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Introduction to Alcohol and Substance Abuse

Mark Dombeck, Ph.D.

Alcohol ;-)image by Anton Fomkin (lic)Since the beginning of human history and before, people have found ways to alter their bodies and their consciousness by taking substances such as herbs, alcohol, and drugs. Out of this practice has sprung many important contributions to science and culture, prominent among them being the development of modern medicine and the medical profession and the making of fine wines and liquors. Some religions have found uses for mind-altering drugs as a way to aid communion with the divine principle. For all the positives that mind and body altering substances have brought us, one fact is clear. There have always been people who were unable to restrict their use of mind and body altering substances to culturally prescribed limits, and who have fallen into the trap we know today as addiction.

Addiction usually does not happen overnight. Rather, people who become addicted to drugs (such as alcohol, cocaine, heroin, marijuana, etc.) are gradually introduced and desensitized to them over a period of time. They may initially enjoy the use of drugs in a recreational sort of way. For instance, someone might get into the habit of having a beer or some wine after work as a way of releasing the days' stresses. Someone else may use marijuana on an occasional basis as a way to share special time with friends or as an aid to appreciating food, music, or sex. Another person may start using cocaine as a way of staying up late at night to study for exams.

Some people are able to keep using drugs on an occasional basis. Many other people are not so lucky. For these unlucky others, their use of drugs begins (gradually in some cases, abruptly in others) to increase, and the amount of attention they spend thinking about getting high, purchasing drugs, preparing drugs and taking drugs increases until it becomes the center of their lives. Other responsibilities - work, friends and family, and community - fall by the wayside. As their consumption of drugs rises, users may become physically dependent on their drug to the extent that if they do not take it on a particular day, they get sick. As dependence increases, tolerance to the drugs increases as well - meaning that it takes more and more of the drug to get the same 'high' or 'buzz' effect. As most drugs (with the exception of alcohol) are illegal, they may become increasingly involved in criminal activities (buying drugs is a criminal activity, as is driving while intoxicated). If the process continues long enough, it may become impossible for the addict to hold a job - they may lose their relationships, their income and their marriages. They may resort to criminal activity (such as robbery, prostitution and drug dealing) in order to gain continuing access to their drugs. They may also kill or injure other people (through driving and firearm accidents) while intoxicated, and may get and pass along to others infectious diseases (like AIDS and Hepatitis). Ultimately, they may end up killing themselves (through suicide, malnutrition, overdose, or drug related physical degeneration and disease). A grim picture that is all the more tragic because no one who starts out experimenting with a drug ever really believes that they would ever experience any of these awful things.

Reader Comments

Powerful and emotive introduction - - May 6th 2018

I have to say the introduction made me look at substance abuse in different way.

 I can definitely use parts of it for my future presentations.

Cold turkey can kill you - Vixen-future addictions counselor - Sep 12th 2014

No one should ever quit cold turkey. The withdrawals can kill you and has done so in many cases. When you are ready to quit, please, please, please seek out professional help so you can do it safely, and live.

Psychological addiction? - Amanda - May 17th 2014

My boyfriend is in his fifties and has a long history of alcohol and drug use.  He was addicted to cocaine for a few years in his youth, and psychologically addicted to weed from age 17 until age 45 when he decided daily use was no longer wise.  He said it took him quite some time to decrease his usage.  Now, he says he still likes to "get a buzz on" every evening, whether it's with weed or with 3 to 5 large glasses of wine a night.  He insists he does not have a problem because he never misses work, has never had a DUI, and is in good health.  He claims his substance use is strictly for fun.  Still, I feel very uneasy watching him numb himself nightly.  Should I be concerned or leave him alone to enjoy his vices?

respond to not only about you-hleping no one posted on Nov 16, 2009 - - Oct 13th 2011

Hello, I read your post on how addiction is not only about the person who is addicted !  It's much bigger than that isn't it?  I am an only child of a father who I believe was an alcoholic.  I can't totally tell you he was diagnosed with it, because to my knowlege, he never got help.  I am now 44 and for the last 2 years have been piecing the puzzle of my relationship with my father and his life together because as I was growing up, he let his addiciton take over his life, and I understand it is a TRUE illness, but the sick part of it is exactly what you posted, it is not only about you-  It was also about his only daughter, the one that missed out on a great secure relationship with her father that she so dearly loved, it was about the two wonderful grandsons that he never got to know, it was about the lasting effects he left behind, because his addiction caused his death, and his only daughter, his only child is left to figure out why, why, why....left to bend her broken heart....Thanks for posting that it really is about the ones that love you (the addicts) that hurt and suffer too !  Maybe the most because they are alert for all of the pain...God Bless all of the addicts needing and even trying to find their way, and also to the families that so desperatly love and want to have healthy relationships with them....I pray for enlightenment to all !!

Ban Xanax - retired psych med nurse - Sep 14th 2011

By far the most addictive drug on the shelf.

