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Substance use, abuse and dependence

Here are some definitions, just to clarify things:

Substance: Any substance that is taken in and affects the way you feel, think, see, taste, smell, hear and behave. A substance can take many different forms and can be ingested, inhaled, snorted, inserted, drank, and injected.

Substance Use: This is defined as the act of using a substance either recreationally (irregularly) or habitually (regularly). This is usually without any significant harmful affects.

Substance Abuse: This term is used when substance use becomes a maladaptive pattern of repeated overindulgence, which has ongoing and harmful consequences for the health and wellbeing of the individual and those around them. Examples of such consequences include: (1) an inability to fulfil major obligations at work, school or home; (2) use in situations where it is deemed physically hazardous, like driving; (3) increase in legal problems, possibly for disorderly conduct; and (4) increase in social or interpersonal problems, like physical fights when under the influence.

Substance Dependence: This term is used there is clearly a lack of independence and self-sufficiency from a particular substance. Through repeated use there is an increase in tolerance or need for increased amounts of a substance to attain the desired effect, withdrawal symptoms when substance is not used, increased time spent in activities to obtain substances, withdrawal from most social and recreational activities, and continued use despite the presence of continued physical and psychological problems.

Effects: The effects experienced when taking a drug depends on the particular drug, the size of the dose, variations in pharmacological agents in the drug, chemicals used to manufacture the drug, possible contaminants present in the drug, the setting in which the drug is taken, the user’s expectations, past experiences with the drug, and the user’s personality.

Tolerance: This term describes when a person’s reaction to a particular substance decreases so that larger doses are required to achieve the same effect.

Withdrawal: This term describes the symptoms experienced after the cessation of, or reduction in, heavy and prolonged drug use.

Polypharmacy: This term is used in cases where three or more groups of substances are used repeatedly, and simultaneously, during the same 12 month period (for example simultaneous use of alcohol, cocaine and over-the-counter sleeping tablets).

We put together a PDF document, which lists most commonly used substances, with their effects (this document can be downloaded from our M2M Library HERE).

The Link between Substance Use/Abuse and STI/HIV Transmission

There is increasing evidence that drug use/abuse plays a direct and indirect role in the transmission of HIV (and other sexually transmitted infections). Research has shown the following:

  • Impairment of judgement and decision-making;
  • A decrease in inhibitions and increase in impulsivity;
  • An increase in sexual desire and arousal;
  • An increase in sexual risk-taking;
  • An increase in number of sexual partners;
  • Impairment of ability to enter into safer sex negotiation; and
  • An increase in odds of engaging in unprotected sex.

Traditionally, drug treatment and HIV prevention services were offered in isolation. However, there is now a move towards integrating these services and viewing drug treatment as a form of HIV prevention. As such, OUT is running a Play Safe Campaign. For more information call the Play Safe Co-ordinator on 012 344-5108.