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13: Substance Use and Misuse

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    Close-up of a man's left eye as he looks to the right.
    Figure \(\PageIndex{1}\): (Red Eye by Diane Picchiottino on Unsplash)

    Introduction to Substance Use and Misuse

    Substance use and injury prevention are vital components of personal and public health. Understanding the broad scope of issues related to addiction, alcohol and tobacco use, drug misuse, and injury risk empowers individuals to make healthier decisions and supports broader community efforts to reduce harm. From the biological and psychological roots of addiction to the societal consequences of risky behavior and violence, these topics intersect with nearly every aspect of human development and well-being. Whether intentional or unintentional, many injuries and addictions are preventable with education, early intervention, and supportive environments.

    This module explores the science behind addiction, highlighting the factors that influence drug misuse, the effects of commonly used substances, and the importance of treatment and prevention strategies. It also addresses the significant health risks posed by alcohol, tobacco, caffeine, and emerging products like e-cigarettes. By understanding how substances affect the brain and body, and how behavior becomes compulsive and destructive over time, individuals are better equipped to recognize warning signs, seek help, and support others in recovery.

    In addition, this content examines the leading causes of unintentional and intentional injuries, from falls and motor vehicle crashes to violence, abuse, and suicide. Injury prevention strategies, such as safe environments, behavioral interventions, and community-wide support systems, are emphasized throughout. The goal is to empower learners not only to assess their risk but also to promote safety, resilience, and healthier choices in their homes, schools, and communities.

    Learning Objectives
    • Explain the nature of addiction as a chronic brain disease, including how it develops and impacts behavior and health.
    • Identify biological, psychological, and environmental risk and protective factors for substance use and addiction.
    • Recognize common types of drugs and behavioral addictions, including their effects on the brain and body.
    • Describe the short-term and long-term health consequences of drug, alcohol, tobacco, and e-cigarette use.
    • Define a standard drink and Blood Alcohol Concentration (BAC), and explain how alcohol affects individuals differently by gender, age, and body size. Distinguish between moderate, binge, and heavy drinking, and understand the health risks of excessive alcohol use.
    • Summarize the health impacts of tobacco products, including cigarettes, smokeless tobacco, and secondhand smoke.
    • Explain the risks associated with electronic cigarettes and their current regulatory status.
    • Describe effective treatment and cessation strategies for substance and behavioral addictions, including behavioral therapies and medications.
    • Differentiate between unintentional and intentional injuries, and identify common causes of each.
    • Identify prevention strategies for unintentional injuries, including those related to falls, drowning, motor vehicles, fires, and poisoning.
    • Explain the risks and safety measures for driving, cycling, and pedestrian activities.
    • Recognize forms and impacts of intentional injuries, including intimate partner violence, child abuse, sexual violence, firearm violence, and suicide.
    • Understand the public health approach to violence prevention, including the Social-Ecological Model and community-level strategies.
    • Identify national and local resources for addiction recovery, injury prevention, crisis response, and violence support services.

    • 13.1: Addiction
      Addiction is a chronic brain disease that alters brain function and behavior, leading to compulsive drug use despite harmful consequences. It is influenced by genetic, environmental, developmental, and psychological factors, and affects not only individuals but also families and communities. Effective prevention and treatment require a combination of behavioral therapies, medication, and long-term support tailored to each person’s needs.
    • 13.2: Recreational Drugs
      Recreational drug use, whether legal or illegal, poses serious health risks including addiction, physical harm, and mental health challenges. Substances like marijuana, cocaine, methamphetamine, opioids, and hallucinogens affect the brain and body in unique and dangerous ways, with some—such as fentanyl—being fatal even in small doses. Understanding the short- and long-term effects of these drugs is crucial for prevention, informed decision-making, and effective treatment.
    • 13.3: Alcohol
      Alcohol use is common but carries significant health risks, including damage to vital organs, increased cancer risk, and impaired decision-making, especially when consumed excessively. Factors such as gender, body composition, and drinking patterns influence blood alcohol concentration and health outcomes. Effective strategies for reducing or quitting alcohol include evidence-based treatments like Cognitive Behavioral Therapy, Motivational Enhancement Therapy, Contingency Management, and 12-Step
    • 13.4: Tobacco
      Tobacco use causes serious health issues, including cancer, heart disease, and early death. Nicotine is highly addictive, and even secondhand smoke is dangerous. Quitting improves health quickly and extends life. Treatments like counseling, nicotine replacement, and medications can help, and new therapies are being developed.
    • 13.5: Caffeine
      This section explores caffeine’s widespread use, cultural significance, and health effects, with a focus on high-risk consumption and dependence. It examines patterns of use, withdrawal symptoms, and impacts on vulnerable groups such as adolescents, pregnant individuals, and older adults. The chapter also outlines treatment strategies, including behavioral interventions, tapering, and patient education, to manage problematic caffeine use.
    • 13.6: Unintentional and Intentional Injury
      Injuries—both unintentional (like falls and car crashes) and intentional (such as violence and suicide)—are leading causes of death and disability, especially among people under 45. These events have widespread physical, emotional, and financial impacts. While some injury rates have declined, issues like drug overdoses and firearm violence remain critical. Prevention efforts must address individual behaviors and broader social factors through education, policy, and community support to create sa
    • 13.7: Comprehension Check
      Chapter 13 summary and test your understanding
    • 13.8: Glossary
      Glossary terms for Chapter 13
    • 13.9: References
      References from Chapter 13

    Thumbnail: Close-up of a left eye looking to the right. (Red Eye by Diane Picchiottino on Unsplash)
    This chapter was remixed and authored by Rusty Johnson.

    This page titled 13: Substance Use and Misuse was last modified on Mon, 31 Aug 2026 22:48:09 GMT and is shared under a CC BY-NC-SA 4.0 license and was authored, remixed, and/or curated by Danielle Altman, Rusty Johnson, and Cheryl Owiesny.