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Substance-related disorders, also known as
substance use disorder Substance use disorder (SUD) is the persistent use of drugs (including alcohol) despite substantial harm and adverse consequences. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as ...
s, can lead to large societal problems. It is found to be greatest in individuals ages 18–25, with a higher likelihood occurring in men compared to women, and urban residents compared to rural residents. On average, general medical facilities hold 20% of patients with substance-related disorders, possibly leading to psychiatric disorders later on. Over 50% of individuals with substance-related disorders will often have a "dual diagnosis," where they are diagnosed with the substance use, as well as a psychiatric diagnosis, the most common being major depression, personality disorder, anxiety disorders, and dysthymia. Substance use, also known as drug use, is a patterned use of a substance (drug) in which the user consumes the substance in amounts or with methods which are harmful to themselves or others. The drugs used are often associated with levels of
substance intoxication Substance intoxication is a transient condition of altered consciousness Consciousness, at its simplest, is sentience or awareness of internal and external existence. Despite millennia of analyses, definitions, explanations and debates by p ...
that alter judgment, perception, attention and physical control, not related with medical effects. It is often thought that the main used substances are illegal drugs and alcohol; however it is becoming more common that prescription drugs and tobacco are a prevalent problem.


Signs and symptoms

Common symptoms include: * Sudden changes in behaviour – may engage in secretive or suspicious behaviour * Mood changes – anger towards others, paranoia and little care shown about themselves or their future * Problems with work or school – lack of attendance * Changes in eating and sleeping habits * Changes in friendship groups and poor family relationships * A sudden unexplained change in financial needs – leading to borrowing/stealing money There are many more symptoms such as physical and psychological changes, though this is often dependent on which substance is being used. It is, however, common that people who use substances will experience unpleasant withdrawal symptoms if the drug is taken away from them. It is also reported that others have strong cravings even after they have not used the drug for a long period of time. This is called being "clean". To determine how the brain triggers these cravings, multiple tests have been done on mice. It is also now thought that these cravings can be explained by substance-related disorders as a subcategory of personality disorders as classified by the DSM-5.


Classification and terminology

Substance-related disorders were originally subcategorized into "
substance use disorder Substance use disorder (SUD) is the persistent use of drugs (including alcohol) despite substantial harm and adverse consequences. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as ...
s" (SUD) and "substance-induced disorders" (SID). Though
DSM-IV The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of ...
makes a firm distinction between the two, SIDs often occur in the context of SUDs.


Substance-induced disorders

Substance-induced disorders include medical conditions that can be directly attributed to the use of a substance. These conditions include
intoxication Intoxication — or poisoning, especially by an alcoholic or narcotic substance — may refer to: * Substance intoxication Substance intoxication is a transient condition of altered consciousness Consciousness, at its simplest, is sentienc ...
, withdrawal,
substance-induced delirium Delirium, also known as acute confusional state, is the organically caused decline from a previous baseline mental functioning that develops over a short period of time, typically hours to days. Delirium is a syndrome encompassing disturbances in ...
,
substance-induced psychosis Substance-induced psychosis (commonly known as toxic psychosis or drug-induced psychosis) is a form of psychosis Psychosis is an abnormal condition of the mind that results in difficulties determining what is Reality, real and what is not rea ...
, and
substance-induced mood disorder Mood disorder, also known as mood affective disorders, is a group of conditions where a disturbance in the person's mood (psychology), mood is the main underlying feature. The classification is in the ''Diagnostic and Statistical Manual of Mental ...
s.


Substance use disorders

Substance use disorder Substance use disorder (SUD) is the persistent use of drugs (including alcohol) despite substantial harm and adverse consequences. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as ...
s include substance use and substance dependence. In DSM-IV, the conditions are formally diagnosed as one or the other, but it has been proposed that
DSM-V The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomy (general), taxonomic and diagnostic tool published by the Am ...
combine the two into a single condition called "Substance-use disorder".


Changes in Classification

The more recently published
DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomy (general), taxonomic and diagnostic tool published by the Am ...
combined substance abuse and substance dependence into a single continuum; this is simply known as substance use disorder and requires more presenting symptoms before a diagnosis is made. It also considers each different substance as its own separate disorder, based upon the same basic criteria. It also distinguishes the difference between dependence and addictions as two separate disorders, not to be confused.


Complications

There are many potential complications that can arise due to substance use such as severe physiological damage, psychological changes and social changes that are often not desirable. Physiological damage is often the most obvious, observed as an abnormal condition affecting the body of an organism: For instance, there are several known alcohol-induced diseases (e.g.
alcoholic hepatitis Alcoholic hepatitis is hepatitis Hepatitis is inflammation Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogen In biology Biology is the natural scie ...

alcoholic hepatitis
,
alcoholic liver disease Alcoholic liver disease (ALD), also called alcohol-related liver disease (ARLD), is a term that encompasses the liver The liver is an organ Organ may refer to: Biology * Organ (anatomy) An organ is a group of Tissue (biology), tissues w ...
,
alcoholic cardiomyopathy Alcoholic cardiomyopathy is a disease in which the chronic long-term heavy use of alcohol In chemistry, alcohol is an organic compound that carries at least one hydroxyl functional group (−OH) bound to a Saturated and unsaturated compoun ...
.) Substance use is also often associated with premature ageing, fertility complications, brain damage and a higher risk of infectious diseases due to a weakened immune system. Long-term use has been linked to personality changes such as depression, paranoia, anxiety which can be related to psychological disorders. It is often reported that substance use coincides with personality disorders, such as
borderline personality disorder Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), is a mental illness A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that ...
. It has also now been linked to severe brain damage leading to an inability to control behaviours, which could explain why many people who use substances go on to develop addictions. Substance use is often regarded as negative in society and therefore those who engage in such behaviours can often be subject to social discrimination. The use of many drugs can lead to criminal convictions, whether the drug itself is illegal or people who use them use unlawful methods to fund their substances. It is also more likely that someone will partake in criminal or anti-social behaviour when they are under the influence of a drug.


See also

*
Anxiety Anxiety is an emotion Emotions are mental state, psychological states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavioural responses, and a degree of pleasure or suffering, disp ...

Anxiety
*
Behavioural sciences Behavioral sciences explore the cognitive processes within organism In biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemical processes, ...
*
Chemical dependency Substance dependence, also known as drug dependence, is a biopsychological situation where-by an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance, because of an adaptive state that has develo ...
*Major depressive disorder *Psychological trauma *Self-medication *Shared care *
Substance use disorder Substance use disorder (SUD) is the persistent use of drugs (including alcohol) despite substantial harm and adverse consequences. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as ...
*Drug rehabilitation *Dual diagnosis


References


External links

* *National Institute on Drug Abuse:
NIDA for Teens: Brain and Addiction
. {{Psychoactive substance use Substance-related disorders, Substance dependence