Definition

A substance use disorder refers to the ongoing use of a substance or drug even when faced with physical, emotional, or social harm.

Substances that are commonly misused include:

  • Caffeine
  • Tobacco
  • Alcohol
  • Marijuana
  • Methamphetamine (crystal meth, speed)
  • Cocaine
  • Heroin
  • Morphine
  • LSD
  • PCP
  • Ecstasy
  • GHB
  • Ketamine
  • Inhalants
  • Prescription medications that are used improperly such as steroids, opioid pain relievers, sedatives, sleeping pills, or amphetamines.

The addictive potential of each drug is different.

Causes

The exact cause of substance abuse disorder is unknown, but there are many theories. For example, some people may inherit certain genes that make them more likely to misuse substances. Another theory is that people learn how to use substances by copying the behavior of others, especially their parents. Also, changes that happen in the brain due to long-term use that may reinforce a person's desire to keep using the substance.

Chemical Release in Brain

neurotransmitter
Drugs stimulate unnecessary chemical release in the brain. Long-term drug use may change brain function.
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Risk Factors

Substance use disorder is more common in young men, but can occur in anyone at any age. Other factors that may increase the chances of substance use disorder:

  • Family members with substance use problems
  • Mental health conditions such as post-traumatic stress disorder, anxiety, depression, bipolar disorder, or panic disorder
  • Social and peer pressure to use substances, which may include spending time with other substance users
  • Early antisocial behavior such as breaking the law or repeated lying
  • Easy access to substances
  • Stress
  • Poor attachment to your parents or little parental supervision

Symptoms

Symptoms of substance use disorder include:

  • Poor ability to control substance use, including:
    • Taking the substance in much higher amounts for longer periods of time than intended
    • Inability to cut down or stop using the substance
    • Spending large amounts of time getting or using the substance, or recovering from using it
    • Craving the substance
  • Repeated work, school, home, or relationship problems due to substance use
  • Continued use of the substance even though it means risking physical safety, or knowing it will make existing physical or mental problems worse
  • Recurring trouble with the law related to substance use such as driving while under the influence of a substance or stealing to get the substance

Diagnosis

Your doctor will ask you about your symptoms and medical history. A physical exam will be done.

Your doctor will also ask about:

  • Your history of substance use
  • Emotional problems that may have occurred while using a substance
  • Problems with work, school, homelife, or the law

Your doctor may order blood or urine tests to check for the presence of substances.

Treatment

While there is no cure for substance use disorder, there are 3 main treatment goals:

  • To help you stop using the substance
  • Detoxification to decrease the toxic effects of the substances being used and to aid with symptoms of withdrawal
  • To prevent relapse

Successful treatment depends on you being able to recognize that you have a problem and having the desire to change. Recovery takes a long time. It is a difficult process. In some cases, you may need to go through treatment several times.

Treatment options may involve one or more of the following:

Medication may be recommended to help relieve withdrawal symptoms and reduce the risk of relapse.

Therapy can help raise your awareness of issues and lifestyle choices that lead you to misuse substances. Through therapy, you can improve your coping skills and problem-solving skills. You can also learn how to replace substance-using activities with healthier choices. It is also important that your family is involved in your treatment.

There are many organizations and support groups dedicated to helping people become substance-free. Two examples are the 12-step programs Narcotics Anonymous and Cocaine Anonymous. Members meet regularly to talk about their misuse problems and their recovery. They provide a network of support.

Prevention

To help reduce your chances of substance use disorder:

  • Learn about risks related to substance use.
  • Do not spend time with people who are misusing substances.
  • Learn ways to handle peer pressure.
  • Have a good relationship with your children to help reduce their risk of substance use disorder.
  • Seek therapy for post-traumatic stress disorder, anxiety, depression, and other mental health problems.