Substance Use
Although the term substance can refer to any physical matter, "substance abuse" has come to refer to the overindulgence in and dependence of a drug or other chemical leading to effects that are detrimental to the individual's physical and mental health, or the welfare of others.
The disorder is characterized by a pattern of continued pathological use of a medication, non-medically indicated drug or toxin, which results in repeated adverse social consequences related to drug use, such as failure to meet work, family, or school obligations, interpersonal conflicts, or legal problems. The most common types of substance use disorders are addictions to alcohol and drugs.
Substance dependence or addiction is the progressive need for alcohol or drugs that results from the use of that substance. This need creates both psychological and physical changes that make it difficult for the users to control when they will use the substance or how much they will use. Psychological dependence occurs when a user needs the substance to feel normal or to engage in typical daily activities. Physical dependence occurs when the body adapts to the substance and needs increasing amounts to ward off the effects of withdrawal and to maintain physiological functioning. Dependence can result in:
The continued use of a substance despite negative consequences. The individual continues drug or alcohol use despite incidents, such as accidents, arrests, or a lack of money to pay for food because it was spent on drugs.
An increase in tolerance to the substance. The individual requires more of the alcohol or drug to obtain the same effect.
Withdrawal symptoms. The individual needs to consume the substance in order not to experience unpleasant withdrawal effects, such as uncontrollable shaking and tremors or intense nausea
Behavioral changes. The individual who is dependent:
Uses more than intended
Spends a majority of the time either obtaining, using, or withdrawing from the use of the substance
Cannot stop using until the substance is gone or the individual passes out.
The continued use of a substance despite negative consequences. The individual continues drug or alcohol use despite incidents, such as accidents, arrests, or a lack of money to pay for food because it was spent on drugs.
An increase in tolerance to the substance. The individual requires more of the alcohol or drug to obtain the same effect.
Withdrawal symptoms. The individual needs to consume the substance in order not to experience unpleasant withdrawal effects, such as uncontrollable shaking and tremors or intense nausea
Behavioral changes. The individual who is dependent:
Uses more than intended
Spends a majority of the time either obtaining, using, or withdrawing from the use of the substance
Cannot stop using until the substance is gone or the individual passes out.
Mental Illness
SUDS have a strong association with mental illness. In 2007, an estimated 24.3 million adults aged 18 or older had a serious mental illness. (Having a serious mental illness is defined as having a diagnosable mental, behavioral, or emotional disorder during the past year that met the DSM-IV criteria.) Adults with a serious mental illness are much more likely to have used illicit drugs within the past year than those adults without a serious mental illness (28.0 percent versus 12.2 percent).
It is not clear why there is a high correlation between SUDs and mental illness. Three ways in which they may relate to one another are:
The disorders may occur independently of each other.
The mental health disorder may place an individual at greater risk for SUDs.
Alcohol or drug intoxication or withdrawal may result in temporary mental health disorders, such as paranoia or depression.
The disorders may occur independently of each other.
The mental health disorder may place an individual at greater risk for SUDs.
Alcohol or drug intoxication or withdrawal may result in temporary mental health disorders, such as paranoia or depression.
It is common for either the SUD or the mental health issue to go undiagnosed. In addition, not all mental health problems affecting a parent necessarily will appear severe or profound. As a result, when one issue is identified, it is important to screen for the other. When both are identified, current accepted practice is to treat both disorders simultaneously, especially with individuals who have serious mental illnesses.
· Services for the treatment of substance use disorders, including detoxification, rehabilitation, and outpatient group and family therapy.
Substance Abuse Treatment
Most substances abusers believe they can stop using drugs on their own, but a majority who try do not succeed. Research shows that long-term drug use alters brain function and strengthens compulsions to use drugs. This craving continues even after your drug use stops.
Because of these ongoing cravings, the most important component of treatment is preventing relapse. Treating substance abuse depends on both the person and the substance being used. Behavioral treatment provides you with strategies to cope with your drug cravings and ways to avoid relapse. Your doctor may prescribe medications, such as nicotine patches and methadone, to control withdrawal symptoms and drug cravings.
Often, a drug user has an underlying mental disorder, one that increases risk for substance abuse. Such disorders must be treated medically and through counseling along with the drug abuse.
