Why do people use substances and when does it become harmful?

By D&M Consultants

The desire to mood and mind alter is part of human behaviour. Do you remember when you were a kid spinning around until you were so dizzy you fell over? Substances have been in human societies for millennia and fulfill numerous social and cultural functions, many have been forgotten in our modern world.

Researchers have identified a number of reasons why modern individuals use substances, including:

  1. Because it feels pleasurable and enjoyable
  2. To manage aspects of living, and physical pain
  3. To manage feelings/emotions
  4. To increase the sense of belonging
  5. To engage in ‘normal’ socialisation’
  6. To expand consciousness
  7. To counteract the effects of another drug
  8. To maintain physiological dependence and/or avoid withdrawal

[Ritter, King & Lee, 2017, pp.5-6]

It would be unusual to find an individual who doesn’t use substances – tobacco, caffeine, alcohol and illicit or prescription drugs. Drug use is not only common, many substances are legal and socially sanctioned or promoted.

Despite this, research suggests that the harms for individuals, families and our society is wide-ranging, contributing to the largest cause of preventable disease and injury.

  • In 2019, 11.0% of Australians smoked tobacco daily.
  • 1 in 10 individuals (9.9%) who consumed alcohol within the past 12 months are likely to meet the criteria for alcohol dependence.
  • In 2019, 1 in 4 (25%) people drank at a risky level on a single occasion at least monthly, while about 1 in 6 (16.8%) exceeded the lifetime risk guideline.
  • In 2019, 43% of Australians aged 14 and over had illicitly used a drug at some point in their life (including pharmaceuticals used for non-medical purposes) and 16.4% had used one in the last 12 months.
  • Cannabis was the most commonly used illicit drug in 2019, with 11.6% of Australians using it in the last 12 months. This was followed by cocaine (4.2%), ecstasy (3.0%) and non-medical use of pain-killers and opioids (2.7%).

(AIHW: Household Survey, 2019).

Although data is still being collected from 2020, there are indications that COVID-19 further contributed to addiction related harms within Australian communities, particularly with the more accessible substances (such as alcohol).

So, when does using substances become harmful?

Not all drug use is harmful. How many of us reach for a coffee when we are tired? Panadol when in pain? Or even an alcoholic beverage when celebrating a special occasion?

Is ‘harm’ defined by the number of number of drinks you consume or cones you smoke? The DSM-V (Diagnostic and Statistical Manual) does not stipulate that someone has to consume a specific ‘quantity’ of a substance before it is considered harmful. For example, you only need to meet two of 11 criteria in the DSM-V to be considered as having an ‘alcohol use disorder’. 5 of these criteria include:

  1. Alcohol is often taken in larger amounts or over a longer period than was intended
  2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
  3. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effect of alcohol.
  4. A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
  5. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbate by alcohol.

[DSM-5, 2013]

The point is that harm and problematic use are on a continuum. There are vast numbers of people who may be consuming substances at harmful levels and not even be aware of the risks they are taking. In our experience, most high functioning addicts never receive treatment, let alone reach a point where a medical professional will offer a diagnosis.

Our REFRAME YOUR LIFE program offers a non-medical, holistic approach to dealing with the problematic use of alcohol and other drugs. We encourage clients to assess their own use and define for themselves the extent of harm. We collaborate with clients to create solutions so they can reduce negative consequences for them and their family.

D&M Consultants understand the challenges faced by individuals and families struggling with addictive behaviour. We absolutely can support you to find your own solutions and to begin your journey of recovery. Contact us at D&M Consultancy for more information on our REFRAME YOUR LIFE program.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Australian Institute of Health and Welfare (2020). National Drug Strategy Household survey

2019: Detailed findings (PHE 270). Canberra: Australian Institute of Health and Welfare.

Biddle N, Edwards B, Gray M & Sollis K (2020). Alcohol consumption during the COVID-19 period: May 2020. ANU Centre for Social Research and Methods: Canberra. Viewed 10 June 2020.

Ritter, A. E., King, T. E., & Lee, N. E. (2017). Drug use in Australian society. Oxford University Press Australia & New Zealand.

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