Trajectories of Substance Use

All individual substance use ‘pathways’ are different, but the concept of a general pathway can be a useful way of thinking about the progression of substance use. The three phases below should be considered as independent. Entering one phase is necessary but not sufficient to progress towards the next phase, because specific individual risk factors are needed [1].

  • Recreational and/or sporadic use, in which substance use intake is moderate and sporadic, and still one among many recreational activities of the individual.
  • Intensified, sustained, escalated use, in which substance use intensifies, becomes more sustained and frequent, and there is a narrowing of social identity and interests towards substance use. Although some decrement in social and personal functioning starts to appear, behaviour is still largely organised, and the individual can fulfil most of their roles and responsibilities.
  • Development of a substance use disorder means that substance-related activities are now the principal focus of the individual.

[1] Piazza, P. V. and Deroche-Gamonet, V. (2013) ‘A multistep general theory of transition to addiction’, Psychopharmacology, 229 (3), pp 387–413.

Back to Drug Misuse – Introduction