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Substance Abuse Disorders

Substance Abuse Disorders

Substance use disorders often involve behavioral patterns in which people continue to use a substance despite having problems with their use.

Substance use disorders often involve behavioral patterns in which people continue to use a substance despite having problems with their use.

Related substances tend to be members of the 10 classes of drugs that typically cause substance-related disorders:

  • Alcohol
  • Anxiety and sedative medications
  • Caffeine
  • Marijuana (including marijuana and synthetic cannabinoids)
  • Hallucinogens (including LSD, phencyclidine, and psilocybin)
  • Inhalants (such as thinners and some adhesives)
  • Opioids (including fentanyl, morphine, and oxycodone)
  • Stimulants (including amphetamines and cocaine)
  • Tobacco
  • Other (including anabolic steroids and other commonly abused substances)

All of these substances directly activate the brain’s reward system and produce a sense of pleasure. The activation can be so strong that people may crave the substance intensely. They may neglect normal activities to obtain and use the drug.Substance use disorders can develop regardless of whether a drug is legal, socially acceptable, or has an accepted medical use (prescription or over-the-counter). Details on specific drugs and their effects are discussed elsewhere in the GUIDE.

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The terms “addiction”, “abuse” and “addiction” have traditionally been used for people with substance use disorders. However, all of these terms are too loosely and variably defined to be very useful, and are also often used in a judgmental way. That’s why doctors now prefer to use the broader and less negative term “substance use disorder.”

Recreational and illegal substance use

Illegal drug use, while problematic from a legal standpoint, does not always involve a substance use disorder. On the other hand, legal substances such as alcohol and prescription drugs (and marijuana in a growing number of states in the United States) can be implicated in substance use disorder. Problems arising from prescription and illicit drug use cover all socioeconomic groups.

Recreational drug use has existed in one form or another for centuries. People have used drugs for a variety of reasons, including:

  • To change or improve mood
  • As part of religious ceremonies
  • To gain spiritual enlightenment
  • To improve performance

Substance Abuse Disorders Beaumont

People who take drugs recreationally can sometimes take them in relatively small doses, sometimes without harming themselves. That is, users do not develop drug withdrawal and the drug does not physically harm them (at least in the short term). Drugs that are generally considered recreational include opium, alcohol, nicotine, marijuana, caffeine, hallucinogenic mushrooms (see also Mushroom [Poisoning] Intoxication), and cocaine. Many recreational drugs are considered “natural” because they are close to their plant origins. They contain a mixture of low-concentration psychoactive ingredients rather than an isolated, more concentrated psychoactive compound.

Recreational drugs are usually taken orally or inhaled.

 

Substance use disorders often involve behavioral patterns in which people continue to use a substance despite having problems with their use.
Related substances tend to be members of the 10 classes of drugs that typically cause substance-related disorders:

• Alcohol
• Anxiety and sedative medications
• Caffeine
• Marijuana (including marijuana and synthetic cannabinoids)
• Hallucinogens (including LSD, phencyclidine, and psilocybin)
• Inhalants (such as thinners and some adhesives)
• Opioids (including fentanyl, morphine, and oxycodone)
• Stimulants (including amphetamines and cocaine)
• Tobacco
• Other (including anabolic steroids and other commonly abused substances)
All of these substances directly activate the brain’s reward system and produce a sense of pleasure. The activation can be so strong that people may crave the substance intensely. They may neglect normal activities to obtain and use the drug.Substance use disorders can develop regardless of whether a drug is legal, socially acceptable, or has an accepted medical use (prescription or over-the-counter). Details on specific drugs and their effects are discussed elsewhere in the GUIDE.

Contact:- Substance Abuse Disorders Beaumont

The terms “addiction”, “abuse” and “addiction” have traditionally been used for people with substance use disorders. However, all of these terms are too loosely and variably defined to be very useful, and are also often used in a judgmental way. That’s why doctors now prefer to use the broader and less negative term “substance use disorder.”
Recreational and illegal substance use
Illegal drug use, while problematic from a legal standpoint, does not always involve a substance use disorder. On the other hand, legal substances such as alcohol and prescription drugs (and marijuana in a growing number of states in the United States) can be implicated in substance use disorder. Problems arising from prescription and illicit drug use cover all socioeconomic groups.
Recreational drug use has existed in one form or another for centuries. People have used drugs for a variety of reasons, including:
• To change or improve mood
• As part of religious ceremonies
• To gain spiritual enlightenment
• To improve performance
People who take drugs recreationally can sometimes take them in relatively small doses, sometimes without harming themselves. That is, users do not develop drug withdrawal and the drug does not physically harm them (at least in the short term). Drugs that are generally considered recreational include opium, alcohol, nicotine, marijuana, caffeine, hallucinogenic mushrooms (see also Mushroom [Poisoning] Intoxication), and cocaine. Many recreational drugs are considered “natural” because they are close to their plant origins. They contain a mixture of low-concentration psychoactive ingredients rather than an isolated, more concentrated psychoactive compound.
Recreational drugs are usually taken orally or inhaled.

  • It is helpful to examine a range of psychological and physical symptoms
  • Emergency treatment for sudden mental problems
  • Creates effective treatment plans to help the patient move forward
  • Admission into hospitals
  • Educates patients about positive lifestyle changes
  • Medication for mental disorders that must be prescribed by a psychiatrist
  • Treatment for complex mental issues that are tough to diagnose
  • Help with suicidal thoughts or plans

Causes of Substance Use Disorders

People often progress from experimentation to occasional use and then to heavy use and sometimes to substance use disorder. This progress is complex and only partially understood. The process depends on the interactions between the drug, the user, and the environment.

