Substance Use and Misuse: An Introduction

This article provides an introduction to substance use and misuse, including the four major groups of substances and common terms used in the field. It also includes a case study and discusses the physical and psychological effects of substance use, as well as the impact of addiction on smaller communities. The article covers current legislation related to non-prescribed substances and the tiered support system for addiction services. Finally, it explains three treatment models used by addiction services and the concepts of harm reduction and abstinence approaches to treatment.

UNIT NAME: SUBSTANCE USE & MISUSE: AN INTRODUCTION
1. Identify the four major groups of substances and provide two examples for each
Ans. The four main groups of substance are as mentioned below:
 Depressants for example alcohol and minor tranquillisers.
 Hallucinogens for example LSD and mescaline.
 Stimulants for example cocaine and nicotine.
 Opium associated painkillers for example heroin (Luoma, J.B and et. al.,
2019).
2. Define the following terms which are in common use.
a) Substance use: The substance use is generally a type of pattern of harmful
of any of the substance for the purpose of changing the mood. In this, it can
either be alcohol, inhalants or solvents, an illegal drug or even it can be coffee
also (Dhumal et. al., 2021).
b) Substance misuse: The substance misuse is generally a use of alcohol or
any other substance such as medication which is taken in a way that it is not
meant to be used or it can be harmful to the human body (Resko et. al.,
2018).
c) Substance abuse: The substance abuse is generally defined as if an
individual is taking an excessive amount of substance such as drinking too
much of alcohol, excessive use of drugs or medications where it’s use is
inappropriate.
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d) Dependency: The term dependency is generally an addition towards drugs or
it can be alcohol. Its continuous abuse can create various adverse actions in
human body causing various issues (Salas-Wright et. al., 2018). It is generally
a tendency of a person to relay on the other person for support, guidance or it
can be advice. It is a state of being abnormally tolerant to as well as
dependent on something which is psychologically or physically habit-forming
for example, narcotic drugs or alcohol.
e) Addiction: The concept of addiction is generally a chronic medical illness
containing complex interactions within brain, genetics, or people’s
experiences of life (Lea et. al., 2020). It is an urge to do something which is
significantly hard to control or to avoid. If an individual is consuming drugs,
then they could become addicted to them.
f) Compulsion: In terms of addiction process, the word compulsion is much
slighter. It can illustrate an intense urge to do something which can lead
towards a specific behavior (Ornell et. al., 2018).
3. Read the case study and answer the following two questions:
Mick is 27 years old and lives next door to you. You are told by another neighbour
that he injects heroin and you notice that he always has a runny nose, dilated pupils
and he is often irritable and short tempered. When you first moved in, he was polite
and even charming to you and asked you if you had any pain killers that he could
have. When you said that you didn’t, he became angry and threatened you. When he
passed you in the street last week, he told you that the police are out to get him and
not to tell them where he lives. He usually seems very anxious and often panics but
this was worse than usual.
You know that his sister Helen visits every week and you mention to her that you are
worried about Mick. She says that she is too as he has told her that he has stomach
cramps, muscle spasms, chills despite it being summer, a pounding heart, high
blood pressure and is running a slight temperature. Mick has stolen money from
Helen’s purse in the past and now she finds it hard to trust him. She doesn’t bring
her children round any more as she doesn’t think that he’s a good influence on them.
He isn’t eating well and has lost a lot of weight. Mick’s parents won’t have anything
to do with him anymore since he was diagnosed with a psychotic disorder and told
Helen that they are ashamed of him.

