Definitions, categories and legal status of substances

1. Definitions, categories
and legal status of
substances

2. Aim of this resource
The aim of this resource is to provide an introduction to the main health
and social issues associated with substance misuse in the UK today
by:
• Identifying definitions of misuse.
• Outlining the main models of misuse & categories of substances.

3. So, what is ‘misuse’?
• Addictive behaviour – binge drinking?
• Substance use – alcohol, caffeine, heroin, tobacco, aspirin?
• Drug dependence – physical, psychological, sociological?
• It all depends who you ask – what perspective you take.

4. World health organization
guidelines (definition of ‘misuse’):
• Unsanctioned use
– Not approved by society.
• Hazardous use
– Leading to harm or dysfunction.
• Dysfunctional use
– Leading to impaired psychological or
social functioning.
• Harmful use
– Known to cause tissue damage or
psychiatric disorders.

5. Addictive behaviour - six main
components (Griffiths 1995)
• SALIENCE - drug seeking/taking behaviour takes over a wide range of
life activities – friends, partner, job etc.
• EUPHORIA - experience from behaviour – high, buzz, rush chill.
• TOLERANCE - need to increase behaviour/amount to gain same
experience.
• WITHDRAWAL - unpleasant feelings when deprived.
• CONFLICT - conflicts with others who don’t share same salience –
partner, family, employers, law, society. Also inner conflict from guilty
conscience.
• RELAPSE - hard to give up addictive behaviour, but easy to take up
again.

6. Progress made, challenges ahead
In a report entitled Drug Treatment 2012: Progress Made, Challenges
Ahead, Public Health England (2013) set out some of the key statistics
about the number of people using drugs and entering treatment.
It reported that:
• drug use is declining, more drug users are recovering.
• the original pool of people with problematic heroin and crack use is
shrinking.
This was reinforced further by data from subsequent years....

7. NTA (2013)
why invest?
• NTA (2013) why invest?
Public Health England
reports fewer heroin and
crack users in England...

8. NTA (2013)
why invest?
Shorter waiting times for
treatment....

9. NTA (2013)
why invest?
More successful
treatment completions....

10. NTA (2013)
why invest?
And fewer young people
needing treatment for
hard drugs.

11. Alcohol
• Alcohol is a regulated legal substance in the UK
• This means it is governed by laws regarding its supply, quality and
use.
• For instance, it cannot be sold to people under 18. It must be
labelled correctly. Advertising of alcohol is strictly limited.
• Despite being legal, it is responsible for most harm in the UK among
all substances used (Nutt, 2009).
• Alcohol-related deaths in the UK peaked in 2008 to over 9000.
• Scotland has the largest death rate in the UK at over double that of
England for men and women (Institute of Alcohol Studies, 2015).

12. Alcohol (cont.)
• 9 million adults drink at levels that increase the risk of harm to their
health.
• 1.6 million adults show some signs of alcohol dependence.
• Overall, alcohol is the third biggest risk factor for illness and death.
• 15,479 people died from alcohol-related causes in 2010, up 30%
since 2001
• 27% of social care serious case reviews mention alcohol misuse.
• There are recognised physical, psychological and behavioural
problems for children of parents with alcohol problems.
• 16% of road fatalities are due to alcohol intoxication.
Sources: NTA (2013); The Alcohol Strategy (2012); Drug Strategy – Home Office, (2010);
Drug Strategy Annual Review (2013)

13. Categorising substances
regulated
illegal
legal
Substances can be divided into
different legal statuses.
• ‘Legal’ includes coffee, herbal
remedies
• ‘Regulated’ includes alcohol,
solvents and cigarettes,
prescription-only & over the
counter medication.
• ‘Illegal’ includes substances
used outside the regulations,
i.e. cannabis, heroin, cocaine.

14. Misuse of Drugs Act 1971
Substances are legally divided into schedules 1-5.
• Schedule 1 - no known medical use so totally banned, like LSD.
• Schedule 2 – controlled drugs like morphine.
• Schedule 3 - as above but less control like temazepam.
• Schedule 4 - typically, most prescription only drugs.
• Schedule 5 – typically, over the counter drugs.

15. Misuse of Drugs Act 1971 (cont.)
• Drug classes govern the legal ‘tariff’ for using illegally. i.e. The
possession or, supply of drugs.
• There are three classes, A – C.
• Class A drugs have the highest tariffs, class C the lowest.
• Drug classes change so you need to keep alert for changes. However,
heroin and cocaine are likely to remain as Class A drugs.
• Go to the UK Government’s website for the main drug classification list.
Be aware that it can change to accommodate new substances and
policies. https://www.gov.uk/penalties-drug-possession-dealing

16. Types of drug by effect
stimulants
hallucinogens
depressants
Substances commonly
misused can be divided into
three types according to the
effect they have on the
nervous system.
These three types are:
1. Depressants
2. Stimulants
3. Hallucinogens.

17. Typical drug types are:
• Depressants (they slow down the nervous system)
– Heroin, methadone, alcohol, benzodiazepines , some solvents
• Stimulants (they speed up the nervous system)
– Cocaine, crack, amphetamines, ecstasy, crystal meth, many ‘legal
highs’ (new psychoactive substances)
• Hallucinogens (typically, change perception)
– LSD, cannabis* & synthetic cannabinoids*, magic mushrooms
*these drugs can fit into a number of categories dependent on the type and use

18. References
• Griffiths E (2000) Alcohol, the Ambiguous Molecule. Harmondsworth, Penguin Books.
• HM Govt. (2012) The Government’s Alcohol Strategy. Available at:
https://www.gov.uk/government/publications/alcohol-strategy
• Home Office (2015) Drug Strategy Annual Review 2014-2015. Available at:
https://www.gov.uk/government/publications/drug-strategy-annual-review-2014-to-
2015
• Institute of Alcohol Studies (2015) Alcohol related mortality rates.
http://www.ias.org.uk/Alcohol-knowledge-centre/Health-impacts/Factsheets/Alcohol-
related-mortality-rates.aspx
• NTA (2013) Why Invest? National Treatment Agency. Available at:
http://www.nta.nhs.uk/uploads/why-invest-2014-alcohol-and-drugs.pdf
• NTA (2012) Drug Treatment: Progress Made, Challenges Ahead. London. National
Treatment Agency.
• Nutt, D. (2009). Estimating drug harms: a risky business. London: Centre for Crime
and Justice Studies.