Continuum of Use

There is a broad range of substance use – from abstinence to dependence. An individual’s substance use may change throughout their life, for a variety of reasons.The following information describes the continuum of substance use. Where do you sit on this continuum?

*information adapted from the Ontario HIV & Substance Use Training Program (OHSUTP)

Continuum of Use:

  • No Use – the person does not use particular substances.
  • Experimental Use – the person tries a substance and may or may not use it again.
  • Social or Occasional Use – the person uses the substance in an amount or frequency that is not harmful (e.g., drink on social occasion; ceremonial use).
  • Medication (prescribed) – the person uses a medication as directed, under medical supervision. Risks are minimized.
  • Problematic Use – the person experiences negative consequences from using a substance (e.g., health, family, school, work, financial, legal problems).
  • Dependence – the person is psychologically and/or physically dependent on a substance and continues using, despite experiencing serious problems. Withdrawal symptoms may exhibit if use stops.

Notes about the continuum of use:

1. People do not automatically move along the continuum.

  • Some people may stay social users for their entire lives.
  • Some people can move around the continuum over time.

2. People can be at different points of the continuum for different substances.

3. Where a person is on the continuum, does not necessarily impact her/his ability to manage and minimize risks. For example:

  • Someone that is “heavily addicted” may still use new equipment every time.
  • A long time cocaine user may overdose.
  • A social user may overdose or spend too much.

4. For people struggling with dependency, not using for a while, then using again (sometimes referred to as “relapse”) is the norm.

5. The reason(s) people start to use are not always the reason(s) they continue to use.