The other neighbours in your street avoid Mick and tell their children to keep away
from him. They blame him for any graffiti or burglaries in the area. He rarely has
anyone visit his flat other than Helen.
3. i) Explain the physical effects of substance use on Mick.
Ans. As per the above case scenario, the physical effects of substance use on
Mick are that he has lost his body weight a lot as he is not eating a healthy food.
He is also getting angry on small things. Another physical effect in his case is he
has a runny nose, he also has a stomach cramp, muscle spasm and feeling chill
despite being summer (James and Jordan, 2018).
ii) Explain the psychological effects of substance use on Mick.
Ans. In the case scenario of Mick, the psychological effects are in his case is
having psychosis. As psychosis is quite rare but it can occur under various specific
conditions. It can occur when an individual is having some stress along with usage of
heroin drug abuse. As per above case study, Mick is having stress and along with
this he uses heroin injections, ultimately causes the mental health conditions.
Another psychological effect in the case of Mick is dilated pupils, short tempered and
many more (King et. al., 2020).
4. In his medical records, Mick is classed as having a ‘dual diagnosis’. What does
this mean?
Ans. The term “dual-diagnosis” generally means that an individual having both
mental well-being issues and also uses substance abuse. These both situations can
occur simultaneously. An individual who involves mental health issues will also
abuses drugs at the same time in their lives. This is called as “dual-diagnosis”.
5. Using examples from the case study as well as general observations, what are
the effects of addiction on smaller communities?
Ans. There is a negative impact over smaller communities as abuse of drug is
significantly accompanied by a devastating the social influence upon the life of
community. The abuse of drug can make a negative impact on the education, family
as well as it can contribute towards crime, violence, financial issues, housing issues
and homelessness also (Knopf, 2020). In addition to this, stolen money from purse,
the neighbours in Mick’s Street often blame him for the burglaries or graffiti occurs in
their area. The neighbours thought that these things of Mick make negative impact
over their children.
6. Identify two examples of how Mick’s neighbours are
a) prejudiced: Mick is a drug addict and his neighbours thought that he will make
a negative influence over their children too. They often blame him for any
Burglaries or graffiti happens within their area.
a) stereotyping him: Mick stolen money from her sister’s purse. His neighbours
often saw his rude or aggressive attitude towards everyone. The neighbours
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always saw him anxious and often panic. The neighbours has blamed about
Mick that he does burglaries and graffiti.
7. Where might these attitudes and assumptions originate from?
Ans. Mick is drug addict as he is suffering from psychotic disorder that is generally
caused by the over consumption of the drugs or medications. In this, person having
psychotic disorder is generally not aware with its own behaviours.
8. Describe one piece of current legislation relating to the use of non-prescribed
substances and explain the impact this piece of legislation might have on
attitudes and assumptions in wider society.
Ans. The legislations that is associated with the non-use of prescribed drugs such as
The Misuse of Drugs Act 1971. In this, the impacts can include the loss of memory,
difficulties in concentration, reduced daily activities. The main purpose of
establishing this act is to prevent the misuse of the controlled drugs as well as
accomplish this by significantly imposing a complete ban over the possession, its
supply or the manufacturing exports and imports of the controlled drugs excluding
the exceptions as allowed by the higher authorities.
9. Complete the following table identifying the legal categorisation for each
substance and listing the legal process for substance-related offences.
Substance Legal
categorisation
Consequence of arrest and legal
penalties
Alcohol
The minimum legal
age of drinking
legislation has
specified the legal
age of drinking
among people is 18
years.
Drinking alcohol can lead to several
legal consequences such as
arrests, fine, jail time, court-ordered
treatment, loss of job and many
more.
Amphetamine It can be legal and
illegal. Legal when
prescribed by
healthcare
professionals and
illegal when taken
without prescription
and in huge amount.
If a person
consuming the drugs,
above 18 years then
person must be
anticipated such that
person will receive a
caution and further
The legal consequences by taking
drug such as facing potential
sentence of up to 5 years in prison,
unlimited fine.