The ultimate cost of addiction - Barbara - Apr 17th 2011

I became an addict to food when I was a teenager. My specific drug was sugar - tons of it! This was in response to my father's drinking and abusive behaviors. My addiction, which provided initial comfort proved to create a lot of problems in the mental health arena. And it crippled me with regard to solving the original problems.

There are healthier ways to deal with stress.

TOBACCO AND ALCOHOL ARE DRUGS! - Vince - Jan 30th 2011

Tobacco and alcohol ARE drugs, people! They are the worst.

The tobacco drug KILLS 500,000 addicts and another 65,000 INNOCENT people (who breathed toxic tobacco smoke) in the U.S. EVERY YEAR.

90% of alcoholics ARE smokers. 90% of crime committed by smokers. 90% of suicides are smokers!


More info at:

Addiction is Inhumane - Living an amazing life - Jan 19th 2011

I am now a recovering addict, clean of drugs and alcohol for going on nine years. I used drugs as a crutch to much lonliness and unhappiness due to growing up with alcoholic parents, and the horrible things that come with it , naturally i was drawn to the lifestyle. I thank god and my will to change the pattern for my children of alcohol and substance abuse in their life so that they could  have a better future as myself. For over ten years i lived with the struggle before I found a life more deserving in many ways not only for myself but for my family who are my life, my everything. Just know that you gotta be strong, think of all the people who have made a difference in your life, cling to happy memories and shove the bad ones farthest away as you can, because they will keep you buried alive and keep you down! BE STRONG AND YOU WILL SUPERSEED YOUR GOALS TO TAKE ON ANYTHING!  WITH GOD ALL THINGS ARE POSSIBLE!


Speaking out of a personal experience, addiction is the event that precedes death the moment a person start engaging in alcoholism and substance abuse. Nevertheless, addiction is curable though not easily. I became an alcoholist after joining university and I'll tell you that life has not been easy for me. But wow! This is my 4th month since disengaging myself from that akward behaviour and I'm not prepared for a backslide. It has not been easy for me but I have realised that perseverance beats resistance.

Sinclair method - Rapper - Nov 20th 2009

The Sinclair Method is an option for alcohol abuse. It is not for those that find that abstinence is their only way. It is a great program and I recommend that anyone having trouble google it. You will also possibly find how naltrexone is used(or supposed to beused) for other addictions.

not only abou you - helping no one - Nov 15th 2009

There are many people battling with addictions.I pray that they find there way back to life, real life! Drugs and alcohol addictions do not let you live a true life. However there are the forgotten population, the ones at home that are trying to ride out this horrifing nightmare. Many of us have had our lives destoyed by these people. There are no treatement centers for us to check into until we heal. Some of us never heal. We may manage to go on but you have taken the sparkle from our eyes.

Wrong approach - sandow - Nov 14th 2009

Part of the problem with drug abuse in the US, is our society's approach to drug prohibition.  Rather than viewing substance abuse as an illness and sickness in itself, or a person self-medicating an unddiagnosed or untreated mental illness, our fine citizenry would rather look down thier self righteous noses, upon the moral failing of the depraved drug use.  Rather than offer help and support we punish the poor soul with the permanent stigma of a criminal record and the horrors of incarceration.   Our "War against Drugs" is waged against our own neighbors, friends, and families.  It accomplishes nothing other than more pain and suffering.  I am not in favor of legalization, but to punish the drug user is just insane.  Place them in treatment, offer therapy, but treating someone as a criminal is just morally repugnant.

nothing to loose - ronnie - Nov 8th 2009

having heard over the years, the doctors.phsyciatrists and social departments opinions for getting free of addictions. . surely the simple message is that once you are of whatever you are addited to.....if you dont touch the first one..its impossible to go back there. On this theory and a lot of help from Alcoholics which I am still a member, I have'nt had a drink for almost 16 years, day at a time.

Why not give it a go ..NA, AA, GA whatever your've nothing to loose ...


Alcohol high - to 'Dumb and Dumber' - JR - Aug 7th 2009

First - "Dumb and Dumber" ?  Do not put youself down like that !  Alchohol makes plenty of us feel pretty dumb, but you can beat it.  I believe that we are all responsible for our alcohol use and abuse, but excessive self-blame does not help in overcoming this problem.

As regards the "high", well, I am sorry to tell you that this may be gone for you, never to return.  There is no high like the first high, whether you are talking about alcohol or any other drug.  One rapidly develops a tolerance, and the kick fades over time.  When it goes, you can be left with all the damage and ill-effects of drinking, but drinking more and more to regain the elusive high only burns your liver, kidneys and (not least) brain, with no prospect of ever getting the relief or buzz that came, once upon a time.  I would suggesst reading the essay, "The Lizard-Brain Addiction Monster" on, which provides, among other things, a description of this process that is both amusing and informative. 

I know that by the end of my drinking, not only was I not getting the "high", but I came positively to dislike the stuff.  And yet - I was still drinking to destruction, until circumstances forced me to accept the problem for what it was, and seek help.

Forget about the high.  Very likely, it is gone forever.  Going back on booze will not restore it.  Moving on to other drugs is likely to see a repeat of the same depressing cycle, with further physical and mental damage as the only long-term payoff.

