Whatever the substance of abuse, the pattern of progression from use to abuse to dependence typically begins with the first rewarding experience with a psychoactive substance; a rewarding experience usually results in a person’s seeking another rewarding experience.

If the experience is unpleasant, the individual will most likely not repeat the experience.

When substance use does progress, the progression typically follows a pattern. The pattern of use may:

• Recreational use
• Circumstantial use
• Regular use
• Compulsive use

Recreational Use

Recreational use is the least severe level and also known as experimental use. It is often driven by curiosity or peer pressure. It usually occurs in a social setting among friends, does not happen very often, and typically involves consuming small to moderate amounts of psychoactive substances.

Circumstantial Use

Circumstantial use happens often when an individual is motivated to achieve a desirable effect as a way of coping with something circumstantial. For example, an individual with a chronic pain disorder may use a drug or substance only when he experiences pain or a very shy person may find that smoking marijuana makes him or her more relaxed and able to talk to people, dance, or otherwise be more social. Or a person with depression may try alcohol or substances to feel better or lift his mood. A person at this level also may use occasionally for fun or to be social. A person may or may not experience problems because of use at this level because to an extend they have control over it.

Regular Use

Some people start out with recreational or circumstantial use but begin to use more of the substance, more often. When psychoactive substances are used daily or almost daily, in low to moderate doses, the effect is intensified and tolerance develops. At this level, a person is often motivated by a need to get regular relief from an ongoing problem, such as anxiety or depression, or to maintain a desired level of performance. At this level, a person is beginning to experience problems with use (e.g., being lateness to work, other’s being concerned about the use). This level of substance use is considered abuse.

Compulsive/Addictive Use

Compulsive use is the most dangerous and severe. At this level, high doses are needed daily or almost daily to reach a desired physical and/or psychological effect or to avoid withdrawal symptoms. At this level, the substance becomes the priority in the individual’s life, around which all other activities are organized. At this level, a person experiences problems related to use but continues using in spite of them. This level of use is known as dependence and at this stage there are obvious dysfunction in most areas of functioning e g work, school, family life, legal problems etc

By: Dr. Ogonnaya Ndupu