actions will be taken
like prosecution and
many more.
Cocaine
It is not a
pharmacologically
narcotic, the federal
and state drug control
laws have classified it
one from the 1922 till
present. If a person
consuming the drugs,
above 18 years then
person must be
anticipated such that
person will receive a
caution and further
actions will be taken
like prosecution and
many more.
Punish with rigorous imprisonment
for a term that can be extended to 1
year.
Magic
mushrooms
(Psilocybin)
It is schedule I drug
under United Nation
1971 convention for
abuse of drug.
2 to 20 years of imprisonment,
heavy fine.
Tobacco
Illegal to sale in front
of educational
institutions.
Loss of driving license, having
imprisonment as a penalty.
Cannabis
Schedule IV
category. If a person
consuming the drugs,
above 18 years then
person must be
anticipated such that
person will receive a
caution and further
actions will be taken
like prosecution and
many more.
Jail up to 5 years, fine up to £2,500.
If a person is prosecuted for
supplying or producing an illegal
drug then they will prison sentence
for life time.
Heroin It includes class A
substance
Rigorous imprisonment up to 1 year,
unlimited fine.
Tranquilisers
(Benzodiazepin
es)
Both legal and illegal.
Its classification such
as Rohypnol is illegal.
If a person
consuming the drugs,
above 18 years then
person must be
anticipated such that
person will receive a
caution and further
Arrest, if a person is intended to
supply or dealing of illegal drugs
then he/she will be life-
imprisonment.
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actions will be taken
like prosecution and
many more.
10. Explain the tiered support system currently in place for classifying addiction
services. Ensure you include examples of day care and residential services.
Ans. There are generally the four-tiered support system that are introduced in the
year 2002 by the health department and are as mentioned below:
 Tier 1: The non-specific or the general services.
 Tier 2: An open access service.
 Tier 3: The community services.
 Tier 4a: The specialist services or the residential services.
 Tier 4b: The highly specialist or the non-substance abuse services.
In this, the treatment services of drugs providing the structured support for the clients
on the exits from another programme. In this the improvement of the suitable
package of the day care and the support that must be take place in the end phase of
the care treatment episodes of the service users generally involve a goal to attain the
abstinence.
11. Treatment models vary between geographical areas, health authorities and
setting and can be dependent up on funding, research-based efficacy and
political support. Choose three treatment models currently used by addiction
services in your local area and explain each.
Ans. The very three treatment models that can be used by the addiction services
such as the cognitive behavioural model, trans-theoretical model and the family
systems model.
Cognitive behavioural model: In this, the patients can work with the therapist to
breakdown the issues into their different parts like the thoughts, actions and the
physical feelings. The main aim of the particular therapy is to teach the patients to
effectively apply the skills which they have learned during the care treatment towards
their daily life.
Trans-theoretical models: in this model, the alterations can occur gradually. The
people more frequently unwilling to alter in the very early stages. The particular
model exhibit that the alterations are rarely easy.

Family systems model: The model said that family is generally a unit rather than a
group of people. And all the personal problems are the family problems. In this, if the
one member of the family is stressed, then it can effectively make impact over the
whole other members of the family. The aim of the family model is to effectively
enhance the communication among the family members.
12. What is meant by
a) Harm reduction: The harm reduction is generally a public well-being response
that is primary aimed at decreasing the very negative consequences of the specific
actions which can enhances the risk of an adverse well-being outcomes containing
the use of substances. The particular category specifically incorporates the treatment
services of drugs which can basically fulfil a drug associated harm reduction
function.
b) Abstinence approaches to treatment: In this, there are the community sentence
known as the drug treatment and testing orders, are specifically introduced as a part
of the crime and disorder act 2000. in this, the order generally involves the
similarities towards the treatment of drug and the testing orders as it can specifically
compels the serving of an individual the order to undergo the regular testing of the
drug. It firstly aims to be the drug abstinent instead of decrease the use of drugs.
And the second part is this, that the treatment of the drug in this is not the formal part
of the order.
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REFERENCES:
Books and Journals:
Dhumal, T and et. al., 2021. Patient satisfaction with substance use disorder
rehabilitation services: A Qualitative Study. The Journal of Behavioral Health
Services & Research, 48(2), pp.213-239.
James, K. and Jordan, A., 2018. The opioid crisis in black communities. Journal of
Law, Medicine & Ethics, 46(2), pp.404-421.
King, C and et. al., 2020. Targeted intervention to increase awareness of opioid
overprescribing significantly reduces narcotic prescribing within an academic
orthopaedic practice. Journal of Surgical Education, 77(2), pp.413-421.
Knopf, A., 2020. Primary drug prevention—stopping use before it starts—under
budget threat. The Brown University Child and Adolescent Behavior Letter, 36(4),
pp.3-4.
Lea, T and et. al., 2020. Perceived outcomes of psychedelic microdosing as self-
managed therapies for mental and substance use
disorders. Psychopharmacology, 237(5), pp.1521-1532.
Luoma, J.B and et. al., 2019. Substance use and shame: A systematic and meta-
analytic review. Clinical Psychology Review, 70, pp.1-12.
Ornell, F and et. al., 2018. Brain-derived neurotrophic factor in substance use
disorders: A systematic review and meta-analysis. Drug and Alcohol
Dependence, 193, pp.91-103.
Resko, S.M and et. al., 2018. Suicidal ideation and suicide attempts among women
seeking treatment for substance use and trauma symptoms. Health & Social
Work, 43(2), pp.76-83.
Salas-Wright, C.P and et. al., 2018. Substance use disorders among immigrants in
the United States: A research update. Addictive behaviors, 76, pp.169-173.