Overview
The National Cancer Institute defines “impairment” as:
A loss of part or all of a physical or mental ability, such as the ability to see, walk, or learn. 1
Taber’s Medical Dictionary provides a somewhat more specific definition that explicitly invokes a biopsychosocial perspective:
Any loss or abnormality of psychological, physiological, or anatomical structure or function. Impairments represent a deviation from generally accepted benchmarks in biomedical or psychosocial functioning. 2
Substance use is almost always going to involve impairment in some way as they interact with the nervous system.
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Depressants like alcohol and benzodiazepines enhances the activity of GABA while blocking glutamate, which leads to slower central nervous system activity and the disorientation associated with drinking, like delayed reaction time, loss of motor coordination, slurred speech, blurry vision, and lack of inhibition and judgment.
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Opioids like heroin, fentanyl, and oxycodone mimic natural endorphins while heavily suppressing brainstem activity, leading to lethargy, drowsiness, falling into unresponsive stupors, lack of awareness of the external world, and respiratory depression that might stop breathing.
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Stimulants like cocaine and methamphetamine prevent the reuptake of dopamine, so the nervous system is forced into hyperarousal with racing thoughts, hyperfixation, a sense of invincibility, paranoia, agitation, and extreme impulsivity.