Substance Use Disorder (SUD) and Addictions

What is Substance Use Disorder (SUD)?

Firstly, substance abuse is a mental disorder that affects a person’s brain and behaviour, leading to their inability to control their use of substances such as legal or illegal drugs, alcohol, or medications.

World Health Organization refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. For example, one of the key impacts of illegal drug use on society is the negative health consequences experienced by its members. As a matter of fact, drug use also puts a heavy financial burden on individuals, families and communities.

These drugs are:

• Alcohol
• Caffeine
• Cannabis
• Hallucinogens
• Inhalants
• Opioids
• Sedatives
• Hypnotics, or anxiolytics
• Stimulants (including amphetamine-type substances, cocaine, and other stimulants)
• Tobacco

The Diagnostic and Statistical Manual (DSM-5) recognises substance-related disorders resulting from using ten separate classes of drugs. The activation of the brain’s reward system is central to problems arising from drug use. Actually, the rewarding feeling people experience from taking drugs may be so profound that they neglect other normal activities in favour of taking the medication. Therefore, the pharmacological mechanisms for each class of drug are different. However, the activation of the reward system is similar across substances in producing feelings of pleasure or euphoria, often referred to as a “high.”

Additionally, the DSM-5-TR recognises that people are not automatically or equally vulnerable to developing substance use disorders. 

Symptoms of Substance Use

Substance use has no specific symptoms, although a few could be named as definite. Thus, it could be hard to recognise when you or someone in your life has a substance use disorder. This means that understanding the signs and symptoms of substance addiction can help you decide when you or a loved one must seek help.

Signs or symptoms of alcohol addiction could be:

• Problems at work, school or home due to drinking,
• Risking physical safety,
• The trouble with the law, often due to drinking and driving,
• Continuing to drink despite problems relating to alcohol.

Consequently, the use of the amount of alcohol one may consume could lead to alcoholism, which means that the body becomes physically dependent on alcohol.

Symptoms of alcoholism include:

• Craving a drink regularly
• Being unable to stop or limit drinking
• Needing greater amounts of alcohol to feel the same effect
• Withdrawal symptoms when not drinking, for example, nausea, sweating, shaking, anxiety, increased blood pressure or seizures
• Giving up activities to drink or to recover from hangovers
• Drinking even after it causes health problems
• Not being able to stop drinking

Other than alcohol, there could also be drug use and addiction. People who use drugs may use cocaine, heroin, morphine, LSD, marijuana, sedatives, speed, PCP, ecstasy, prescription pills and other substances.

Fortunately, substance use disorder treatments exist.

Treatments for Substance Use Disorder

Incidentally, there are several types of treatments for Substance Use Disorder (SUD) and addiction. A few of those treatments include:

• Comprehensive medical testing helps you understand all aspects of your physical health and determine steps to improve your well-being.
• Psychiatric and psychotherapeutic sessions help address underlying mental issues such as depression, anxiety and trauma.
• Experiential therapy – It is possible to use various forms of experiential therapy designed to facilitate access to emotions and awareness.
• Noninvasive brain stimulation therapy – Using rTMS to ease cravings and treat depression, anxiety and other mental health issues.
• Body-centred activities – Such as yoga or breathwork, promote mindfulness and regulation of the nervous system.
• Complementary therapy – Methods are rounding off personalised treatment programs.
• Group therapy – as it is one of the most effective and powerful forms of substance abuse treatment.

Medication for Substance Use Disorder

Furthermore, patients aren’t typically given medications for substance use, mainly offering therapy. However, the medication for substance use varies. Indeed, most of the medications are pharmacotherapies, and they target the brain receptors of neurotransmitters/neuromodulators that are dysregulated as a result of the specific substance abuse. Moreover, it would be better to get treatments as they greatly affect the patient.

What is addiction?

Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences – causing a person to be unable to survive without a particular substance or activity.

By WHO, Addiction is seen as a Disorder which forms due to addictive behaviours and is a recognisable and clinically significant syndrome associated with distress or interference with personal functions that develop as a result of repetitive, rewarding behaviours other than the use of dependence-producing substances.

Additionally, the Diagnostic and Statistical Manual (DSM-5) describes addiction as using more of a substance than intended or using or longer than you’re meant to.

Levels of Addiction

There are four levels of addiction: physical, emotional, mental, and spiritual.

• Trying the substance (usually a drug) – Most people who try drugs or risky activities do not become addicted and walk away without problems. However, some people develop a physical dependence on the substance or activity, meaning they need it to function normally. Physical dependence can lead to addiction.
• Regular Use and Substance Use – People who develop a physical dependency on a substance or activity tend to try and use it regularly to loosen stress, relax or feel good. This regular use could then turn into substance use, and this abuse can lead to addiction.
• Dependency and Tolerance – People addicted to a particular substance need it to function normally. Still, their bodies have built up a tolerance to the drug, and they need to use increasingly larger amounts to get the same effect. If they try to quit this, they may experience withdrawal symptoms.
• Substance Use Disorder – People with a substance use disorder tend to have an intense craving for the substance they consume and usually lose control of the usage. They continue to drink it even if it negatively affects their life at home, school or work.

There are many resources available to aid people in overcoming their addictions and living healthy lives.

Symptoms of Addiction

In all honesty, addiction to a substance is quite easy to recognise, as the person constantly buys and consumes it, acts strange, etc.

Signs of addiction could be:

• Craving that substance
• Inability to stop or limit the use of that substance
• Having withdrawal symptoms when you stop using the substance
• Spending a lot of time getting the substance and then recovering from its effects
• Giving up activities so you could use the substance or recover from the use of it
• Using the substance even after it causes health or psychological problems
• Wanting to stop but being unable to do so.

Indeed, there are a variety of different causes and risk factors that can contribute to the development of an addiction. These may include:

• Genetics, for example, the family history of substance addiction
• Starting using the substance at an early age
• Easy access to the substance, especially from a young age
• Exposure to a heavy advertisement of the substance (like alcohol)
• A current mental health diagnosis
• Low parental monitoring
• A high amount of family conflict
• A history of abuse or neglect
• Family conflict or violence

And so, the core reasoning for the development of addiction can be discussed through therapy, counselling, rehab, and other treatment modalities. Coping mechanisms and healing can begin.

Treatments for addiction

Consequently, depending on the strength of the addiction, the person might require either one level of care or multiple levels to achieve long-term recovery. Hence, the following treatments are the types of rehabilitation where therapy programs can be utilised.

• Detoxification
• Inpatient/Residential Rehabilitation
• Outpatient Rehabilitation

There are also alternative therapies that can complement the more standard treatment types to aid recovery. Those are exercise, meditation, yoga, and massage.

Medication for addiction

Different medications are used to treat various withdrawal symptoms and some of the medications that physicians may prescribe include:

– Benzodiazepines – This reduces anxiety and irritability, but doctors are cautious about prescribing Benzos as it is addictive. Benzos has a sedative effect, which helps ease withdrawals.

– Antidepressants – Without a certain amount of the substance, the person cannot produce a natural amount of happiness-inducing chemicals in their brain. Because the person has relied on the substance for so long, the absence of it causes the person to go into depression. Antidepressants can help relieve these feelings until the brain can produce happiness-inducing chemicals by itself.

– Clonidine – Clonidine treats alcohol and Opiate withdrawals, reducing sweating, cramps, muscle aches and anxiety. It can also stop tremors and seizures.