Substance Use Disorders

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Person tipping pills from a pill bottle

A person is classified as having a substance use disorder, also known as a drug addiction, if they are unable to control or stop their use of a substance, even though it is causing harm and severely impacting their day to day life. The substance can be a drug or medication, such as alcohol, nicotine, opioids, stimulants, or cannabis. 

Someone may use a drug because it makes them feel good, maybe euphoric, ‘high’, or relaxed. This feeling is caused by activation of the reward system within the brain. They like this feeling so they take the drug again. However, repeated use of the drug causes physical changes within the brain, and more and more of the drug is needed each time to produce the same effect. These changes within the brain can lead a person to crave the drug, feel they need it to function, and if they don’t take the drug this can lead to physical withdrawal symptoms. 

There are genetic and environmental factors involved in the development of a substance use disorder. A family history of addiction, having other mental health conditions, associating with certain peer groups, and starting drug use at a young age are all factors which can increase the risk of developing a substance use disorder. 

Drug abuse and dependence is associated with many physical, mental, and social harms. It can lead to problems at home, at work, in relationships, and cause financial issues. Addiction can severely impact a person's life but there are effective treatments.

Common symptoms
  • Craving a substance/ drug - Feeling you need to use the drug daily or multiple times a day.
  • Feeling you are unable to stop or reduce drug use.
  • Taking a drug for longer than intended, or in larger amounts than intended.
  • Drug use causes you to neglect other things in your life [e.g. family, work].
  • Continuing to use the drug despite it causing harms to your physical health, mental health, and/or other harms in your life [e.g. relationship issues, financial issues].
  • Large amounts of time spent using or getting the drug and then recovering from use.
  • Failing to meet responsibilities and obligations [e.g. at work/ home/ school].
  • Failing to attend important work and social events due to drug use.
  • Spending more money than you can afford or doing things you wouldn’t normally do [e.g. stealing] to get the drug.
  • Engaging in risky behaviour while influenced by the drug [e.g. driving].
  • Tolerance - Needing more and more of a drug to get the same effect/ ‘high’.
  • Withdrawal symptoms - Attempts to stop taking the drug cause intense craving and physical illness.
How common is in the general population
It is estimated that around 10% of the general population experience substance dependence or abuse at some point in their lives.
Gender differences
Substance use disorders are more common in men than women.
Onset
Substance use disorders most often begin in adolescence or early adulthood, but can begin at any stage of life. Those who begin drug use at a young age are at an increased risk of developing a substance use disorder.
Typical Course
Substance use disorder is a disease of the brain; it is chronic. However, there are effective treatments to help people learn to manage the condition and stop drug use.
Common Comorbid (concurrent) Conditions
Anxiety disorders, PTSD, depression, ADHD, bipolar disorder, borderline personality disorder, schizophrenia.
Common treatments

If you think you are dependent on or abusing drugs it is important to speak to your doctor. There are effective treatments available and earlier help leads to better outcomes.

Treatment for substance use disorder focuses on stopping drug use and preventing future use. Treatment will vary based on the type of drug and other individual factors, and may take place in individual or group settings. The process of stopping drug use (detoxification) can be done at home, or inpatient treatment may be needed (e.g. in hospital). 

Psychological Therapy:

Behaviour therapy and counselling are used in the treatment of substance use disorder. These psychological therapies focus on learning how to cope with cravings, preventing relapse, developing strategies for if relapse occurs, and addressing other problems (e.g. work or relationship issues). Substance use disorders commonly occur alongside other mental health problems, or drug use may be a way to cope with other emotional issues. Talk therapies, such as cognitive behavioural therapy, can be beneficial to address these issues. 

Support Groups:

Joining a support group can be a great way to meet a supportive network of people going through a similar experience. Support groups provide an opportunity to speak with and learn from others who are facing similar issues.