drugs or drink alcohol at all. Perhaps he or she drank in the past, but does not do so now.

Use--This phase of drug and alcohol abuse is often referred to as "experimenting."  The person can take it or leave it at this stage.

Misuse--Drug and alcohol abuse which is harmful to self or others is usually in this phase. Perhaps the use impacts school, job, or family. Perhaps the person is misusing prescription drugs (taking more than what is prescribed) or drinking alcohol before the legal age of consumption. It hasn't become a regular pattern...yet. The most common pattern in this stage is occasional binge drinking and drugging.

Abuse--When drug and alcohol abuse is planned and systematic, it's a pattern. The person may drink more than what he/she intended to drink. Tolerance increases. He/she has to drink or use more in order to get the same effect. Alcohol blackouts may occur. He/she may believe that drug or alcohol abuse is required for good times. Some negative patterns have started. The person may rationalize and glamorize their usage. The battle cry, "Marijuana should be legal" is common in this stage. The person is very close to being a full-fledged addict/alcoholic.  The brain does not function as well and some important changes have taken place in the brain. The person usually doesn't notice the changes, but others may.

Dependence--At this stage the person feels compelled to use drugs or drink alcohol. There's control of the drug and alcohol abuse at this stage once it starts. Everything in the person's life begins to revolve around the chemical misuse, planning to use, and cravings for the drug of choice. He/she thinks about it every day and begins to associate almost exclusively with other addicts/alcoholics. Nothing else in the person's life is as important as their drug of choice. Problems emerge, but the person may not notice or may not care. Criminal activities are common in this stage. The disease is well-established and must be addressed. If it's not addressed, the person may suffer a premature death, prison, or institutions.

The last person to recognize these stages in him or herself is the addict/alcoholic. Denial is a part of the disease, so the person doesn't see it. However, others may be able to identify where the person is on the drug and alcohol abuse spectrum.