Substance abuse
From Halbeeg, the open encyclopedia · Af-Soomaali
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Substance abuse is the repeated use of psychoactive substances in a way that harms a person's health, work, or social relationships. It includes the use of alcohol, tobacco, illegal drugs, and the misuse of prescription medications.
The term is translated as 'substance abuse' in English and 'تعاطي المخدرات' in Arabic. Modern health textbooks, including the ICD and DSM, tend to use alternative terms such as 'substance use disorder', since the word 'abuse' carries a stigmatizing judgment that can impede treatment.
Types of substances
Substances are generally classified by how they affect the brain. Depressants such as alcohol slow down central nervous system activity. Stimulants such as cocaine and amphetamine increase alertness. Opioids such as heroin and certain painkillers reduce the sensation of pain. There are also hallucinogens and substances chewed as a preparation, such as khat (Catha edulis), which is widely used in the Horn of Africa.
Mechanism of action
Most substances affect the brain's reward system, particularly dopamine pathways. Repeated use leads to tolerance, meaning a person needs larger amounts to achieve the same effect. When use stops, withdrawal symptoms may occur, including tremors, insomnia, anxiety, and physical pain. Both physical and psychological dependence can develop together.
Risk factors
There is no single cause. Risk factors include family history, psychological conditions such as depression, anxiety, and past trauma, and environmental factors such as peer influence, poverty, conflict, and easy access to substances. Starting use at a young age increases the likelihood of dependence.
Effects and treatment
Health effects include liver disease, heart disease, lung disease, and infectious disease from shared needles. Socially, it affects education, employment, and family relationships. Treatment includes medical management of withdrawal symptoms, counseling and behaviour change, support groups, and in some cases medications such as opioid substitutes. The harm reduction approach focuses on reducing harms rather than demanding complete abstinence.