SUBSTANCE USE DISORDER(SUD)

Substance use disorder is a health condition involving compulsive substance use. It develops when substance use interferes with the ability to function day to day. It can occur with prescription or nonprescription drugs.

Medical professionals previously used the term “drug abuse” to describe substance use disorder. Another term for substance use disorder is addiction. This differs from dependence.

Substance misuse greatly affects public health.

Substance misuse also leads to other public health problems, such as:

• Drunk and impaired driving
• Violence
• Familial stress
• Potential for child abuse and neglect

Sharing or reusing needles for intravenous drug use also increases the risk of contracting and transmitting infectious diseases, including HIV and hepatitis.

The American Psychiatric Association (APA) describes substance use disorder as a brain disease. It’s characterized by repeated substance use despite negative effects. Substance use disorder involves many social and biological factors.

RISK FACTORS

Substance misuse and addiction can affect anyone. However, there are some things that may increase the chance of developing a substance use disorder.

As is the case with many conditions, genetics play a key role in addiction. Research indicates that genetic factors may be responsible for 40 to 60 percent of an individual’s susceptibility to developing a substance use disorder.

Other risk factors for developing substance misuse issues include:

• Physical, sexual, or emotional abuse
• Exposure to trauma
• Family members or peers who use or misuse substances
• Access to these substances
• Mental health disorders, such as:
  • Depression
  • Anxiety
  • Eating disorders
  • Personality disorders                

SYMPTOMS

• Feeling that you have to use the drug regularly — daily or even several times a day
• Having intense urges for the drug that block out any other thoughts
• Over time, needing more of the drug to get the same effect
• Taking larger amounts of the drug over a longer period of time than you intended
• Make certain that you maintain a supply of the drug
• Spending money on the drug, even though you can’t afford it
• Not meeting obligations and work responsibilities, or cutting back on social or recreational activities because of drug use
• Continuing to use the drug, even though you know it’s causing problems in your life or causing you physical or psychological harm
• Doing things to get the drug that you normally wouldn’t do, such as stealing
• Driving or doing other risky activities when you’re under the influence of the drug
• Spending a good deal of time getting the drug, using the drug, or recovering from the effects of the drug
• Failing in your attempts to stop using the drug
• Experiencing withdrawal symptoms when you attempt to stop taking the drug

CAUSES

Like many mental health disorders, several factors may contribute to the development of drug addiction. The main factors are:

• Environmental factors, including your family’s beliefs and attitudes and exposure to a peer group that encourages drug use, seem to play a role in initial drug use.
• Once you’ve started using a drug, the development into addiction may be influenced by inherited (genetic) traits, which may delay or speed up the disease progression.

COMPLICATIONS

The complications of substance use disorder are broad and may depend on the type of substance use.

Substance use disorder can impact multiple systems of your body, including your:

• Nervous system, including psychiatric impacts.
• Cardiovascular system.
• Endocrine system.
• Immune system.
• Hepatic (liver) system.

Specific chronic and acute complications can include:

• Memory loss and overall cognitive issues.
• Personality changes and mood dysregulation.
• Loss of nerve function.
• Stroke.
• Seizures.
• Heart failure.
• Nasal septal perforation.
• Respiratory depression.
• Liver failure.
• Certain cancers. For example, alcohol use disorder is associated with cancers of the mouth, throat, esophagus, liver, colon, and breast.
• Blood-borne virus infections, such as hepatitis B (HBV), hepatitis C (HCV)and the human immunodeficiency virus (HIV) from using shared injection equipment.
• Overdose.
• Coma.
• Death.

DIAGNOSIS

• Diagnosing drug addiction (substance use disorder) requires a thorough evaluation and often includes an assessment by a psychiatrist, a psychologist, or a licensed alcohol and drug counselor. Blood, urine, or other lab tests are used to assess drug use, but they’re not diagnostic test for addiction. However, these tests may be used for monitoring treatment and recovery.
• For diagnosis of a substance use disorder, most mental health professionals use criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

TREATMENT

Effective treatments are available for substance use disorder. Treatment is highly individualized — one person may need different types of treatment at different times.

Treatment for SUD often requires continuing care to be effective, as SUD is a chronic condition with the potential for both recovery and relapse.

As people with SUD often have co-occurring mental health conditions, treating them together rather than separately is generally better.

The three main forms of treatment include:

• Detoxification– In detoxification, you stop taking the substance(s), allowing them to leave your body. Depending on the severity of the SUD, the substance or an alternative may be tapered off to lessen the effects of withdrawal. It’s the first major step of treatment for SUD. You can go through detoxification in both inpatient and outpatient settings.
• Cognitive and behavioral therapies (CBT)–is a structured, goal-oriented type of psychotherapy. A mental health professional helps you look closely at your thoughts and emotions during CBT. You’ll come to understand how your thoughts affect your actions. You can unlearn negative thoughts and behaviors through CBT and learn to adopt healthier thinking patterns and habits. CBT also involves encouraging motivation to change and education about treatment and preventing relapse
• Medication-assisted therapies-Medication may be part of your treatment plan. Medications can help modify your brain chemistry to help treat certain SUDs. They can also relieve cravings and withdrawal symptoms. Which include :
• Opioids: Methadone, buprenorphine, and naltrexone are FDA-approved for the treatment of opioid use disorder.
• Alcohol: Three FDA-approved drugs include naltrexone, acamprosate, and disulfiram.
• Tobacco: A nicotine patch, spray, gum, or lozenge can help. Or your provider might prescribe bupropion or varenicline
• There are also several different types of treatment settings, including:
• Outpatient counseling.
• Intensive outpatient treatment.
• Inpatient treatment.

OUTLOOK

• Substance abuse is a complicated mental health and neurological problem.
• Alcohol, stimulants, and painkillers all have an effect on your brain, including your decision-making capacity.
• Even if you want to, these modifications make it difficult to stop using the chemical.
• The most successful way to prevent substance use disorder is through education.

If you or a loved one has a substance use disorder, seek treatment as soon as possible. A healthcare provider can help you find the treatment you require.