When I was an active drug user I was always baffled by the individuals who could use with us and then abruptly stop. Those who could try cocaine or meth and just not like it. Those who were able to wake up in the morning after a hard night out and not crave a little something to get them going. Those fortunate individuals with the self-control and soundness of mind to party on a Friday night, and stay in watching movies and drinking tea on a Saturday.
For me it was not that simple. I needed drugs to get up in the morning. I needed to smoke a joint at work just to cope with my co-workers. I needed a drink at night to go to bed. It was as if I couldn’t do anything without a vast amount of chemicals running through my system.
It took me a while in recovery to understand this phenomenon. Even the Alcoholics Anonymous Big Book makes a distinction between different types of drinkers – from the teetotaler to the casual drunk and the full blown alcoholic – we come to realize that there are different kinds of users, and therefore different interventions for each individual case.
In terms of addiction the UN World Drug Report sheds some light on the matter.Their report indicates that more than 247 million people have experimented with drugs, and that from that total about 10% have a substance use disorder/addiction.
If you question whether or not you might have a substance use disorder and if you might need help, consider this: has your use of a substance led to disorder in any one or more facets of your life? If yes, please consider reaching out.
Below we will look at 5 types of drug users with a brief discussion of each.
It is important as we look into the classifications to realize that these are the ideal types. Most users will not fit neatly into any specific category, yet these definitions do remain quite useful for classification.
An abstainer or teetotaler might once in a while, for example have a drink.Others might shift from one category to another as context and circumstances change.
It is also important to understand that psychological dependence varies by degree.
This set of classifications, unlike the stages of addiction, does not follow a linear pattern. It is not a progression from one to the other. Simply these are the relative position one might find oneself in in terms of the use of substances. A description of condition dependent on circumstance, context and situation.
There is no predictable progression between categories, and one might find an individual user swinging from one extreme to the other.The full blown addict might abruptly discontinue his usage of mind altering substances and become an abstainer, or an individual might try crack for the first time and become completely physically and psychologically dependant.
The Abstainer
People might abstain from drugs and alcohol, or even certain behaviors like gambling or sex, for various reasons. Whether for religious (for example 7th Day Adventists going as far as abstaining from tea and coffee because of the caffeine content) or moral reasons, or as the after effect of a series of traumatic experiences (growing up in an alcoholic household) certain people abstain because of the belief that drugs or alcohol is inherently wrong. Others still become abstainers later in life after having seen or lived the horrors of active addiction or having had a bad drug or alcohol experience.
The Social User
This type of drug use is the most common and constitutes the majority of the drug using population. A social user is an individual who uses alcohol or other psychoactive substances but are able to limit their use, using only in social settings or once in a while.
Mind altering substances are seen as a way to enhance the pleasure of a social setting and is used to accomplish social goals.
Not every social user becomes dependent although the likelihood of addiction depends on the substance being used.
The danger however does come in with reinforcement of the behaviour.
“There is still considerable debate whether people can experiment with certain mind-altering drugs (e.g., marijuana, methamphetamine, crack, or heroin) without escalating into misuse (Type 3) or dependency (Types 4 and 5). With some drugs, like alcohol, most people seem to be able to continue indefinitely as social users (Type 2); research shows only about 20% appear to develop a more depen-
dent relationship. However, a larger percentage of marijuana users (as many as 25%) escalate into dependency if they regularly use over an extended time.” (The Addiction Counselors Desk Reference, Coombs and Howatt, 2005)
Drug Abuser
Where the social user might enjoy the use of mind and mood altering substances as part of a social experience where the use of the drug itself is not the priority, the drug abusers main goal in these same settings is intoxication.
The drug abusers usage patterns might still be sporadic, unlike the dependant, but might include binges and more risky use of the drug.
The motivation changes from social reward and becomes way more internal.
Some might start using drugs to avoid or numb unwanted feelings, to change mood or personality or even to enhance performance (eg. Amphetamines for studying, or marijuana to be more ‘creative).
Others use drugs and go on binges to escape from the reality of their responsibilities at home, work or school, or just be less themselves.
Physical Dependence
Physically dependent users are not necessarily psychological addicted to the substance they are using, but because of prolonged use and tolerance these users often have to continue their use of the substance because of the severe discomforts of detox and withdrawal. We see this especially in those addicted to their prescription medication.
The physically but not psychologically dependent user might even come to despise the medications or drugs they are on and might want to stop, but discontinuation poses certain challenges.
Detox can be between 3-5 days for fast acting substances like heroin, alcohol or cocaine, or up to two weeks in the case of drugs like benzodiazepines or methadone.
“Situational addicts, such as some Vietnam veterans, offer another example of Type 4 addicts. Although numerous enlisted men became addicted to narcotics while serving in Southeast Asia, many stopped without aid on their return to the United States. They returned to normal living by reconnecting with schools, families, churches, and other social support structures that provided the psychological nourishment psychoactive drugs only simulate. After detoxifying, a large percentage walked away from drugs, or used them only intermittently for recreation. Surprisingly, full recovery did not require abstinence. Although nearly half of Vietnam veterans who became addicted tried narcotics again after their return, only 6% became readdicted.” (The Addiction Counselors Desk Reference, Coombs and Howatt, 2005)
Physically and Psychologically Dependent
“Unlike Vietnam veterans, individuals in this condition cannot simply walk away from their addictions and resume a normal life. They depend on psychoactive drugs to cope with life. When the reward-pain ratio shifts and unpleasant and disruptive events accelerate, rather than discontinuing the drugs as Type 4 users do, they increase the dosage, switch to other drugs, or try to titrate various substances. Instead of blaming drugs for their spiraling decline, they regard
them as the solution and often mourn their loss just as one mourns the death of a loved one.” (The Addiction Counselors Desk Reference, Coombs and Howatt, 2005)
Type 5 users have become fully dependent on the drug and cannot return to being a social user. This is the kind of solution that AA and other 12-step fellowships offer. Complete abstinence is the cure for this obsession of the mind and allergy of the body.
Besides the physical consequences that comes with physical dependence, the psychologically dependent user is completely hooked and obsessed with the next fix. Drug-seeking behaviour becomes a survival instinct and users of this type will continue to use and self-medicate their feelings.
Even guilt or a desire to stop can cause the psychologically addicted user to reinforce his use as he tries to escape the feeling of impending doom and hopelessness that comes with abuse, hoping he can dig down and out of the hole he has found himself in.
These users might try to stop, but cannot do so without a healthy support system and a program. Relapse is common among this kind of user, and this condition is the most severe.
If the Type 5 user does go back to trying a mind-altering substance in a social setting relapse is almost certain as they cannot stop once they start. As the AA adage goes ‘1 is too much and a 1000 never enough.’
Unlike other categories of users the Type 5 user has a permanent, chronic chemical dependence and left untreated will almost inevitably lead to debilitation or death.
Reach Out
If you believe you might have a substance use disorder or fall into one of these categories, reach out today. There are so many options available, you do not have to do it alone. Contact us on 0653703806 or via email.