Substance abuses
Classification and external resources
Comparison of the perceived harm for various psychoactive drugs from a poll among medical psychiatrists specialized in addiction treatment[1]
ICD-10	F10.1-F19.1
ICD-9	305
DiseasesDB	3961
MeSH	D019966

Substance abuse, also known as drug abuse, refers to a maladaptive patterned use of a substance (drug) in which the user consumes the substance in amounts or with methods not condoned by medical professionals. Substance abuse/drug abuse is not limited to mood-altering or psycho-active drugs. Activity is also considered substance abuse when inappropriately used (as in steroids for performance enhancement in sports). Therefore, mood-altering and psychoactive substances are not the only drugs of abuse. Substance abuse often includes problems with impulse control and impulsivity.

The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts. The terms have a huge range of definitions related to taking a psychoactive drug or performance enhancing drug for a non-therapeutic or non-medical effect. All of these definitions imply a negative judgment of the drug use in question (compare with the term responsible drug use for alternative views). Some of the drugs most often associated with this term include alcohol, amphetamines, barbiturates, benzodiazepines (particularly temazepam, nimetazepam, and flunitrazepam), cocaine, methaqualone, and opioids. Use of these drugs may lead to criminal penalty in addition to possible physical, social, and psychological harm, both strongly depending on local jurisdiction.^[2] Other definitions of drug abuse fall into four main categories: public health definitions, mass communication and vernacular usage, medical definitions, and political and criminal justice definitions. Substance abuse is prevalent with an estimated 50 million users of hard drugs such as cocaine, heroin and other synthetic drugs.

Substance abuse is a form of substance-related disorder.

Classification[link]

Public health definitions[link]

Public health practitioners have attempted to look at drug abuse from a broader perspective than the individual, emphasizing the role of society, culture and availability. Rather than accepting the loaded terms alcohol or drug "abuse," many public health professionals have adopted phrases such as "substance and alcohol type problems" or "harmful/problematic use" of drugs.

The Health Officers Council of British Columbia — in their 2005 policy discussion paper, A Public Health Approach to Drug Control in Canada — has adopted a public health model of psychoactive substance use that challenges the simplistic black-and-white construction of the binary (or complementary) antonyms "use" vs. "abuse". This model explicitly recognizes a spectrum of use, ranging from beneficial use to chronic dependence (see diagram to the right).

Medical definitions[link]

In the modern medical profession, the three most used diagnostic tools in the world, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM),the World Health Organization's International Statistical Classification of Diseases and ICRIS Medical organization Related Health Problems (ICD), no longer recognize 'drug abuse' as a current medical diagnosis. Instead, DSM has adopted substance abuse^[3] as a blanket term to include drug abuse and other things. ICD refrains from using either substance abuse or drug abuse, instead using the term "harmful use" to cover physical or psychological harm to the user from use. Physical dependence, abuse of, and withdrawal from drugs and other miscellaneous substances is outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) ). Its section Substance dependence begins with:

Substance dependence When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed. Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped. These, along with Substance Abuse are considered Substance Use Disorders…

—^[3]

However, other definitions differ; they may entail psychological or physical dependence,^[3] and may focus on treatment and prevention in terms of the social consequences of substance uses.

Drug misuse[link]

Drug misuse is a term used commonly for prescription medications with clinical efficacy but abuse potential and known adverse effects linked to improper use, such as psychiatric medications with sedative, anxiolytic, analgesic, or stimulant properties. Prescription misuse has been variably and inconsistently defined based on drug prescription status, the uses that occur without a prescription, intentional use to achieve intoxicating effects, route of administration, co-ingestion with alcohol, and the presence or absence of abuse or dependence symptoms.^[4][5] Tolerance relates to the pharmacological property of substances in which chronic use leads to a change in the central nervous system, meaning that more of the substance is needed in order to produce desired effects. Stopping or reducing the use of this substance would cause withdrawal symptoms to occur.^[6]

As a value judgment[link]

Legal drugs are not necessarily safer. A study in 2010 asked drug-harm experts to rank various illegal and legal drugs. Alcohol was found to be the most dangerous by far.

