Substance Abuse

Medically reviewed by:
Dr. Joshua M. Gleason, M.D.

Table of Contents

What Is Substance Abuse?

Substance abuse, is a dangerous relapsing brain disease requiring intensive treatment in a professional setting. Someone who is suffering from substance abuse will have cravings and compulsive drug use that persists even in the face of negative consequences. Although substance abuse may start out as voluntary, over time, the drug changes the way the brain works, leading to tolerance and addiction.

Understanding The Addiction Cycle

Addiction tends to follow a pattern known as the addiction cycle. First the individual uses the substance, and if they enjoy the experience, they are motivated to use again, and again, initiating a pattern of misuse. As the individual begins to use more frequently, they enter the abuse phase of the cycle. They use the substance to escape reality or satisfy cravings as the body develops a tolerance and dependence to the substance. Soon the individual is addicted, with altered brain chemistry and structure, which causes them to make drug seeking and using the center of their life, despite the many mental, physical, emotional, social and financial consequences they may be suffering. They may attempt to quit, and they may even succeed, but addiction is very powerful, and can lead to relapse even after an individual is past the physical withdrawal phase of addiction. With relapse, the cycle of addiction begins again. Breaking this cycle will require professional rehab treatment.

When Does Substance Abuse Lead to Addiction?

Substance abuse can lead to a person feeling physically and psychologically unable to stop using the drug, even if they have the best intentions to quit. Long-term substance abuse intensely affects the brain composition, typically by flooding the brain’s reward pathway with dopamine. This eventually reduces the individual’s ability to experience normal pleasure and happiness without the use of drugs. As a result, someone who is addicted to a substance won’t feel “good” from any normal experience, activity, or interaction except for substance abuse.

The individual is now addicted to the drug. At the same time, chronic drug use creates a tolerance to the substance, meaning the individual will have to take increasing doses of the drug to experience the same effects.  If the individual attempts to quit the substance, or even just to cut down, they will experience unpleasant withdrawal symptoms such as anxiety, vomiting, and physical pain. This is the result of their body attempting to function without a substance that it has become reliant upon.

Which Substances Are Frequently Abused?


In the United States in 2015, approximately 15.1 million adults and 623,000 youth from 12 to 17 suffered from alcohol abuse. Only a small percentage of these individuals get the treatment they need to overcome alcohol addiction, which is one of the oldest and most widespread addiction issues in the world.

Anyone who has been addicted to alcohol for a long time or is a particularly heavy drinker should not attempt to quit drinking on their own. Alcohol withdrawal can cause delirium tremens, a form of withdrawal with potentially fatal symptoms that require immediate medical treatment. Rehab in a medical facility is recommended in serious cases of alcohol addiction. .


Cocaine is an extremely addictive stimulant drug made from the leaves of the coca plant, and which is often injected, snorted or smoked.

Crack cocaine, a crystalized form of the drug, has even more intense effects, causing some individuals to become addicted after their first use. There were approximately 1.5 million current cocaine users age 12 and up in 2014, and cocaine was responsible for over half a million emergency room visits in 2011.


Heroin is another extremely dangerous and addictive illegal drug. It is an opioid and can either be found as a powder or a sticky goo known as black tar heroin. Heroin use has been rising at a shocking rate in recent years, partly as a cheaper and more readily available substitute for prescription opioids. Heroin overdose fatalities have increased from approximately 1,960 per year in the late 1990s to 15,482 in 2017.

In addition, those who use this drug often inject it, which puts them at risk of contracting dangerous blood-borne diseases like HIV and hepatitis. Some states are attempting to counter this by opening up “safe injection sites.”


Ecstasy is often referred to as a club drug because it is mostly abused at parties and in clubs and bars. It has both hallucinogenic and stimulant properties.

A person who overdoses on ecstasy can become dehydrated and suffer heat exhaustion. Long term use of ecstasy can create extensive psychological and cognitive problems, some of which may be permanent.


Also known as meth or crystal meth, this drug is a powerfully addictive stimulant that causes a number of other severe side effects like dental problems, malnourishment, and psychosis.

People can often create meth with materials that can be easily purchased in stores, which makes the drug extremely available and dangerous.


This drug class includes substances like:

  • Psychedelic mushrooms
  • LSD
  • Peyote
  • PCP

Hallucinogen abuse can cause an individual to experience intense hallucinations and sensory alterations. Though some of these drugs are not actually addictive, they can still be extremely dangerous to those who abuse them.


Inhalants are chemicals in products that can often be found around the house. Inhaling the vapors from these products allows the user to experience an intense high. Severe brain damage, lung damage, and even sudden death can occur with the abuse of inhalants.

Prescription drugs

Addictive prescription drug abuse often falls into one of three categories:

  • Opioids
  • Stimulants
  • CNS depressants

Many people start out taking these drugs as prescribed, but then end up abusing them to get high or because they have built up a tolerance to the drugs’ intended effects. In the United States, prescription drugs are the most commonly abused addictive substances after marijuana and alcohol.


Still considered one of the most widespread addictions, tobacco use leads many individuals to seek treatment every year.

Our understanding of the long-term issues of smoking and chewing tobacco has become greater over the years, such as the risk of developing cancer, heart disease, and other severe issues. Smokers should also be aware, that while e-cigarettes have been promoted as a safe alternative to traditional cigarettes, vaping liquid contains a high amount of addictive nicotine, and recent research has uncovered previously unknown and potentially fatal health issues that can result from vaping.

Why Do Only Some People Become Addicted After Substance Abuse?

There are risk factors that can make a person more susceptible to developing an addiction. These can include biological, environmental, and developmental factors such as:

  • Gender
  • The presence of certain mental disorders
  • Ethnicity
  • Past physical or sexual abuse
  • Poverty
  • Peer pressure
  • Stress
  • Early exposure to drugsTaking drugs at an early age
  • Lack of parental supervision

Although there are many different reasons why some people may become addicted to drugs while others do not, the fact remains that the longer an individual misuses a dangerous substance, the more likely they are to become addicted to it. It is important to remember that substance abuse is always dangerous, no matter what your situation or background may be.

How Do I Get Help for A Substance Use Disorder?

If you or someone you love has been abusing an addictive substance and needs help to quit, it is time to seek professional treatment. Rehab centers offer many treatment options so patients can safely navigate their recoveries, put an end to their substance abuse, and avoid relapse.

These treatment options can include:

  • Behavioral therapies that allow patients to learn new life skills in order to better cope with cravings and stress
  • Medications that can minimize cravings, reduce withdrawal symptoms, and allow patients to maintain their daily lives without substance abuse
  • Holistic methods that treat addiction with interventions addressing the body, mind, and spirit, such as:
    • Yoga
    • Meditation
    • Art and dance therapy
    • Animal therapy
    • Massage therapy