A substance abuse disorder is when a person uses drugs and/or alcohol to a point where it leads to major health problems or complications with his/her responsibility, such as work, school, or home.

As the recent opioid epidemic tells us, substance abuse is a common mental illness within the United States. One of the biggest reasons for this is the rise of prescription medications which has occurred since the late 1990s. Often, people who run out of a prescription have already developed an addiction and will turn to the streets to get their fix.

“About 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.” [1]

If you are struggling with a substance abuse disorder, you’re not alone. There are many out there trying to find treatment options and a way out of the addiction cycle. In fact, most people struggling with drug or alcohol dependence desire to quit.

This article seeks to give you all the information you need pertaining to what a substance abuse disorder is. We also offer advice on how to find the right treatment option for you.

At the end, we invite you to ask further questions.

Signs and Symptoms

When it comes to substance abuse disorder, everyone reacts to the mental health condition differently. Part of this has to do with the fact that everyone’s body reacts differently to drugs or alcohol. However, the substance of choice also plays a major role.

For example, someone who abuses opioids will not experience the same symptoms as someone chronically smoking marijuana. Still, there remain some similarities.

Common symptoms for people struggling with addiction include:

• Confusion
• Creating excuses to continue using drugs
• Drug use persists even when you’re alone
• Hostility towards discussions of drug addiction
• Lack of appetite
• Lack of sleep/more sleep than necessary
• Lack of control over drug abuse
• Lack of performance in responsibilities, such as work or school
• Loss of interest in activities due to drug abuse
• Necessity for daily and/or regular drug use in order to feel “normal”
• Not caring about what you look like
• Persistent use of drugs even when it’s caused negative reactions towards your health, work, or family
• Secretive conduct as a means of hiding drug use
• Violent episodes

Again, not everyone suffering from a substance abuse disorder will have all these symptoms. Furthermore, you may have symptoms due to your drug use which are unique to you. For example, some people develop other mental illnesses, such as bipolar disorder or schizophrenia, due to their struggle with addiction.

If you have (or noticed a loved one has) experienced any of the above symptoms, it’s important to consult a doctor as soon as possible. The longer an addiction carries on for, the more damage it does to the person suffering.

Risk Factors

Substance abuse disorder is a complex illness and people often start the cycle of addiction differently. Currently, there’s a stigma surround substance abuse claiming that the disorder all begins with a choice. It’s vital to understand that addiction isn’t always a choice and most people fall into it without ever making the decision to.

For example, a major cause of a drug or alcohol dependence is one’s environment. Naturally, if a person lives somewhere where substance abuse is common, s/he will feel more inclined to taking drugs.

This is especially true for children who grow up with parents or other close family members/friends who use drugs. In fact, genetics also plays a vital role in determining whether or not a person develops a substance abuse disorder.

Mental Illness and Substance Abuse

One of the biggest risk factors for substance abuse disorder is mental health [2]. People who suffer from depression, attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), anxiety, and/or other mental conditions are vulnerable to falling into an addiction. Namely, people of mental illness initially seek out a way to self-medicate. With enough time, an addiction may develop.

As mentioned in the introduction, many people fall into substance abuse after receiving prescription medication. Often the case, the prescription alone causes an addiction. When the prescription runs out, people turn to the streets to fill their fix.

Those who suffer from a mental health condition are regular victims of this prescription epidemic. Due to the high volume of prescription medication being handed to people of mental illness, people who are already extremely stressed and have low levels of self-esteem naturally fall vulnerable to substance abuse.

If you or anyone you love is looking to treat mental illness, it’s important to remember there are natural remedies available. If interested in these remedies, check out Harvard Medical School’s list of “natural” therapies.

Most Commonly Used Substances

A large reason substance abuse is so complex is due to the number of different substances there are out there. Though there are some similarities found in some, many affect the brain and body in different ways.

The most commonly used substances are:

• Depressants – drugs which cause drowsiness and reduce feelings of anxiety.
  • alcohol
  • barbiturates
  • benzodiazepines (Ativan, Valium, Xanax)
  • chloral hydrate
  • paraldehyde
• Opiates – narcotics sometimes referred to as painkillers. Often cause drowsiness and intense feelings of euphoria.
  • Codeine
  • Heroin
  • Narcotic pain medicines (such as morphine)
  • Opium
• Psychedelics – cause hallucinations, changes perceptions, and inflicts feelings referred to ask “out of reality”. It’s important to note, psychedelics only cause psychological dependence and have no scientific evidence pointing towards physical dependence.
  • LSD
  • Marijuana (cannabis, hashish)
  • Mescaline
  • Phencyclidine (PCP or “angel dust”)
  • Psilocybin (“mushrooms”)
• Stimulants – drugs which stimulate the brain and nervous system.
  • Amphetamines (Adderall, methylphenidate, Ritalin)
  • Cocaine
  • Crack
  • Methamphetamine (“meth”)
  • Nicotine

Stages of Drug Use

When it comes to the way a person uses drugs, there are three specific stages happening one after the other which inevitably lead to an addiction. These stages are prominent in all drug users. However, they seem to move more rapidly in young people in comparison to adults.

These stages are:

1. Experimental Use: When drugs are taken recreationally, usually in a peer-like setting. This stage usually begins in adolescence when a teenager is likely to enjoy going against parents are other authority figures.
2. Regular Use: The user has become prone to thinking regularly about his/her drug use. So much so, s/he worry about losing his/her source of drugs. Furthermore, s/he has become prone to using drugs as a means of “fixing” negative feelings. This is often the stage where a user will avoid friends and/or family and only hang around others who are also regular users. As tolerance to the drug builds up, the person needs to take more in order to get high. Naturally, s/he begins to miss more school or work.
3. Problem/Risky Use: No longer does the user care about what s/he misses at school or work. S/he has lost much motivation to continue with responsibilities and previous interests (such as a relationship or activities). With that, a number of behavioral changes have appeared. The user has become much more secretive, might start selling drugs as a means of affording his/her habit, has begun using other, harder drugs, and has run into legal issues.
4. Addiction: The user now needs drugs daily. S/he denies any problems even though his/her physical condition has worsened. S/he has lost control over using and has found themselves in serious financial and legal problems. Once this dependence has taken full force, users may cut ties with family or friends and become suicidal.