Philip Jenkins points out that there are two issues with the term "drug abuse". First, what constitutes a "drug" is debatable. For instance, GHB, a naturally occurring substance in the central nervous system is considered a drug, and is illegal in many countries, while nicotine is not officially considered a drug in most countries. Second, the word "abuse" implies a recognized standard of use for any substance. Drinking an occasional glass of wine is considered acceptable in most Western countries, while drinking several bottles is seen as an abuse. Strict temperance advocates, which may or may not be religiously motivated, would see drinking even one glass as an abuse, and some groups even condemn caffeine use in any quantity. Similarly, adopting the view that any (recreational) use of marijuana or amphetamines constitutes drug abuse implies that we have already decided that the substance is harmful, even in minute quantities.^[7]

Signs and symptoms[link]

Depending on the actual compound, drug abuse including alcohol may lead to health problems, social problems, morbidity, injuries, unprotected sex, violence, deaths, motor vehicle accidents, homicides, suicides, physical dependence or psychological addiction.^[8]

There is a high rate of suicide in alcoholics and other drug abusers. The reasons believed to cause the increased risk of suicide include the long-term abuse of alcohol and other drugs causing physiological distortion of brain chemistry as well as the social isolation. Another factor is the acute intoxicating effects of the drugs may make suicide more likely to occur. Suicide is also very common in adolescent alcohol abusers, with 1 in 4 suicides in adolescents being related to alcohol abuse.^[9] In the USA approximately 30 percent of suicides are related to alcohol abuse. Alcohol abuse is also associated with increased risks of committing criminal offences including child abuse, domestic violence, rapes, burglaries and assaults.^[10]

Drug abuse, including alcohol and prescription drugs can induce symptomatology which resembles mental illness. This can occur both in the intoxicated state and also during the withdrawal state. In some cases these substance induced psychiatric disorders can persist long after detoxification, such as prolonged psychosis or depression after amphetamine or cocaine abuse. A protracted withdrawal syndrome can also occur with symptoms persisting for months after cessation of use. Benzodiazepines are the most notable drug for inducing prolonged withdrawal effects with symptoms sometimes persisting for years after cessation of use. Abuse of hallucinogens can trigger delusional and other psychotic phenomena long after cessation of use and cannabis may trigger panic attacks during intoxication and with use it may cause a state similar to dysthymia^{[citation needed]}. Severe anxiety and depression are commonly induced by sustained alcohol abuse which in most cases abates with prolonged abstinence. Even moderate alcohol sustained use may increase anxiety and depression levels in some individuals. In most cases these drug induced psychiatric disorders fade away with prolonged abstinence.^[11]

Drug abuse makes central nervous system (CNS) effects, which produce changes in mood, levels of awareness or perceptions and sensations. Most of these drugs also alter systems other than the CNS. Some of these are often thought of as being abused. Some drugs appear to be more likely to lead to uncontrolled use than others.^[12]

Traditionally, new pharmacotherapies are quickly adopted in primary care settings, however; drugs for substance abuse treatment have faced many barriers. Naltrexone, a drug originally marketed under the name "ReVia," and now marketed in intramuscular formulation as "Vivitrol" or in oral formulation as a generic, is a medication approved for the treatment of alcohol dependence. This drug has reached very few patients. This may be due to a number of factors, including resistance by Addiction Medicine specialists and lack of resources.^[13]

The ability to recognize the signs of drug use or the symptoms of drug use in family members by parents and spouses has been affected significantly by the emergence of home drug test technology which helps identify recent use of common street and prescription drugs with near lab quality accuracy.

