The 4 Degrees of Drug Use We all know someone who drinks every night and swears they can stop any time they want. Is it just an excuse, or is the person truly in control of their drug use? Not everyone who uses drugs or alcohol needs rehab; at the same time, not everyone who needs treatment recognizes the seriousness of their problem. How can you differentiate controlled, moderate use from out-of-control drug use?

Here are four degrees of drug use and what to do if you or someone you know falls into each:

#1 Experimentation

People experiment with drugs for all kinds of reasons. Some are curious about a particular drug’s effects, others are pressured by someone else. Most people who experiment with drugs or alcohol do not become addicted. Still, just one use can cause harm (especially if the individual makes poor decisions such as drinking and driving) and, in someone who is predisposed to addiction, can set in motion a pattern of drug abuse and dependency.

What to Do: Monitor the behavior and learn as much as you can about the signs of drug abuse. If you can determine the reasons for experimentation (e.g., to have fun, fit in or to escape problems), you can better assess how important it is to get involved and the appropriate type of intervention.

#2 Social Use

The social drinker or drug user uses substances in social situations, usually to relax, fit in or have fun.  Although it seems innocent enough, especially compared to the solitary drug user, social use often leads to greater degrees of substance use. If the social user continues using even in the face of negative consequences, they’ve crossed the line into substance abuse.

What to Do: Inquire further. A social user may appear to just “enjoy having a good time” but, in reality, they start using long before a social event begins and continue long after the party ends. Drug use that is limited to social settings can quickly escalate and should be monitored, especially if the individual has a family history of addiction, struggles with depression, anxiety or other forms of mental illness, or has any other risk factors for addiction.

#3 Binge Drinking

Often overlooked because it involves periodic heavy drinking, often just once or twice a week, binge drinking is a problematic pattern of drug use. According to the Centers for Disease Control and Prevention, 38 million Americans binge drink an average of four times per month, each session averaging eight drinks.

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Men who drink five or more drinks and women who drink four or more in two hours put themselves and others in danger. Binge drinkers are 14 times more likely to report driving under the influence than those who do not binge drink. Binge drinking has also been linked with alcohol poisoning, unintended pregnancies, sexually transmitted diseases, assaults, accidental injuries, liver disease and high blood pressure, among other negative consequences.

Despite these dangers, more than half of the alcohol consumed by adults and 90 percent of the alcohol consumed by underage drinkers in the U.S. is in the form of binge drinks. Young adults are the most likely to binge drink, even though early drug use is strongly associated with drug and alcohol addictions later in life.

What to Do: Although not all binge drinkers develop alcohol addictions, many have a serious problem that requires treatment. They may not need treatment as intensive as someone with a long history of alcoholism, but research has shown that brief interventions (counseling sessions and education) may help change their dangerous patterns of drinking. Others may benefit from alcohol rehab, self-help support groups and/or more intensive counseling.

#4 Substance Abuse and Addiction

The official definitions of substance abuse and addiction are changing, but the problem behaviors are largely the same. Whether it’s called abuse, dependence or addiction, when drug use interferes with work, health, career, finances, relationships or other areas of life, it’s a problem. Other signs of drug addiction include:

  • Trying to control your drug or alcohol use unsuccessfully
  • Using drugs or alcohol in dangerous situations (e.g., before driving)
  • Spending a great deal of time finding, using and recovering from the effects of drugs
  • Withdrawing from friends and family, or giving up other activities to use drugs
  • Needing more of a drug to get the same high (i.e., tolerance)
  • Experiencing withdrawal symptoms when trying to quit

What to Do: Addiction is a chronic, relapsing disease that requires long-term treatment. The more advanced the disease, the harder it is to treat. At the earliest sign of a problem, research treatment centers and, if necessary, stage an intervention to get a loved one the help they need.

David Sack, M.D., is board certified in psychiatry, addiction psychiatry and addiction medicine. Dr. Sack currently serves as CEO of Elements Behavioral Health, a network of addiction treatment centers that includes Promises Treatment Centers, The Ranch, Sexual Recovery Institute, The Recovery Place, Right Step, Promises Austin, Lucida, Journey, Sundance, and Clarity Way.