Diagnosis

When it comes to diagnosing a substance abuse disorder, there’s a set of criteria medical professionals follow. This criterion is as follows:

• Taking a substance in large amounts for a longer period than you’re meant to.
• Desiring to stop using drugs, but unable to.
• Spending more time than necessary getting, using, and recovering from drug use.
• Developed strong cravings and urges to use drugs.
• Inability to manage responsibilities (such as school, work, or home life) due to drug use.
• Pursuing drug use even when it causes problems within your relationships.
• Surrendering important social, occupational, and/or recreational activities in replacement for drug use.
• Continuing to use drugs even when it puts you in danger.
• Developing physical and psychological problems that are either caused or made worse by drug use.
• Building tolerance to drugs (needing more drugs to receive the initial effects).
• Developing withdrawal symptoms when you don’t have drugs (needing more drugs in order to alleviate withdrawal symptoms).

It’s important to note, you don’t need to have every point of these criteria in order to be diagnosed with a substance abuse disorder. Furthermore, a medical professional will learn about the above criteria through interviews and drug screenings (typically, a urine sample).

Substance Abuse Treatment

Though treating a substance abuse disorder isn’t easy, it’s very possible and many have had successful recoveries through drug and alcohol treatment facilities.

Before you begin treatment, you must understand you have a problem. Many people who struggle with addiction tend to be in denial of their complication.

When figuring out how to treat a substance abuse disorder, it’s important to look towards medical professionals for two reasons:

1. There are some dangers when it comes to substance withdrawal.
2. Those who attempt to quit on their own terms are more likely to relapse.

Why is this?

For one, a reputable treatment facility offers you a drug-free environment with a network of other people in the same boat as you. Furthermore, since you’re under constant medical supervision, you can expect a very safe withdrawal process.

Upon your search for treatment, you’ll run into two types of programs:

1. Inpatient Program – when a person stays within a facility for a period of time (generally 3 to 6 months) under constant supervision.
2. Outpatient Program – when a person stays outside a facility but continues to receive treatment from that facility. Usually, people who need to maintain responsibilities (such as school or work) opt for an outpatient program.

Within both programs, you’ll find treatment works in five steps. These include:

1. Medical Assessment

Upon entering a reputable rehabilitation center, you’re going to need to complete medical evaluation. Similarly to diagnosis, you’ll receive a set of interviews and drug test seeking out your current health state and family history.

The purpose of this medical assessment is to discover the best course of treatment FOR YOU.

2. Detoxification

When you suddenly stop using drugs or alcohol, your brain and body’s natural reaction is to withdraw. This is due to the fact that it’s grown accustomed to the chemical structuring of the substance and now must return to it’s normal, organic functioning – a state known as homeostasis.

Through this withdrawal, you’ll produce a specific set of withdrawal symptoms. Though these symptoms vary depending on the drug, they’re usually very uncomfortable. For this reason, a treatment facility provides you with specific medication and emotional support in order to ease withdrawal symptoms.

It’s important to note that withdrawing through a medical facility is very important as symptoms are sometimes dangerous.

For example, when one stops using opioids, two common symptoms are diarrhea and vomiting. These two symptoms hold potential for dehydration and, if not treated properly, there are fatal risks. A detox clinic will make sure you’re properly hydrated.

3. Psychological Treatment

Once your body has flushed out all the chemicals brought upon by drug use, your brain will still crave to use. This is why the next step addresses all psychological issues.

Typically, this is done through psychotherapy. The goal of this treatment is to change your thoughts, patterns, and beliefs. In turn, creating a new habitual lifestyle for when you re-enter the real world.

Cognitive behavioral therapies (CBT) are the most common when it comes to treating a substance abuse disorder. This form of treatment is also referred to as talk therapy and is either done on an individual or group level.

4. Educational Sessions

While you undergo psychotherapies, it’s important to enroll yourself in education sessions. Through these, you’ll learn all about addiction and how it affects the brain. The purpose of this is to make you aware of the dangers and repercussions created by drug or alcohol dependence. With this knowledge, the idea is to prevent you from relapsing.

5. Support Systems

Most treatment facilities will provide you with a number of supportive services. These are used during and after treatment to keep yourself in the right mindset.

Common support systems include:

• Al-Anon – https://al-anon.org/
• Alateen – https://al-anon.org/for-members/group-resources/alateen/
• Financial assistance
• Housing assistance (sober living homes)
• Legal assistance
• Medical assistance
• Narcotic Anonymous (NA) – www.na.org
• Vocational training

Though this help is optional, it’s highly recommended you use it.

Your Questions

This article sought to give you all the information you need about what a substance abuse disorder is.

Still have more questions?

Feel free to ask them in the comments below. If you have more information on substance abuse disorder or a personal story you’d like to share, we’d also love to hear from you. We reply to each legitimate comment in a timely and personal manner.

Reference Sources

[1] Vowles KE, McEntee ML, Julnes PS, Frohe T, Ney JP, van der Goes DN. Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis. Pain. 2015;156(4):569-576. doi:10.1097/01.j.pain.0000460357.01998.f1.

[2] NIH: Substance Abuse and Mental Health