Epidemiology[link]

Disability-adjusted life year for drug use disorders per 100,000 inhabitants in 2002.

  no data

  less than 40

  40-80

  80-120

  120-160

  160-200

  200-240

  240-280

  280-320

  320-360

  360-400

  400-440

  more than 440

The initiation of drug and alcohol use is most likely to occur during adolescence, and some experimentation with substances by older adolescents is common. For example, results from 2010 Monitoring the Future survey, a nationwide study on rates of substance use in the United States, show that 48.2% of 12th graders report having used an illicit drug at some point in their lives.^[14] In the 30 days prior to the survey, 41.2% of 12th graders had consumed alcohol and 19.2% of 12th graders had smoked tobacco cigarettes.^[14] In 2009 in the United States about 21% of high school students have taken prescription drugs without a prescription.^[15] And earlier in 2002, the World Health Organization estimated that around 140 million people were alcohol dependent and another 400 million suffered alcohol-related problems.^[16]

Studies have shown that the large majority of adolescents will phase out of drug use before it becomes problematic. Thus, although rates of overall use are high, the percentage of adolescents who meet criteria for substance abuse is significantly lower (close to 5%).^{[citation needed]} According to BBC, "Worldwide, the UN estimates there are more than 50 million regular users of morphine diacetate (heroin), cocaine and synthetic drugs."^[17]

Total recorded alcohol per capita consumption (15+), in litres of pure alcohol^[18]

History[link]

APA, AMA, and NCDA[link]

In 1932, the American Psychiatric Association created a definition that used legality, social acceptability, and cultural familiarity as qualifying factors:

…as a general rule, we reserve the term drug abuse to apply to the illegal, nonmedical use of a limited number of substances, most of them drugs, which have properties of altering the mental state in ways that are considered by social norms and defined by statute to be inappropriate, undesirable, harmful, threatening, or, at minimum, culture-alien."

^[19]

In 1966, the American Medical Association's Committee on Alcoholism and Addiction defined abuse of stimulants (amphetamines, primarily) in terms of 'medical supervision':

…'use' refers to the proper place of stimulants in medical practice; 'misuse' applies to the physician's role in initiating a potentially dangerous course of therapy; and 'abuse' refers to self-administration of these drugs without medical supervision and particularly in large doses that may lead to psychological dependency, tolerance and abnormal behavior.

In 1973, the National Commission on Marijuana and Drug Abuse stated:

...drug abuse may refer to any type of drug or chemical without regard to its pharmacologic actions. It is an eclectic concept having only one uniform connotation: societal disapproval. ... The Commission believes that the term drug abuse must be deleted from official pronouncements and public policy dialogue. The term has no functional utility and has become no more than an arbitrary codeword for that drug use which is presently considered wrong.^[20]

DSM[link]

The first edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (published in 1952) grouped alcohol and drug abuse under Sociopathic Personality Disturbances, which were thought to be symptoms of deeper psychological disorders or moral weakness.

The third edition, published in 1980, was the first to recognize substance abuse (including drug abuse) and substance dependence as conditions separate from substance abuse alone, bringing in social and cultural factors. The definition of dependence emphasised tolerance to drugs, and withdrawal from them as key components to diagnosis, whereas abuse was defined as "problematic use with social or occupational impairment" but without withdrawal or tolerance.

In 1987, the DSM-IIIR category "psychoactive substance abuse," which includes former concepts of drug abuse is defined as "a maladaptive pattern of use indicated by...continued use despite knowledge of having a persistent or recurrent social, occupational, psychological or physical problem that is caused or exacerbated by the use (or by) recurrent use in situations in which it is physically hazardous." It is a residual category, with dependence taking precedence when applicable. It was the first definition to give equal weight to behavioural and physiological factors in diagnosis.

By 1988, the DSM-IV defines substance dependence as "a syndrome involving compulsive use, with or without tolerance and withdrawal"; whereas substance abuse is "problematic use without compulsive use, significant tolerance, or withdrawal." Substance abuse can be harmful to your health and may even be deadly in certain scenarios

By 1994, The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association, the DSM-IV-TR, defines substance dependence as "when an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed." followed by criteria for the diagnose^[3]

DSM-IV-TR defines substance abuse as:^[21]

• A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:

1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household)
2. Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
3. Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)

• B. The symptoms have never met the criteria for Substance Dependence for this class of substance.

