People in all cultures across time have used psychoactive substances as part of their social and religious rituals. In North America, people use a variety of substances to commune with others, celebrate, relax, recreate, and de-stress. Some psychoactive substances are legal and socially acceptable (alcohol) and some are not (heroin, cocaine, crystal meth) and others are somewhere in between (tobacco, cannabis).
Although some substances (such as crack cocaine and tobacco) are more addictive than others, substance use by itself is generally not a problem. Substance use becomes a problem when it results in a pattern of impaired control of substance use, social impairment, and risky use.