Substance use disorders are grouped within the cluster of diagnoses called the substance-related and addictive disorders. Substance-related and addictive disorders are characterized by a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the use of substances. These problems are persistent and occur repeatedly within the same 12-month period.
The term substance can refer to a drug, a medication, or a toxin. In addition to alcohol, types of substances to which individuals may become addicted include:
Substance-related disorders are divided into two groups:
The essential feature of a substance use disorder is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems. An important characteristic of this disorder is an underlying change in brain circuits that may persist beyond detoxification, particularly in individuals with severe disorders. The behavioral effects of these brain changes may be exhibited in the repeated relapses and intense drug craving when the individuals are exposed to drug-related stimuli.
Substance abuse continues to be one of the most common and serious mental health disorders, with 35% lifetime prevalence in American society. 30-50% of Substance Use Disorders begin in childhood or adolescence. By the end of high school, almost half of adolescents have abused an illicit drug at least once.
The continuum of child and adolescent substance use ranges from non-users, through experimental and casual users, to substance use and induced disorders. Genetics appear to play a role in the development of substance use disorders.
Children of substance abusers appear to be particularly vulnerable to adolescent drug use, likely resulting from genetic and family dynamic factors with learned attitudes toward substance abuse. The age in which an individual begins to use substances has been shown to be a strong predictor for the development of substance use disorders over the lifetime. Peers are influential and mediate the avoidance of drugs, as well as both the initiation and maintenance of substance abuse. Several cognitive factors determine substance use and are often specific to each drug. This is usually related to the perceived risks and benefits associated with using the substance. There are several psychological factors that impact a young individual's experience with substances. This includes whether they use the substance to produce positive feelings and avoid unpleasant ones, relieve tension and stress, reduce disturbing emotions, alleviate depression and anxiety, and gain peer acceptance.
SUD is treatable and should be matched relative to the severity and intensity of the substance use. If a patient is experiencing severe problems resulting from use, toxicity may require medical monitoring. Thus, intensive inpatient and/or residential treatment are necessary before considering behavioral interventions.
Published treatment guidelines for SUD include those from the National Institute of Drug Abuse and the Society of Clinical Child Psychology.
First Line Treatments
Second Line Treatments
In cases of nonresponse to first-line treatment, alternative treatments with reasonable evidence of efficacy include:
Third Line Treatments
When patients do not respond adequately to the first- and second-line treatments described above, other strategies might include:
Published treatment guidelines for SUD include those from the National Institute of Drug Abuse and the Society of Clinical Child Psychology.
First Line Treatments
Second Line Treatments
In cases of nonresponse to first-line treatment, alternative treatments with reasonable evidence of efficacy include:
Third Line Treatments
When patients do not respond adequately to the first- and second-line treatments described above, other strategies might include:
Withdrawal happens when a person feels physically and emotionally unwell, and using substances again seems like the only way to feel better.
This video from Psych Hub explains the signs and symptoms of substance use disorder (SUD) and highlights treatment options that can support recovery.
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Psych Hub is an educational service. The information provided in this video is not a substitute for professional advice, diagnosis, or treatment. If you believe you or someone you know may be experiencing mental health symptoms, please seek help from a qualified medical or behavioral health professional.
If you or someone you know is in immediate danger, call 911 (U.S.).