The fifth edition of the DSM (DSM-5), planned for release in 2013, is likely to have this terminology revisited yet again. Under consideration is a transition from the abuse/dependence terminology. At the moment, abuse is seen as an early form or less hazardous form of the disease characterized with the dependence criteria. However, the APA's 'dependence' term, as noted above, does not mean that physiologic dependence is present but rather means that a disease state is present, one that most would likely refer to as an addicted state. Many involved recognize that the terminology has often led to confusion, both within the medical community and with the general public. The American Psychiatric Association requests input as to how the terminology of this illness should be altered as it moves forward with DSM-5 discussion.

Society and culture[link]

Legal approaches[link]

Related articles: Drug control law, Prohibition (drugs), Arguments for and against drug prohibition

Most governments have designed legislation to criminalize certain types of drug use. These drugs are often called "illegal drugs" but generally what is illegal is their unlicensed production, distribution, and possession. These drugs are also called "controlled substances". Even for simple possession, legal punishment can be quite severe (including the death penalty in some countries). Laws vary across countries, and even within them, and have fluctuated widely throughout history.

Attempts by government-sponsored drug control policy to interdict drug supply and eliminate drug abuse have been largely unsuccessful. In spite of the huge efforts by the U.S., drug supply and purity has reached an all time high, with the vast majority of resources spent on interdiction and law enforcement instead of public health.^[22][23] In the United States, the number of nonviolent drug offenders in prison exceeds by 100,000 the total incarcerated population in the EU, despite the fact that the EU has 100 million more citizens.^{[citation needed]}

Despite drug legislation (or perhaps because of it), large, organized criminal drug cartels operate worldwide. Advocates of decriminalization argue that drug prohibition makes drug dealing a lucrative business, leading to much of the associated criminal activity.

Cost[link]

It is important to obtain estimates of the costs of problems stemming from substance abuse. In order to make informed decisions when allocating scarce resources, policymakers must have a sound understanding of the relative costs of drug-related interventions. Other things being equal, the lower the cost, the more cost-effective a program or intervention will be, or the higher the net economic benefits it will generate. An appropriate drug policy relies on the assessment of drug related public expenditure on efficiency grounds. This is not feasible without giving a preliminary clear and well-defined classification system where costs are properly identified.

Labelled drug-related expenditures are defined as the direct ex-ante planned spending that reflects the voluntary engagement of the state in the field of illicit drugs. Direct public expenditures explicitly labeled as drug-related can be easily traced back by exhaustively reviewing official accountancy documents such as national budgets and year-end reports. Unlabelled expenditure refers to unplanned spending and is estimated through modeling techniques, based on a top-down budgetary procedure. Starting from overall aggregated expenditures, this procedure estimates the proportion causally attributable to substance abuse (Unlabelled Drug-related Expenditure = Overall Expenditure × Attributable Proportion). For example, to estimate the prison drug-related expenditures in a given country, two elements would be necessary: the overall prison expenditures in the country for a given fiscal year, and the attributable proportion of inmates due to drug-related issues. The product of the two will give a rough estimate that can be compared across different countries.^[24]

Europe[link]

As part of the reporting exercise corresponding to 2005, the European Monitoring Centre for Drugs and Drug Addiction's network of national focal points set up in the 27 European Union (EU) Member States, Norway, and the candidates countries to the EU, were requested to identify labeled drug-related public expenditure, at the country level.^[24]

This was reported by 10 countries categorized according to the functions of government, amounting to a total of EUR 2.17 billion. Overall, the highest proportion of this total came within the government functions of Health (66%) (e.g. medical services), and Public Order and Safety (POS) (20%) (e.g. police services, law courts, prisons). By country, the average share of GDP was 0.023% for Health, and 0.013% for POS. However, these shares varied considerably across countries, ranging from 0.00033% in Slovakia, up to 0.053% of GDP in Ireland in the case of Health, and from 0.003% in Portugal, to 0.02% in the UK, in the case of POS; almost a 161-fold difference between the highest and the lowest countries for Health, and a 6-fold difference for POS. Why do Ireland and the UK spend so much in Health and POS, or Slovakia and Portugal so little, in GDP terms?

