Continuum of Substance Use and Abuse

Stages of Drug Use

The continuum of substance abuse is a term that is used to refer to the stages of substance use and abuse. The use of a drug can be only labeled drug abuse when the user becomes dysfunctional as a result of their use. If a person can maintain healthy relationships, does not suffer financial hardships, does not become unwell or is harmed from the use of the substance, then the use is maintained as drug use and not abuse. However, if a person begins to exhibit adverse reactions from a drug, has considerable problems with relationships with others, acts in a harmful, dangerous or reckless manner and begins to use significant amounts of energy acquiring and using a drug, then it can be considered that the individual has a drug abuse problem.

The theory of a continuum of drug use can be used to assess where a person is at in terms of their drug use and evaluate the type of treatment that may be appropriate, if any. Policymakers may also use the continuum to make decisions on education, harm minimization and policing. Some stages in the continuum, such as experimental or occasional use, can be considered as relatively harm free. Others such as regular or dependent use may require some intervention to alleviate or prevent further harm from occurring.

The stages that are defined in the continuum include:

• Non-Use
• Experimental Use
• Recreational / Social Use
• Regular Use
• Dependent / Compulsive Use

The stages in the continuum do not necessarily progress from one to another. Some users will remain experimental or non-users for a lifetime. Others will skip other stages and become dependent and compulsive users early on in their drug use.

Non-Use

Non-use is the stage at which a person has made a decision to not take substances for personal, health or cultural reasons. They may have had experience in the past of taking drugs or drinking alcohol but for any number of reasons, decided to not take them anymore.

Experimental Use

Experimental drug use is the phase where a person begins to explore the world of psychoactive substances. Limited exposure and no development of regular use or substance related harm are features of experimental use. A person may become interested in using a substance for any number of reasons. They may be curious about the effects of the drug, may be pressured by friends or family members to indulge, feel social pressures to take a drug to fit in or simply be interested about what it feels like. Experimental drug use may include simply having a few puffs on a joint or cigarette, having a glass of wine or a small amount of other illicit drugs.

Some critics believe that experimental drug use can lead to long term damage, continued use and adversely affect a persons’ health. However, the majority of people who experiment with any kind of substance, legal or illegal, will not use the drug again, will not become addicted and will not be injured or harmed.

Recreational or Social Use

This stage is the social or casual use of a drug. Typically, users who indulge in this kind of drug use do so to create or enhance an experience. This experience may be a music event, a social event or simply going to a bar or nightclub. A person may drink alcohol at a social setting, take cocaine sometimes or smoke marijuana occasionally. Most people who are recreational or social drug users do not use beyond the social situation – they need certain elements such as music, people or a certain place to take a drug but will not take it beyond that. In some cases, a person will only take a drug if they are with certain people with whom they feel they need to take the substance to fit in.

Recreational drug users can easily slide into a stage of regular drug use due to their reliance of using a drug in a social setting. The habit of taking a drug or drinking alcohol can quickly emerge as a regular pattern of use. However, most recreational users take a substance infrequently, are cautious and wary of using. They may have experienced some negative reactions to the drug or seen others adversely affected.

Regular Use

Regular use of a substance is the frequent and patterned shift from occasional or experimental use. Someone may go from the occasional drink of alcohol to using it on a weekly basis. In some cases, this transition to regular happens without the person realizing the change. A person who becomes a regular user of a substance is at risk of becoming a dependent user. Once a regular pattern of use is established, a person may begin to feel psychological changes associated with non-use.

Regular drug users do not always progress into more harmful use of a substance. They may be able to limit their use so that they are not harmed by the substance, such as drinking in moderation. Additionally, regular use is not always associated with negative social consequences. Most people who consume alcohol or take drugs do not have the adverse effects and are able to stop using if they wish.

Dependent Use

When a person begins to compulsively use a substance and experience the negative effects associated with withdrawals and dependence, they can then be considered at one end of the spectrum of the continuum. Repeated and regular abuse of a substance is now having an affect on a person’s health, social status, relationships, finances and emotional wellbeing. An individual will spend a considerable amount of their time and energy on obtaining and using a drug, despite the consequences of the use.

Drug users who are dependent on a drug can be considered drug abusers. Their body has undergone significant chemical changes and they now require the drug to starve off painful symptoms of abstinence from the drug which can include mental impairments. People in this stage are unable to control their drug use and will be preoccupied with the drug. They may be violent, depressed, anxious, and physically ill when they do not have it.

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