9.1 Common Misperceptions about Substances & Substance Use
In order to understand substance use and substance use disorders (SUDs), it is important to recognize that there are many common misperceptions about substances and substance use, particularly problematic substance use. Common misperceptions include the following:
Misperception #1
“Some drugs are intrinsically dangerous and possess the power to control human behaviour” (Reist & Reimer, 2013, pg. 8).
This belief is based on flawed assumptions, with little supporting data (Reist & Reimer, 2013). Instead of placing the emphasis on the substance, we need to focus on the individual and the role social/contextual factors play in substance use behaviour (CISUR, 2017; Reist & Reimer, 2013).
Misperception #2
Use of any substance with “addictive properties” will result in immediate addiction to the drug (CMHA, n.d.b; Alexander, n.d.).
The basis of this belief includes: a misunderstanding of substances; different attitudes and beliefs about the nature of legal and illegal substances (See Chapter on Introduction to Psychoactive Drugs); and a failure to consider the complex biopsychosocial factors that contribute to the development of problematic substance use and SUDs (CMHA, n.d.a.; Jemberie et al., 2020). While many psychoactive substances can be “addictive,” problematic substance use is not caused by the simple consumption of a drug (CMHA, n.d.b).
Misperception #3
Illicit substances cause the most harm to individuals and society.
In reality, it is the legal substances, alcohol and tobacco (nicotine), that cause the most individual and social harm. The overuse of alcohol and tobacco cost the Canadian economy and public health more than all the other substances combined (CISUR, 2017).
In Canada in 2017, alcohol and tobacco contributed to:
- The majority of the costs to the Canadian economy and public health (63%).
- Over 66,000 preventable deaths.
- 89% of the 277,060 hospital admissions.
- 76% of the 751,356 years of life lost due to substance use.
(Stockwell & Young, 2020)
Misperception #4
People experiencing substance use issues and SUD are to blame for their own substance using behaviour and any consequences that result from it.
No person chooses to develop a SUD (CMHA, n.d.a). Instead, there is a complex “combination of biological, psychological and social factors” that contribute to why a person may use substances and experience problematic substance use (CMHA, n.d.c). SUDs differ for each person and are connected to the places (physical and social) where they live, work and play (Ewald et al., 2019) (See Chapter on the Social Determinants of Health – SDoH).
Misperceptions, such as the four outlined here, perpetuate the vilification of substances (particularly illicit substances), as well as the stigmatization and discrimination of people who use substances, particularly those who develop SUDs (See Chapter on Stigma). Such beliefs reinforce support for policies that continue to harm the health and well-being of PWUS (e.g., drug prohibition and the criminalization of PWUS; limited treatment options that are primarily abstinence-only in nature – See Chapters on the War on Drugs and Harm Reduction).