To respond to this question and to make a comprehensive assessment of drug-related public expenditure across countries, this study compared Health and POS spending and GDP in the 10 reporting countries. Results found suggest GDP to be a major determinant of the Health and POS drug-related public expenditures of a country. Labelled drug-related public expenditure showed a positive association with the GDP across the countries considered: r = 0.81 in the case of Health, and r = 0.91 for POS. The percentage change in Health and POS expenditures due to a one percent increase in GDP (the income elasticity of demand) was estimated to be 1.78% and 1.23% respectively.

Being highly income elastic, Health and POS expenditures can be considered luxury goods; as a nation becomes wealthier it openly spends proportionately more on drug-related health and public order and safety interventions.^[24]

UK[link]

The UK Home Office estimated that the social and economic cost of drug abuse^[25] to the UK economy in terms of crime, absenteeism and sickness is in excess of £20 billion a year.^[26] However, it^{[clarification needed]} does not estimate what portion of those crimes are unintended consequences of drug prohibition (crimes to sustain expensive drug consumption, risky production and dangerous distribution), nor what is the cost of enforcement. Those aspects are necessary for a full analysis of the economics of prohibition.^[27]

The Home Office has a recent history of taking a hard line on controlled drugs, including those with no known fatalities and even medical benefits,^[28] in direct opposition to the scientific community.^[29]

US[link]

In the year 1995, drug abuse cost the American economy $109.8 billion.^[13]

Treatment[link]

Treatment for substance abuse is critical for many around the world. Often a formal intervention is necessary to convince the substance abuser to submit to any form of treatment. Behavioral interventions and medications exist that have helped many people reduce, or discontinue, their substance abuse. From the applied behavior analysis literature, behavioral psychology, and from randomized clinical trials, several evidenced based interventions have emerged:

• Behavioral marital therapy
• Motivational Interviewing
• Community reinforcement approach
• Exposure therapy
• Contingency management^[30][31]
• Pharmacological therapy - A number of medications have been approved for the treatment of substance abuse.^{[citation needed]} These include replacement therapies such as buprenorphine and methadone as well as antagonist medications like disulfiram and naltrexone in either short acting, or the newer long acting form (under the brand name Vivitrol). Several other medications, often ones originally used in other contexts, have also been shown to be effective including bupropion (Zyban or Wellbutrin), Modafinil (Provigil) and more.

According to some nurse practitioners, stopping substance abuse can reduce the risk of dying early and also reduce some health risks like heart disease, lung disease, and strokes.^[32]

In children and adolescents, cognitive behavioral therapy (CBT) ^[33] and family therapy ^[34] currently have the most research evidence for the treatment of substance abuse problems. These treatments can be administered in a variety of different formats, each of which has varying levels of research support ^[35]

It has been suggested that social skills training adjunctive to inpatient treatment of alcohol dependence is probably efficacious,^[36] including managing the social environment.^[37]

See also[link]

• Addictive personality
• Combined drug intoxication
• Drug addiction
• Drug overdose
• Harm reduction
• Low-threshold treatment programs
• Needle-exchange programme
• Poly drug use
• Polysubstance abuse
• Risk factors in pregnancy
• List of controlled drugs in the United Kingdom
• List of drug-related deaths
• Self-medication
• Substances controlled for their drug effects by the US federal government

Notes[link]

Further reading[link]

• Lowinson, Joyce H; Ruiz, Pedro; Millman, Robert B; Langrod, John G (eds) (2005). Substance Abuse: A Comprehensive Textbook (4th ed.). Philadelphia: Lippincott Williams & Wilkins. ISBN 0-7817-3474-6. http://books.google.com/books?id=HtGb2wNsgn4C&printsec=frontcover&dq=substance+comprehensive+textbook#v=onepage&q&f=false. Retrieved 2 December 2010 

External links[link]

