Health Information A-Z   >   Alcohol and Drugs

What is substance use?

Substance use refers to the ingestion or administration of any substance that is psychoactive, meaning that the substance alters a person’s state of consciousness. Psychoactive substances include alcohol, tobacco, caffeine, illegal drugs, some medications, solvents and glues.

What is the difference between substance “use” and “misuse”?

Substance use may range from beneficial to problematic, depending on the quantity, frequency, method or context of use. For example, beneficial use can include using a medication in the way your physician instructs you to, or having an occasional cup of coffee (caffeine) to increase alertness. However if you begin to use the medication incorrectly or consume coffee excessively, it can become problematic. The behaviour then becomes substance “misuse”, which may lead to substance “abuse”.

Substance misuse refers to instances or patterns of substance use not consistent with legal or medical guidelines associated with physical, psychological, economic or social problems, or use that constitutes a risk to health, security or the well-being of individuals, families or communities. In other words, if a substance is being used in a manner that was not intended or is harmful, it is being “misused”; however this behaviour may or may not be illegal. For example, potentially harmful behaviours such as impaired driving, using a substance while pregnant, heavy consumption and routes of administration (i.e., ways of taking a substance into one’s body) that increase harm are examples of “misuse”.

Substance misuse also includes substance use disorders (e.g. clinical conditions defined by medical diagnostic criteria, including dependence or addiction).

Substance misuse is not solely related to the legal status of the substance used, but to the amount used, the pattern of use, the context in which it is used and, ultimately, the potential for harm.

Legal and illegal drugs

While illegal drugs create much public concern and discussion, legal substances such as tobacco and alcohol usually cause the greatest amount of individual and societal harm, followed by prescription and illegal drug use.

Alcohol is a drug that is readily accessible and legal to consume. Illicit drugs are illegal and although the use of illegal drugs presents significant health risks, the direct costs of alcohol present a more substantial issue for Ontarians.

Alcohol is the most widely used psychoactive drug. In Ontario, 82% of adults 18 years and over report using alcohol in the past 12 months.

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