Drugs-

Drugs in the 10 classes differ in their likelihood of causing a substance use disorder. Probability is called dependency liability. Dependency liability depends on a combination of factors including:

  • How to use the drug
  • How strongly does the drug stimulate the brain’s reward pathway?
  • How fast does the drug work
  • Ability of the drug to produce tolerance and/or withdrawal symptoms

Also, legal and/or readily available substances such as alcohol and tobacco are more likely to be used first. As people continue to use a substance, they generally see less risk in using it and may begin to increase their use and/or experiment with other substances. People’s perception of risk can also be affected by the social and legal consequences of use.

People are routinely prescribed opioids during treatment of a medical illness or following surgical or dental procedures. If people don’t take the full prescribed amount, drugs sometimes end up in the hands of people who want to use them recreationally. Since the use of these drugs for non-medical purposes has become a huge problem, many healthcare providers have responded.

  • Prescribing lower amounts of opioid medication
  • Encouraging people to safely store or dispose of leftover medication
  • Expanding prescription retrieval programs

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User-

Factors that may predispose users to substance use disorder include:

  • physical properties
  • Personal characteristics
  • Conditions and disorders

Physical characteristics likely involve genetic factors, but researchers have yet to find more than a few biochemical and/or metabolic differences between people who develop and do not develop a substance use disorder.

People with low levels of self-control (impulsivity) or high levels of risk-taking and novelty-seeking behaviors may be at higher risk of developing a substance use disorder. However, there is little scientific evidence to support the concept of “addictive personality” defined by some behavioral scientists.

A number of conditions and co-existing disorders appear to increase the risk of substance use disorder. For example,

  • People who are sad, emotionally distressed, or socially alienated may be temporarily relieved of drug use, which can lead to increased use and sometimes substance use disorder.
  • People with other unrelated mental disorders, such as anxiety or depression, have a higher risk of developing a substance use disorder. (Doctors use the term “dual diagnosis” to refer to people with both mental and substance use disorders.)
  • People with chronic pain often need opioid medications for relief. Some of these people later develop a substance use disorder.

However, for most of these people, nonopioid drugs and other treatments are not enough.

Setting-

Cultural and social factors are very important in initiating and maintaining (or relapsing to) substance use. Watching family members (eg, parents, older siblings) and peers using substances increases the risk that people will begin using substances. Peers are a particularly powerful influence among adolescents (see Substance Use and Abuse in Adolescents). People who are trying to stop using a substance find it much more difficult if they are around others who also use that substance.

Doctors may inadvertently contribute to harmful use of psychoactive drugs by overzealously prescribing them to relieve stress. Many social factors, including mass media, contribute to the expectation that drugs should be used to relieve all distress.

Symptoms

Symptoms and behaviors of drug use may include:

  • Confusion
  • Continuing to use drugs, even when health, work, or family are being harmed
  • Episodes of violence
  • Hostility when confronted about drug dependence
  • Lack of control over drug abuse, being unable to stop or reduce alcohol intake
  • Making excuses to use drugs
  • Missing work or school, or a decrease in performance
  • Need for daily or regular drug use to function
  • Neglecting to eat
  • Not caring about physical appearance
  • No longer taking part in activities because of drug abuse
  • Secretive behavior to hide drug use
  • Using drugs even when alone

Exams and Tests

Drug tests (toxicology screens) on blood and urine samples can show many chemicals and drugs in the body. How sensitive the test is depends on the drug itself, when the drug was taken, and the testing laboratory. Blood tests are more likely to find a drug than urine tests, though urine drug screens are done more often.

Treatment

Substance use disorder is a serious condition and not easy to treat. The best care and treatment involves trained professionals.

Treatment begins with recognizing the problem. Though denial is a common symptom of addiction, people who are addicted have far less denial if they are treated with empathy and respect, rather than told what to do or being confronted.

The substance may either be slowly withdrawn or stopped abruptly. Support for physical and emotional symptoms, as well as staying drug free (abstinence) are also key to treatment.

  • People with drug overdose may need emergency treatment in the hospital. The exact treatment depends on the drug used.
  • Detoxification (detox) is the withdrawal of the substance abruptly in an environment where there is good support. Detoxification can be done on an inpatient or outpatient basis.
  • At times, another drug with a similar action or effect on the body is taken, as the dose is slowly decreased to reduce the side effects and risks of withdrawal. For example, for narcotic addiction, methadone or similar drugs may be used to prevent withdrawal and continued use.

Residential treatment programs monitor and address possible withdrawal symptoms and behaviors. These programs use techniques to get users to recognize their behaviors and learn how not to go back to using (relapse).

Outlook

Substance use may lead to a fatal overdose. Some people start taking the substances again (relapse) after they have stopped.

Complications of substance use include:

  • Depression
  • Cancer, for example, mouth and stomach cancer are linked to alcohol abuse and dependence
  • Infection with HIV, or hepatitis B or C through shared needles
  • Loss of job
  • Problems with memory and concentration, for example, hallucinogen use, including marijuana (THC)
  • Problems with the law
  • Relationship breakup
  • Unsafe sexual practices, which may result in unwanted pregnancies, sexually transmitted diseases, HIV, or viral hepatitis

When to Contact a Medical Professional

Call for an appointment with your health care provider if you or a family member is using a substance and wants to stop. Also call if you have been cut off from your drug supply and are at risk of withdrawal. Most employers offer referral services for their employees with substance use problems.

Prevention

Drug education programs can be helpful. Parents can have a strong influence on their children by teaching them about the harm of using substances.

If the person also has depression or another mental health disorder, it should be treated. In many cases, a person starts using drugs to try to self-treat mental illness.

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