The use of various substances to modify mood or behavior is generally regarded as normal and acceptable in our society. Many people drink coffee or tea for the stimulant effects of caffeine, or engage in the social drinking of alcohol. On the other hand, there are wide cultural variations. In some groups, even the recreational use of alcohol is frowned upon, whereas in other groups the use of various legal or illegal substances for mood-altering effects has become widely accepted. In addition, certain over-the-counter and prescription medications may be medically recommended to relieve tension or pain or to suppress appetite.
But when regular use of these substances begins to interfere with normal functioning, creating behavioral changes that would be undesirable to people from any cultural background, substance use has turned to substance abuse. As psychiatrists define it, a person has a substance abuse problem when they continue to use a substance–some form of drug, medication or alcohol — despite the recurring social, occupational, psychological or physical problems such use causes. Such behavior is indicative of a mental disorder which can turn an illegal or a legal substance into a “drug” and which requires psychiatric medical treatment.