• Substance abuse at the Open Directory Project

v t e Recreational drug use Major recreational drugs Opioids Buprenorphine (Subutex · Suboxone) Codeine Dextropropoxyphene (Darvon · Darvocet) Diamorphine (heroin) \ Morphine (Opium) Hydrocodone Hydromorphone (Dilaudid) Methadone Mitragyna speciosa (Kratom) Oxycodone Depressants Barbiturates Benzodiazepines Ethanol (Alcoholic beverages) GHB Kava Nonbenzodiazepines Stimulants Amphetamine Arecoline (Areca) Betel Caffeine (Coffee Tea) Cathinone (Khat) Cocaine (Coca) Ephedrine (Ephedra) Mephedrone Methamphetamine Methylphenidate Nicotine (Tobacco) Theobromine (Cocoa) Entactogens MDA MDMA (Ecstasy) Hallucinogens Psychedelics Bufotenin Psychoactive toads Vilca Yopo DMT (Ayahuasca) LSA LSD-25 Mescaline Peruvian Torch Peyote San Pedro Psilocybin \ Psilocin (Psilocybin mushrooms) Dissociatives DXM Inhalants Nitrous oxide alkyl nitrites – poppers, such as amyl nitrite Ketamine MXE Muscimol (Amanita muscaria) PCP Salvinorin A (Salvia divinorum) Deliriants Atropine and Scopolamine Datura Deadly Nightshade Henbane Mandrake Dimenhydrinate Diphenhydramine Cannabinoids JWH-018 THC (Cannabis Hashish Hash oil) Oneirogens Calea zacatechichi Silene capensis Drug culture Cannabis 420 Cannabis cultivation Cannabis smoking Legal history of cannabis in the United States Legality of cannabis Marijuana Policy Project Medical cannabis NORML Religious and spiritual use of cannabis Stoner film Psychedelic Art Drug Experience Literature Music Other Club drug Counterculture of the 1960s Dance party Drug paraphernalia Drug tourism Entheogen Hippie Party and play Poly drug use Rave Self-medication Sex and drugs Problems with drug use Abuse Dependence Prevention Opioid replacement therapy Rehabilitation Responsible use Drug-related crime Fetal alcohol spectrum disorder Illegal drug trade Long-term effects of cannabis Neurotoxicity Overdose Date-rape drug Passive smoking (of tobacco or other substances) Legality of drug use International 1961 Narcotic Drugs 1971 Psychotropic Substances 1988 Drug Trafficking Cannabis reform at the international level State level Drug policy Decriminalization Prohibition Supply reduction Policy reform Demand reduction Drug Policy Alliance Harm reduction Law Enforcement Against Prohibition Liberalization Students for Sensible Drug Policy Transform Drug Policy Foundation Drug policy by country Australia Canada Germany India Netherlands Portugal Sweden Switzerland Soviet Union United States Just Say No Office of National Drug Control Policy School district drug policies California Colorado Maryland Virginia Other Arguments for and against drug prohibition Capital punishment for drug trafficking Designer drug Drug court Drug possession Drug test Hard and soft drugs Illegal drug trade in Colombia Mexican Drug War Narc Opium production in Afghanistan Politics of drug abuse War on Drugs Zero tolerance Lists of countries by... Alcohol consumption Cannabis legality Annual use Lifetime use Cigarette consumption Cocaine use Opiates use

Russell Brand
Russell Brand at the premiere for Arthur in 2011
Birth name	Russell Edward Brand[1]
Born	(1975-06-04) 4 June 1975 (age 37) Grays, Essex, England, UK
Medium	Stand-up, television, film, radio
Nationality	British
Years active	1994–present
Genres	Observational comedy
Influences	Richard Pryor,[2] Bill Hicks,[2] Peter Cook, Lenny Bruce, Tony Hancock, Jack Kerouac, Stewart Lee[3]
Spouse	Katy Perry (m. 2010–2012)
Website	russellbrand.tv

Russell Edward Brand (born 4 June 1975)^[4] is an English comedian, actor, columnist, singer, author and radio/television presenter.

