Drugs and Substance Use

Technically, any substance other than food that alters our bodily or mental functioning is a drug. Many people mistakenly believe the term drug refers only to some sort of medicine or an illegal chemical taken by drug addicts. They don't realize that familiar substances such as alcohol, caffeine, and tobacco are also drugs. This is why the more neutral term substance is now used by many physicians and psychologists. The phrase ''substance abuse'' is often used instead of "drug abuse'' to make clear that substances such as alcohol and tobacco can be just as harmfully misused as heroin and cocaine.

We live in a society in which the medicinal and social use of substances (drugs) is pervasive: an aspirin to quiet a headache, some wine to be sociable, coffee to get going in the morning, a cigarette for the nerves, perhaps even a tranquilizer to deal with periods of extreme stress. When do these socially acceptable and apparently constructive uses of a substance become misuse? First of all, most substances taken in excess will produce negative effects such as intoxication or intense perceptual distortions. Repeated use of a substance can also lead to physical addiction or substance dependence. Dependence is marked first by an increased tolerance, with more and more of the substance required to produce the desired effect, then by and the appearance of unpleasant withdrawal symptoms when the substance is discontinued.

Drugs (substances) that affect the central nervous system and alter perception, mood, and behavior are known as psychoactive substances. Psychoactive substances are commonly grouped according to whether they are stimulants, depressants, or hallucinogens. Stimulants initially speed up or activate the central nervous system, whereas depressants slow it down (''uppers'' and ''downers,'' in street parlance). Subsequent effects of substances in these categories may be more complex, however. For example, a stimulant may activate some part of the central nervous system (CNS) that then inhibits or depresses activity in another part. Hallucinogens have their primary effect on perception, distorting and altering it in a variety of ways including producing hallucinations. These are the substances often called psychedelic (from the Greek word meaning ("mind-manifesting'') because they seemed to radically alter one's state of consciousness.

Some substances don't fit into the preceding three categories, seeming to require a special category of their own. Two that we shall consider are marijuana (and other forms of cannabis) and PCP or "angel dust." You may be surprised at the way some drugs are categorized. For example, many people think of alcohol as a stimulant, whereas it is actually a depressant; or they think of nicotine as a depressant, whereas it is actually a stimulant. The drugs we shall consider in most detail are those which are often abused. We do this partly because it's important to understand the dangers of such drugs (many of which are illegal), and partly because many of these drugs have been studied more extensively than those which seem less dangerous