Allan's suggestion is correct - you need to get help, both for the alcohol and for related problems that may be prompting you to drink or use.  There is no point in running away - and absolutely no shame in seeking help, in whatever form proves most suited to you.  Start by discussing the matter openly with your doctor.  He or she may prove very helpful in taking the first step to break this destructive cycle.

May I wish you the very best in your efforts to address your undoubted problem.

Best regards,


Alcohol - Allan N. Schwartz, PhD - Aug 7th 2009

Hello "Dumb and Dumber,"

Actually, I do  not like the title you chose for yourself. It does reflect, however, your low self esteem.

While you stopped alcohol at one point, that often is not enough. It is necessary, useful and preventive to go into psychotherapy. There is often an underlying psychological problem to the substance abuse. As you experienced, once you stopped drinking you felt sad.

I recommend that you find a good therapist so that you can work on what could be your underlying depression.

Dr. Schwartz

alcohol then and again - dumb and dumber - Aug 6th 2009

I have been on alcohol alot of years. Then had back problems and od on pain meds. AfTer so long I tried suicide, it didn't work, only made my family hate me.I have been sober for about 5 years, but some sadness drove me back to drinking. I can not get my high anymore. I am scared, that I will go for more like drugs or something. Any sugestions?????? Help if you can.

God help us. - - Aug 3rd 2009

My son is an addict. He first goes back to beer but soon it leads to pot  then hard drugs and he's gone. We could write the book on rehab. I am so worried he will die or kill someone. 

 He is going to meetings now so maybe we can hope.!? I love my son I hate the sickness. I sometimes hate my life. The lies I have made myself believe the phone calls the worry. Please people don't start . Please don't use. God help us all .

we can never escape - - Aug 3rd 2009

hi just wanna say well done to anyone who has quited its the hardest thing ever you will do if this lifetime,but just be carfull as the eagles song hotel california goes"you can cheack out any time you like but you can never leave"powerfull will allways be part of us and the best people to talk to are those who have gone through it themselfs nobody else could ever posibly more thing help others who are still on drugs dont turn your back on them rember we where once the same and still are.peace out joe!ireland"

Say No to Drugs - peace - Jul 16th 2009

I'm a recovery addict! Until i found the god of my understanding that's when i surrender. Started going to as many meeting that i could to stay clean. Drugs are bad so if you are thinking about using Please don't cause using drugs is death.

LOSE A LOVE ONE 2 IT! - NICOLE - Jul 8th 2009


Who cares? - Chris - Apr 8th 2009

Courts don't. They expect me to aplaud my ex wife on going to rehab after my daughter almost died because of her addiction. Now she's "clean" and is getting full custody of my child. "Bravo" to the system!

stay away! - james - Mar 18th 2009

i have smoked marijuana, a lot, railed coke, drank alcohol, i have also encountered a drug which is the most addictive of all no doubt, hands down.  Oxycontin is w/o a doubt the most addictive drug but also one of the most expensive.  i would encourage to not do it it took me one time to get hooked, railing or snorting it was the favorable way,  i have been clean for 2 years and was using almost everyday for a year.

Addiction is terrible - Maria - Jan 21st 2009
I became addicted to drugs, all drugs- one substance is not any different than another, after starting recreationally in 1990 or so, when I was 16.  It's been a long 17 years but the hardest part has been the last two years.  In 2007 I realized that I was 100 % addicted to opiates and i was only using them to stay away from dope sickness and in 2008, I spent all year in anguish trying to quit, relapsing, crying and contemplating suicide.  I went to rehab in October and i am finally on the right path.  People that are addicted have to decide to quit on their own, decide their own bottom.  Go to AA or NA and meet others that are just like you.  Believe me, it is so worth it.

4YRS ON>>> - dee - Jan 10th 2009

My youngest daughter is now on her 4th attempt at coming off heroin/crack........Each time is painful for her ,for me,and for her partner and not least of all her 11yr old little girl.......... Each time I pray this will be the time she can do it ...But in her own words " mum ,i,m scared i,ll relapse again"...........If only there was a quick fix to get off this filthy drug !!!.... All I can do is be there for her again...I know she tries.So hard ....She had a habit of £7,000 a month ,she sold her body and anything else she could  to pay for her fix.......There was no pleasure in her drug taking anymore ,,,,,,,she had to take it to get through a day  without feeling ill.....

    So for anyone thinking of trying it and thinks they can control heroin/crack.............The answer is dont  ...Because it controls you and very quickly ruins your life and all you love    

Life is too Precious - Ann - Dec 8th 2008

This articile has been very well written.  It contains the cold, hard facts!!!

We have to get through to people with substance abuse problems that DEATH is the end result.

I believe education in young children is the only answer to at least making this problem more managable. 

The problem is that people with substance abuse problems, become more and more dependant on the substance, with the brain not being able to process thought patterns, and in turn the person not thinking at all.

It is a sad life for some, however I believe it all comes down to the CHOICES we make for ourselves.

read man - rose - Feb 20th 2008

you got to read this this is good stuff!