He Said/She Said: Drug Use and Abuse



Dear Columns,
Since coming to college, I’ve started experimenting with drugs. I use for recreation, and I try really hard to be careful and stay out of trouble while still having a good time. There have been some problems though; some of my friends don’t like that I do drugs and they’ve stopped hanging out with me, and I feel like they look down on me. I also feel like I’ve been using them more and more often without intending to. So my question is should I be worried about myself? When do I know if I need help or not?

Dr. John Langton

Dear Anonymous,

As someone who has been teaching a course on “Drugs, Politics, and Public Policy” for more than twenty years at Westminster, I understand where you are coming from: you enjoy getting high, but you are concerned that you are becoming dependent on or even addicted to various drugs, because you have “been using them more and more often, without intending to.” You ask if you should be worried about yourself and whether you “need help or not.” To be blunt, if your drug use has become worrisome to you and your friends, you should be concerned about it and you should seek help right away, before it becomes even more problematic. As soon as possible, you should make an appointment to talk to a professional in Counseling and Health Services, like Dr. Kasi Lacy or Dr. Bob Hansen, about why you are “using more and more, without intending to,” which just happens to be, clinically, one of the main behavioral symptoms of a “substance abuse or dependency disorder,” according the Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association.

You say you are “experimenting with drugs,” but you have clearly moved beyond that preliminary stage of use, for one or more drugs. There is something called “the continuum of drug use,” which substance abuse specialists employ to describe the different stages of a person’s involvement with a particular drug. Experimentation means using a drug once or twice; more than that indicates usage that has become casual, regular, dependent or addictive, depending on its frequency and amount. If you want to know if you may be moving toward or even suffering from dependency, which in its most chronic and severe form is called addiction, ask yourself the following questions, which I have derived from the DSM-5 and modified to fit Westminster conditions:  since the beginning of the school year, has the number of times each week that I used a drug or drugs increased? Do I often smoke or drink or snort more than I promised myself that I would? Have I tried to lay off for a week or two but was unable to do so? Have I missed class more than two times because I was hung over, strung out or too stoned to get up? Have I failed to turn in papers because using took too much of my time or prevented me from starting or finishing? Is it getting harder for me to be careful? Do I drive while using or carrying? Do I drive drunk or stoned? Are most of my good friends people who use regularly? Do I frequently crave a toke or a snort or a drink? Do I look forward to getting wasted every Friday or Saturday night?  Do I need to use more now to get the high I want? Do I sell drugs to get the money for drugs?

If you answered yes to three of these questions, you may be, clinically, mildly dependent on drugs, five affirmatives you may be moderately dependent, seven or more you may be severely dependent or even addicted. Even with just three yes answers, I would urge you to talk to someone in Counseling Services, tomorrow if possible.

Dr Kasi Lacey and Anne Rulo, LPC.

Dear Anonymous,

Conversations about drug use can be very difficult, particularly depending on what a person deems “harmful” or considers “a drug” and also if they understand drug use as something that is a recreational part of the college experience.  On a purely scientific basis it is important to understand that “drug” use (ranging anywhere from caffeine to illicit substances) can change the way our brain chemistry works, how our body responds, etc.  The reality is that while anyone who ingests/uses a drug will be affected in some way, there is no way to know for sure when your body will make that switch from “fun” to addicted. For some people that is after many times of use and for others that switch happens the very first time.  Each person is unique in their physical makeup and as such, responds differently.

There is also a difference between use, abuse, and dependence. Some of the questions to ask to decipher whether someone is using or abusing is how their use affects their daily functioning and if it causes them distress. For example, does one’s substance use cause them relationships difficulties, affect their academic performance, have they had legal ramifications, etc. The difference between abuse and dependence is the physical addiction and also increased tolerance.  Individuals who are dependent upon a substance must seek medical attention before abstaining and also will show an increase in tolerance needing more and more of the substance to get the same effect.

In response to some of the specific concerns you listed, it seems as though I am hearing you say that you may be beginning to be concerned and are feeling a little ambivalent yourself about what you are comfortable with.  While you have not been in “trouble” it does sound like your use is beginning to affect your friendships and reputation with others.  However, most concerning is the statement you made about “using them more and more without intending to.”  These criteria seem to be indicating you are further along the road toward addiction and potential life ramifications than you were before.  While the choice to use is always just that, your choice, it does appear as though the opportunity to talk with someone who is a counselor or substance abuse expert may be helpful as you continue to evaluate how you may wish to move forward from here.

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