Conceptualising Alcohol and Other Drug Issues

It is important to recognise that people use alcohol and other drugs for a variety of reasons including:

  • pleasure
  • alleviate distress
  • enhance performance
  • curiosity.

Alcohol and other drug use occur across a continuum from no use, to occasional use, to regular or problematic use, through to dependence. The use of a drug (or drugs) at least once in a lifetime is much more common than regular or dependent drug use. 

In terms of problematic substance use there are essentially three domains:

  • intoxication
  • regular use, and
  • dependence.

Each of these domains can result in widely different harms experienced by both the individual using the substance and the wider community. When people think of alcohol and other drugs and related issues, often the first thing they think about are the problems that occur at the more severe end of the scale, such as those associated with dependence. The reality is that issues related to dependence represent a smaller subset of problems in the community arising from alcohol and other drug use. That is not to say that those affected by alcohol or other drug dependence, and their loved ones, do not experience significant problems. However, far more people engage in regular (but perhaps not 'dependent') substance use and an even greater number engage in substance use where intoxication and associated problems are the main risk. 

The model below illustrates the domains of intoxication, regular use and dependence and attempts to demonstrate proportional harm - that is the largest sector, intoxication, represents the greatest harm to the community by volume.

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Another useful model for conceptualising alcohol and other drug use and related harms (shown below) examines drug use in the context of the characteristics of three interacting factors: the drug being used, the individual using the drug, and the environment in which the drug use occurs. This model explains how alcohol and other drug related harms can be influenced by the different variables related to the drug, the individual and the environment.