Brand achieved mainstream fame in the UK in 2004 for his role as host of Big Brother spin-off, Big Brother's Big Mouth. His first major film role was in the 2007 film St Trinian's. He became known to American audiences when he got a major role in Forgetting Sarah Marshall which led to a starring role in 2010's Get Him to the Greek. He has also been a voice actor for animated films such as 2010's Despicable Me and the 2011 film Hop. He starred in the 2011 remake of the 1981 Dudley Moore film Arthur.

Brand is noted for his eccentricity and his controversies in the British media, including his dismissal from MTV for dressing up as Osama bin Laden and controversies while presenting at various award ceremonies, as well as his former substance abuse. The 2008 prank telephone calls he made to Andrew Sachs while co-hosting The Russell Brand Show with Jonathan Ross led to his resignation from the BBC and major policy changes in that organisation. His prior drug use, alcoholism and promiscuity influenced his comedic material and public image. He married American pop singer Katy Perry in October 2010, and filed for divorce from her in December 2011; the divorce was finalised in 2012.

Early life[link]

Brand was born in Orsett Hospital, Grays, Essex, England, the only child of Barbara Elizabeth (née Nichols) and photographer Ronald Henry Brand.^[5] Brand's parents separated when he was six months old, and he was raised by his mother; he has described his childhood as isolated and lonely.^[6] When Brand was seven, he was sexually abused by a tutor.^[7] When Brand was eight, his mother contracted uterine cancer; a year later she contracted breast cancer.^[8] Brand stayed with relatives while his mother underwent treatment.^[8] When Brand was 14, he suffered from bulimia nervosa. He left home at age 16 because of differences with his mother's live-in partner.^[8] His mother had lymphoma during this time and he began using illegal drugs such as cannabis, amphetamines, LSD and ecstasy.^[8][9] According to an interview on National Public Radio's Weekend Edition Saturday Brand had "a strange relationship with his father, whom he saw sporadically and who took him to visit prostitutes during a trip to the Far East".^[10] After Brand's parents divorced, his father remarried twice.^[11]

Brand attended Grays School Media Arts College, a comprehensive. He made his theatrical debut at the age of 15, playing the role of Fat Sam in a school production of Bugsy Malone, which prompted him to become an actor. He began working as an extra, and applied to study at the Italia Conti Academy. He was accepted, and Essex council funded his tuition for an introductory year, with potential funding for three additional years. Brand joined the Academy in 1991, but was expelled during his introductory year for his bad behaviour and use of drugs. Afterward, Brand had small acting roles in children's show Mud and police drama The Bill.

In 1995, Brand applied for the Royal Academy of Dramatic Art and Drama Centre London and was accepted to Drama Centre. He was expelled in the final term of his last year for smashing a glass over his head and then stabbing himself in the chest and arms after his hearing a criticism of his performance. After leaving Drama Centre, Brand decided to focus on comedy, and began writing material with Karl Theobald.

Career[link]

Stand-up[link]

Brand's first significant stand-up appearance was at the Hackney Empire New Act of the Year final in 2000. Although he finished fourth, his performance attracted the attention of an agent, Nigel Klarfeld of Gagged and Bound Comedy Ltd.^[12] That year, he also made his Edinburgh debut as one-third of the stand-up show Pablo Diablo's Cryptic Triptych, alongside ventriloquist Mark Felgate and Anglo-Iranian comic Shappi Khorsandi.

Brand performs stand-up at the London Roundhouse, 25 January 2008

In 2004, he took his first one-man show, the confessional Better Now to the Edinburgh Festival, giving an honest account of his heroin addiction. He returned the following year with Eroticised Humour. He launched his first nationwide tour, Shame, in 2006. Brand drew on embarrassing incidents in his own life and the tabloid press's treatment of him since he became famous. The show was released on DVD as Russell Brand: Live.

Brand appeared in a sketch and performed stand-up at the 2006 Secret Policeman's Ball. In March 2007, he co-hosted an evening of the Teenage Cancer Trust gigs with Noel Fielding. In December 2007, Brand performed for HM Queen Elizabeth II and HRH Prince Philip as an act in the 2007 Royal Variety Performance.

