The use of both drugs and alcohol is historically rooted in society (Breier-Mackie, 2007). In the many different cultures and various ethnicities, the use of drugs and alcohol has come to be accepted or rejected to varying degrees. For most of us, the use of drugs typically has been for therapeutic reasons—to alleviate pain and suffering (Breier-Mackie, 2007), to stabilize various symptoms and illnesses, and to promote one’s quality of life, survival, and longevity. However, drugs and alcohol can also be used for nontherapeutic means. When they start to be used repeatedly to achieve feelings of euphoria and increased energy, then their use stretches into the boundaries of overuse, misuse, and abuse. Hence, an addiction is formed.
The overuse, misuse, or abuse of drugs and alcohol, as people differentially call it, is what is now termed an addiction (herein referred to often as a substance addiction). An addiction has been defined most thoroughly by the World Health Organization (WHO; 2014) as the “repeated use of a psychoactive substance or substances, to the extent that the user (referred to as an addict) is periodically or chronically intoxicated, shows a compulsion to take the preferred substance (or substances), has great difficulty in voluntarily ceasing or modifying substance use, and exhibits determination to obtain psychoactive substances by almost any means. Typically, tolerance is prominent and a withdrawal syndrome frequently occurs when substance use is interrupted. The life of the addict may be dominated by substance use to the virtual exclusion of all other activities and responsibilities.”
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V,
2015) includes some more specific descriptors, such as significant impairment to
daily function in which one of the following is present during a 12-month period: “(1) recurrent use resulting in a failure to fulfill major obligations at work, school, or home; (2) recurrent use in situations which are physically hazardous (e.g. driving while intoxicated); (3) legal problems resulting from recurrent use; or (4) continued use despite significant social or interpersonal problems caused by the substance use” (American Psychiatric Association, 2013). As health care professionals are often entrusted with our health, well-being, and life, these are the last individuals who would typically be expected to develop an addiction. However, they are at just as much risk, or more so, as anyone else when it comes to developing an addiction (U.S. Department of Justice, 2012). However, when nurses resort to using drugs, their behavior is often explained as a means of trying to cope; only this type of coping mechanism, of course, is a destructive one (Chen, Lin, Wang, & Hou, 2009; Violante et al., 2009).
