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Substance Use Disorder: Causes, Symptoms, Stages, Risk Factors, Diagnosis, Treatment And Prevention
Substance use disorder (SUD) is a major public health concern. It is estimated that worldwide in 2013, between 1, 62,000000 and 3, 29,000000 people aged 14-65 used an illicit drug. And almost nine per cent of all life's years are lost due to death and disability because of alcohol, tobacco and illicit drug use [1].
Substance use disorder emerges during adolescence and it increases among adulthood and is less common among older adults. Marijuana, alcohol, tobacco and prescription medications are the most commonly misused substances among people of all age groups [2].
What Is Substance Use Disorder? [3]
Substance use disorder, also known as drug addiction is a health condition that involves the persistent use of drugs, including alcohol that leads to health problems and affects relationships at work, school or home.
According to the American Psychiatric Association, substance use disorder largely affects the thinking, behaviour and body functions of a person who is consuming it. Continuous use of these substances can cause harmful changes in how the brain functions. And this is what drives people to have intense cravings for the drug and make it hard to stop using the drug despite knowing the harmful consequences. The changes in the brain can last long even after the immediate effects of the drug.
Substance use disorder can range from mild, moderate to severe.
Causes Of Substance Use Disorder
The exact cause of substance use disorder isn't known. But a number of factors like a person's genes, peer pressure, anxiety, action of the drug, emotional distress, depression and environmental stress can result in substance use according to the U.S. National Library of Medicine.
People take drugs to feel good, relieve stress, improve performance and to gain spiritual enlightenment.
Symptoms Of Substance Use Disorder
The symptoms of substance use disorder have been divided into the following categories.
1. Behavioural changes
•
Changes
in
appetite
or
sleep
patterns
•
Poor
attendance
at
work
or
school
•
Engaging
in
secretive
or
suspicious
behaviours
•
Unexplained
change
in
attitude
or
personality.
•
Lack
of
motivation
•
Sudden
mood
swings
or
anger
outbursts
•
Fearful
or
anxious
2. Social changes
•
Changing
a
new
group
of
friends
•
Legal
problems
related
to
substance
use
•
Unexplained
need
for
money.
•
Causing
problems
in
relationships
3. Physical changes
•
Sudden
weight
loss
or
weight
gain
•
Deterioration
of
physical
appearance
•
Slurred
speech,
or
impaired
coordination
•
Large-sized
pupils
•
Unusual
smell
from
the
body
or
bad
breath
[4],
[5],
[6]
International Overdose Awareness Day 2019: Drug Use Scenario In India
Types Of Drugs That Cause Substance Use Disorder
1.
Alcohol
[7]
2.
Cocaine
3.
Prescription
and
over-the-counter
medicines
[8]
4.
Marijuana
[9]
5.
Heroin
6.
Tobacco
Products
[10]
7.
Club
drugs
8.
Anti-anxiety
and
sedative
drugs
9.
Hallucinogens
[11]
10.
Inhalants
11.
Opioids
[12]
12.
Anabolic
steroids
13.
Central
nervous
system
depressants
Stages Of Substance Use Disorder
• Experimental use - In this stage, a person uses substances with peers for recreation.
• Regular use - The person misses school or work, stays away from friends and family, mixed with friends who use substances regularly and uses drugs to fix negative feelings.
• Problem or risky use - In this stage, the person has behavioural changes, loses interest in work or school and preoccupy with the substance.
• Addiction - At this stage, financial and legal problems increase, can't do without drugs, physical health gets worse, loss of control over drug use and may become suicidal.
How Alcohol, Drug Abuse Can Cause Depression
Risk Factors Of Substance Use Disorder
• Physical and sexual abuse [13]
• Trauma exposure [14]
• Family members or peers who use substances
• Mental health problems such as attention deficit disorder and post-traumatic stress disorder [15], [16]
• Eating disorders.
Complications Of Substance Use Disorder
•
Short-term
and
long-term
mental
health
problems
[17]
•
Contracting
an
infectious
disease
•
Legal
and
financial
problems
•
Accidents
[18]
•
Suicide
[19]
•
Problems
at
work
or
school
•
Family
problems
[20]
When To Seek Medical Help?
Substance use disorder can affect the quality of your life and the others around you. Seek medical help if you want to stop taking drugs, having seizures and convulsion, having breathing difficulty, having signs of physical and mental health problems.
Diagnosis Of Substance Use Disorder
The
doctor
will
thoroughly
conduct
a
physical
examination
and
conduct
further
tests
such
as
blood
and
urine
test
to
check
the
presence
of
drugs.
It
is
estimated
that
20.8
million
people
aged
12
or
older
met
the
diagnostic
criteria
for
substance
use
disorder
in
2015
[21].
The diagnostic criteria for substance use disorder include the following:
•
Taking
the
substances
in
excessive
amounts
and
for
a
longer
period.
•
Wanting
to
stop
using
the
substance
but
not
being
able
to.
•
Spending
a
lot
of
time
using
or
recovering
from
the
use
of
substance.
•
Intense
cravings
to
use
the
substance.
•
Can't
manage
work,
school
or
home
due
to
substance
use.
•
Continuous
use
of
substances
even
when
it
causes
problems
in
relationships.
•
Losing
interest
in
social
and
recreational
activities.
•
Using
substances
continuously,
even
knowing
the
health
problems
it
causes.
•
Taking
more
of
substances
to
get
rid
of
withdrawal
symptoms.
Treatment Of Substance Use Disorder
The treatment of substance use disorder varies depending on substances used, severity, comorbidities and the individual's preference. The treatment will help individuals stop the use of substances, improve health and overall quality of life.
1. Individual and group counseling - This involves focusing on reducing the use of substances, building your skills, and adhering to a recovery plan. Counsellors provide therapies like cognitive behavioural therapy, contingency management, and motivational enhancement therapy [22].
2. Medications - Medication Assisted Treatment (MAT) is the use of medications used in combination with counselling and behavioural therapies to treat individuals with alcohol and opioid use disorders [23].
3. Recovery support services - These are non-clinical services that are used along with treatment to support patients in their recovery process. These services include employment or educational support, specialised living situations, mentoring, coaching, and parenting education [24].
4. Rehabilitation - This involves enabling the patient to confront substance dependence to avoid the psychological, social, financial and physical consequences that can be caused by extreme abuse.
5. Hospitalisation - Extreme overdose of drugs requires immediate hospitalisation.
Prevention Of Substance Use Disorder
•
Abstain
from
harmful
drugs
including
alcohol.
•
If
you
are
a
parent,
talk
to
your
child
about
the
harmful
consequences
of
substance
use
disorder.
•
Stay
away
from
people
who
use
substances.
•
Educating
families,
schools,
adolescents
and
communities
can
be
effective
in
reducing
the
misuse
of
drugs.
Common FAQs
Q. Is substance use disorder the same as addiction?
A. Yes, substance use disorder refers to drug addiction that is characterised by a person's inability to control the use of drugs, inspite of knowing the adverse health effects.
Q. How do you detect drug use?
A. Changes in behaviour, staying away from family, school and work, mood swings, decreased performance at school and work, poor eating habits and slurred speech.
Q. Who can diagnose substance use disorder?
A. A psychiatrist, psychologist or a licensed alcohol and drug counsellor can help diagnose substance use disorder.
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