Overview of Substance Use Disorders
What are substance use disorders?
Substance use disorders are marked by a dysfunctional pattern of behavior in which individuals continue to use a substance despite encountering significant negative consequences related to its use. Excessive use of drugs stimulates the brain's reward systems, which normally reinforce positive behaviors and memory formation. This intense stimulation can lead individuals to neglect everyday activities that activate these systems through healthy behaviors in favor of substance use.
The use and cessation of substances can lead to psychological, behavioral, and physiological changes, such as intoxication and withdrawal. Additionally, substance misuse may contribute to psychiatric disorders, including depression, psychosis, anxiety, and neurocognitive issues.
What are these substances?
These Substances (Drugs) are categorized into ten distinct classes, each with varying but not entirely separate pharmacological mechanisms. This classification is not based on whether a drug is legal (eg, alcohol, caffeine), illegal (eg, hallucinogens), or available by prescription (eg, morphine, lorazepam). The classes include:
Alcohol
Caffeine
Cannabis and synthetic cannabinoids
Hallucinogens (eg, LSD, phencyclidine, psilocybin, 3,4-methylenedioxymethamphetamine [MDMA])
Inhalants (volatile hydrocarbons [eg, paint thinner, certain glues])
Opioids (eg, fentanyl, morphine, oxycodone)
Sedatives, hypnotics, and anxiolytics (eg, lorazepam, secobarbital)
Stimulants (eg, amphetamines, cocaine)
Tobacco
Other (eg, anabolic steroids)
What leads to substance use disorders?
People with a substance use disorder often start by experimenting with drugs, then move to occasional use, and eventually may use heavily, leading to a disorder. The process depends on interaction between the drug, user, and setting.
Drug
Addiction liability refers to the likelihood of the drug to cause substance use disorder. It depends upon a combination of factors including:
Route of administration
Rate at which the drug crosses the blood-brain barrier and stimulates the reward pathway
Time to onset of effect
Ability to induce tolerance and/or withdrawal symptoms
User
Predisposing factors in users include the following:
Psychological characteristics ــ people with low levels of self-control (impulsivity) or high levels of risk-taking and novelty-seeking may have an increased risk of developing substance use disorder.
Circumstances and disorders ــ People who experience sadness, emotional distress, or social isolation may temporarily alleviate their feelings through drug use, which can lead to increased consumption and potentially a substance use disorder. Those with other psychiatric disorders are also at higher risk for developing such issues. Patients with chronic pain conditions often turn to opioids for relief and may subsequently develop a substance use disorder, though many can find adequate relief with non-opioid medications and alternative treatments.
Setting
Cultural and social factors greatly impact substance use, with family and peer behaviors increasing the likelihood of initiation and relapse, especially among adolescents.
Signs of substance use disorders
Loss of control over substance use (including having cravings)
Social / occupational problems
Risky use (such as using the drug in physically dangerous situations)
Physical effects including Tolerance and Withdrawal.
Treatment
At Mind Clinic, we employ a multidisciplinary team to address and treat substance use disorders.
The therapists and psychologists at Mind Clinic provide various therapeutic approaches to achieve desired outcomes. This includes individual therapy, where a therapist assists in altering substance-related thoughts and behaviors while enhancing motivation for change. Another approach is group therapy, led by a therapist, where members support each other in making meaningful life changes.
The psychiatrist will prescribe medication alongside therapy after conducting a thorough interview to achieve the most effective results.
We might refer to support groups that allow for peers in recovery to socialize in a substance free environment.
References
Professional, M. (2024). Substance-Related Disorders – MSD Manual Professional Edition. MSD Manual Professional Edition. https://www.msdmanuals.com/professional/psychiatric-disorders/substance-related-disorders HYPERLINK "https://www.bing.com/ck/a?!&&p=e82a58d324cbf230JmltdHM9MTcyNzM5NTIwMCZpZ3VpZD0xOWExODY1Yi0xNjg3LTZjYjctMGEwYi05NDkwMTczYzZkMDUmaW5zaWQ9NTY2Mw&ptn=3&ver=2&hsh=3&fclid=19a1865b-1687-6cb7-0a0b-9490173c6d05&psq=diagnostic+and+statistical+manual+5th+edition&u=a1aHR0cHM6Ly9lbi53aWtpcGVkaWEub3JnL3dpa2kvRFNNLTU&ntb=1"
HYPERLINK "https://www.bing.com/ck/a?!&&p=e82a58d324cbf230JmltdHM9MTcyNzM5NTIwMCZpZ3VpZD0xOWExODY1Yi0xNjg3LTZjYjctMGEwYi05NDkwMTczYzZkMDUmaW5zaWQ9NTY2Mw&ptn=3&ver=2&hsh=3&fclid=19a1865b-1687-6cb7-0a0b-9490173c6d05&psq=diagnostic+and+statistical+manual+5th+edition&u=a1aHR0cHM6Ly9lbi53aWtpcGVkaWEub3JnL3dpa2kvRFNNLTU&ntb=1" The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)
Aid, T. (2024). Addictions Treatment Tools | Therapist Aid. Therapist Aid. https://www.therapistaid.com/tools/substance-use