People around the world consume a staggering range of legal and illegal psychoactive substances on a daily basis. In fact, the range of substances people use is so wide, it isn't practical, or even really possible, for us to familiarize ourselves with each substance. However, there are some substances that are more commonly used and that are personally and socially problematic. It is important that clinical, school, and other counselors familiarize themselves with commonly used substances, as many client's struggle with substance use or are impacted by family members' use. Taking time to familiarize oneself with different substances' effects, methods of administration, and potential for harm can help counselors assess, conceptualize, and treat clients who use substances.
Substance use is a broad, highly complex issue. Throughout this course, you will be asked to reflect on your personal reactions, values, biases, and experiences, since counselors who are self-aware are better able to work with diverse clients.
Recommended Readings & Resources
To get the most out of this unit, please review the following:
After completing this unit, students will be able to:
- List commonly used drugs, their effects, and how they are typically administered.
- Recognize that every day experiences, like eating sugar or using electronic devices, can mimic the physiological effects that drugs have on the brain.
- Critique the DEAs drug schedules.
- Articulate awareness of their personal values, biases, and beliefs about substances.
- Reflect on potentially addictive habits in their own lives.
NIDA Drugs of Abuse
As you read through the list of substances consider what it would be like to work with a client with a long-term history of using a given substance. As you browse the website, pay attention to which substances you might be particularly likely to encounter in your future career and to your personal reactions to each of the substances.
NIDA Exploration Questions:
- What reactions did you have to the list of substances?
- Have you used any of the substances, known anyone who struggled with using these substances, or worked with people who were struggling because of any of these substances?
- How do you think your biases and reactions to the substances you read about might impact your future work with clients?
- Do you believe that the information on this website is factually accurate
and applicable to your future work with clients?
- If you believe so, what markers cued you to it being accurate and/or applicable?
- If you believe there are factual inaccuracies or that it is not otherwise applicable, what experiences of information support your belief?
The Erowid Center website and organization are dedicated to providing resources to people who identify with drug and substance culture. Visit their website and read descriptions of the substances that you saw on the NIDA Drugs of Abuse list. After comparing the sites, dig a bit deeper on Erowid. Try to find the histories of substances you are interested in, and make sure to check out the Experience Vault. Explore a few new substances, before responding to the reflection questions below.
Erowid Exploration Questions:
- How were the descriptions of the risks and effects of the substances similar across NIDA and Erowid?
- How were they different across the sites?
- Which of these sites would you be more likely to use in the future if you needed information on a substance that a client reported using?
- What are your reactions to the Experience Vault?
- Do you believe that a client must cease using substances in order to progress in counseling?
What Constitutes a Drug?
As you likely noted while browsing Erowid, people have access to a massive range of plant based and synthetic substances, some of which have been scheduled as drugs by the United States Drug Enforcement Administration (DEA) The DEA defines a Schedule I Drug as:
...substances or chemicals... with no currently accepted medical use and a high potential for abuse".
US Drug Enforcement Administration
However, the DEA drug schedules are not as clear cut as they may seem at first glance. For example:
Our findings clearly demonstrate that intense sweetness can surpass cocaine reward, even in drug-sensitized and -addicted individuals.
...when rats were allowed to choose mutually-exclusively between water sweetened with saccharin-an intense calorie-free sweetener-and intravenous cocaine-a highly addictive and harmful substance-the large majority of animals (94%) preferred the sweet taste of saccharin. The preference for saccharin was not attributable to its unnatural ability to induce sweetness without calories because the same preference was also observed with sucrose, a natural sugar. Finally, the preference for saccharin was not surmountable by increasing doses of cocaine and was observed despite either cocaine intoxication, sensitization or intake escalation-the latter being a hallmark of drug addiction.
Lenoir, M., Serre, F., Cantin, L., & Ahmed, S. H. (2007)
Sugar addiction can be conceptualized in similar ways to alcohol, cocaine, and other drug addictions. During the Conceptualizing Unit, we will learn about the disease model of addiction, which includes binging, withdrawals, and cravings. Read Avena, N. M., Rada, P., & Hobel, B. G. (2008) now, and keep the authors' descriptions of sugar addiction in mind when you are working on the Conceptualizing Unit.
Sweeteners are not the only things in our lives that can trick our brains the same way substances do. Check out this news article with preliminary data regarding electronic devices stimulating pleasure neurotransmitters.
What Constitutes a Drug Exploration Questions
- Based on what you read do you feel that sweeteners meet the US DEA definition for a Schedule I drug? Why or why not?
- What makes something a drug?
- What legal, cultural, and other implications are associated with something being considered a drug?
- What addictions do you have or are you prone to? Consider
drugs and alcohol, food, and electronic devices.
- How likely are you to change these addictions?
- What social stigmas are associated with these addictions?