Substance use disorders typically involve behavior patterns in which people continue to use a substance (for example, a recreational drug) despite problems resulting from its use.
Substance-Related Disorders Commonly Cause:
- Alcohol
- Antidepressants and sedatives
- Caffeine
- Cannabis
- Hallucinogens
- Inhalants
- Opioids
- Stimulants
- Tobacco
The specific manifestations and treatment of intoxication and withdrawal vary by substance or substance class and are discussed elsewhere in the manual.
The general terms addiction, abuse, and dependence are too loosely and variably defined to be too useful in systematic diagnosis; Substance use disorder is broader and has fewer negative connotations.
Physical Effects Of Substance Use
All of these substances directly activate the reward system of the brain and create a feeling of pleasure. The hyperactivity can be so strong that people have an intense craving for the substance. They may neglect normal activities to obtain and use the drug. These substances also have direct physiological effects, including
- Intoxication
- Withdrawal
- Substance-induced mental health disorder
Substance-induced mental health disorders are mental changes resulting from substance use or withdrawal that resemble mental disorders such as depression, psychosis, or anxiety.
Medical Care For Recreational And Illegal Substance Use
The use of illegal drugs, although problematic from a legal perspective, does not always involve substance use disorder. Also, Legal substances such as alcohol and prescription drugs (and marijuana in an increasing number of states in the United States), may be involved in substance use disorder. Problems caused by the use of prescription and illegal drugs cut across all socioeconomic groups.
People use drugs for a variety of reasons, recreational drug use has existed in one form or another for centuries, including
- To change or enhance the mood
- As part of religious ceremonies
- To gain spiritual knowledge
- To enhance performance
Causes Of Substance Use Disorder
People usually progress from use to occasional use and then to heavy use and sometimes to substance use disorder. This progression is complex and is only partially understood. The process depends on the interaction between the drug, the user, and the setting.
Diagnosing
Sometimes a substance use disorder is diagnosed when people go to a health care practitioner because they want help stopping drug use. Others try to hide their drug use, and doctors may suspect drug use problems when they notice changes in a person’s mood or behavior. Sometimes doctors find signs of substance abuse during a physical exam. For example, they can detect scarring caused by repeatedly injecting drugs intravenously. Track marks are lines of small, dark dots (needle punctures) surrounded by an area of darkened or discolored skin. Injecting drugs under the skin causes circular scars or blisters. People may claim other reasons for these marks, such as frequent blood donations, bug bites, or other injuries.
Healthcare practitioners also use other methods (such as questionnaires) to identify substance use disorders. Urine and sometimes blood tests may be done in some circumstances to check for the presence of drugs.