His second nationwide tour, in 2007, was called Russell Brand: Only Joking and released on DVD as Russell Brand: Doin' Life.

Brand began performing in the US, and recorded a special for Comedy Central titled Russell Brand in New York, which aired in March 2009.^[13] Brand began touring the UK, America and Australia from January to April 2009 on a tour called Russell Brand: Scandalous.^[14] In October, a further four dates that were performed in November were added to raise money for Focus 12, the drug charity for which Brand is a patron.^[15] Russell Brand: Scandalous was released on DVD on 9 November 2009.

Presenting[link]

Brand's first presenting role came in 2000 as a video journalist on MTV. He presented Dancefloor Chart, touring nightclubs in Britain and Ibiza, and hosted the tea-time request show Select. However, Brand was fired after coming to work dressed as Osama bin Laden the day after the 11 September 2001 attacks and bringing his drug dealer to the MTV studios.^[16]

After leaving MTV, Brand starred in RE:Brand, a British documentary and comedy television programme that aimed to take a challenging look at cultural taboos. It was conceived, written, and hosted by Brand, with the help of his comic partner on many projects, Matt Morgan. The series was shown on the now-defunct digital satellite channel UK Play in 2002.

In 2004, he hosted Big Brother's Eforum on E4, a sister show to Big Brother 5. The show gave celebrity guests and the public the chance to have their say on the goings-on inside the Big Brother house. For Big Brother 6, the show's name changed to Big Brother's Big Mouth. Following Celebrity Big Brother 5, Brand said he would not return to host the Big Brother 8 series of Big Brother's Big Mouth. In a statement, Brand thanked all the producers for "taking the risk of employing an ex-junkie twerp" to front the show. Of his time presenting the show, he said, "The three years I've spent on Big Brother's Big Mouth have been an unprecedented joy".^[17]

Brand hosted a one-off special called Big Brother According to Russell Brand, in which Brand took a surreal, sideways look at Big Brother through the ages. On 8 January 2008, Brand was the fifth celebrity to "hijack" the Big Brother house,^[18] in the E4 show Big Brother: Celebrity Hijack. Brand next returned to MTV in the spring of 2006 as presenter of the chat show 1 Leicester Square, which initially aired at 8 pm on Sundays before being shifted to a post-watershed time of 10 pm on Mondays, allowing for a more adult-oriented theme. Guests have included Tom Cruise, Uma Thurman, The Mighty Boosh, and Boy George. A second series began in September 2006 on MTV UK. After Big Brother 7 finished, Brand presented a debate show called Russell Brand's Got Issues, on digital channel E4. The viewing figures for the first episode were seen as disappointing, being beaten by nearly all of E4's main multi-channel rivals despite a big publicity and promotional campaign for the show. The poor ratings prompted the network to repackage the show as The Russell Brand Show and move it to Channel 4.^[19] The first episode was broadcast on 24 November on Channel 4,^[20] and it ran for five weeks.

Brand presented the 2006 NME Awards. At the ceremony Bob Geldof, who was accepting an award from Brand, said at the podium, "Russell Brand – what a cunt", to which Brand replied, "Really it's no surprise [Geldof]'s such an expert on famine. He has after all been dining out on 'I Don't Like Mondays' for 30 years".^[21] Brand hosted the 2007 BRIT Awards and presented Oasis with an "Outstanding Contribution to Music" award at the event.^[22] He also hosted one hour of Comic Relief. On 7 July 2007, he presented at the UK leg of Live Earth at Wembley Stadium, London.

Brand speaking with Courtney Love in Los Angeles, 2008

On 12 December 2007, BBC Four aired Russell Brand On the Road, a documentary presented by Brand and Matt Morgan about the writer Jack Kerouac and his novel On the Road. Brand returned to Channel 4 to host Russell Brand's Ponderland, in which he discussed topics like childhood and science through stand-up comedy. The show first aired on 22 October 2007, and continued for the next five nights. A second series began on 30 October 2008, drawing more than a million viewers, and was broadcast every Thursday night for four weeks, plus a Christmas special that aired in December.