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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].

substance use disorder

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.

substance use disorder infographic

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

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 IndiaInternational Overdose Awareness Day 2019: Drug Use Scenario In India

Types Of Drugs That Cause Substance Use Disorder

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

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 DepressionHow Alcohol, Drug Abuse Can Cause Depression

Risk Factors Of Substance Use Disorder

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

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]

Common Blood Pressure Drug May Increase Heart Attack RiskCommon Blood Pressure Drug May Increase Heart Attack Risk

When To Seek Medical Help?

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

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

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

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.