Substance abuse is a euphemism for the use of potentially addictive substances such as alcohol, various forms of opiates, including heroin and regularly prescribed pain medications of all sorts whose use interferes with an individual’s quality of life and functioning at work, at home, and in the social realm.  Substance abuse becomes substance dependence when the individual can no longer adequately function without the substance.  At first substance abuse can serve to relieve pain and anxiety and sometimes depression.  At first the substance abuse can even bring pleasure.  But eventually these palliative results fade, and the individual simple needs to obtain and consume the substance, just so as not to experience the withdrawal symptoms that accompany the initial absence of such substances from his central nervous system.  Judgment is radically affected and the individual is typically unable to recognize the degree of pain and dysfunction they and their family have become immersed in.  Substance abuse requires the intervention of others, including the very family and friends that have been abused for so many years.