Substance Use Spectrum

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Organization: Health Canada

Date published: 2022-05-10

People use substances, such as controlled and illegal drugs, cannabis, tobacco/nicotine and alcohol for different reasons, including:

  • medical purposes
  • personal enjoyment
  • religious or ceremonial purposes
  • to cope with stress, trauma or pain

About the substance use spectrum

Substance use is different for everyone and can be viewed on a spectrum with varying stages of benefits and harms.

The stages of this spectrum are:

  • Non-use (abstinence)
  • Beneficial use
  • Lower-risk use
  • Higher-risk use
  • Addiction (substance use disorder)

A person may move back and forth between the stages over time.

Stages of the substance use spectrum


  • Non-use is avoiding the use of substances (abstinence)
  • For example:
    • not using drugs, tobacco or alcohol

Beneficial use

  • Beneficial use is use that can have positive health, social, or spiritual effects
  • For example:
    • taking medication as prescribed
    • ceremonial/religious use of tobacco (such as smudging)

Lower-risk use

Higher-risk use

  • Higher-risk use is use that has a harmful and negative impact to a person, their family, friends and others
  • For example:
    • binge drinking
    • impaired driving
    • use of illegal drugs
    • increasing quantity used
    • increasing frequency of use
    • combining multiple substances

Addiction (substance use disorder)

  • Addiction is a treatable medical condition that affects the brain and involves compulsive and continuous use despite negative impacts to a person, their family, friends and others
  • For example:
    • when someone cannot stop using drugs, tobacco or alcohol even if they want to

Notes on the spectrum

  • Drugs, tobacco and alcohol have different effects on a person depending on factors like:
    • sex
    • age
    • weight
    • tolerance
    • underlying health conditions
    • the substance(s) being used
  • The best way to avoid any harms from substance use is to avoid use. However, many people use substances without causing significant harm to themselves or others. In some cases, substances have a serious risk of harm at any level of use.
  • Children and young adults are especially vulnerable to the effects of different substances because of the impacts on their development. In some cases, there may be no level of beneficial use or lower-risk use.
  • The path to recovery from addiction is possible but it looks different for everyone. Some people may benefit from non-use (abstinence). Others may need different support, which could include:
    • counselling
    • medications
    • withdrawal management
    • wrap-around services, such as employment and housing to support longer-term wellness
  • Resources are available to help people struggling with substance use. With the right supports, it is possible for a person to improve their health across the spectrum.

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