Substance-related disorders is a class of
mental disorder
A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is ...
s that affect a person's brain and behavior, leading to their inability to control their use of substances like drugs, alcohol, or medications.
The disorders can lead to large societal problems. Substance-related disorders are found to have greatest prevalence 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 22% 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
Dysthymia ( ), known as persistent depressive disorder (PDD) in the DSM-5-TR and dysthymic disorder in ICD-11, is a psychiatric condition marked by symptoms that are similar to those of major depressive disorder, but which persist for at leas ...
.
Substance use, also known as drug use, is a patterned use of a substance 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 and behavior associated with recent use of a substance. It is often maladaptive and impairing, but reversible. If the symptoms are severe, the term "substance intoxicatio ...
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
Alcohol may refer to:
Common uses
* Alcohol (chemistry), a class of compounds
* Ethanol, one of several alcohols, commonly known as alcohol in everyday life
** Alcohol (drug), intoxicant found in alcoholic beverages
** Alcoholic beverage, an alco ...
; 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 despite substantial harm and adverse consequences to self and others. Related terms include ''substance use problems'' and ''problematic drug or alcohol use''. Along with substance-ind ...
s" (SUD) and "substance-induced disorders" (SID).
Though
DSM-IV
The ''Diagnostic and Statistical Manual of Mental Disorders'' (''DSM''; latest edition: ''DSM-5-TR'', published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a com ...
makes a firm distinction between the two, SIDs often occur in the context of SUDs.
Substance-induced disorder
Substance-induced disorders include medical conditions that can be directly attributed to the use of a substance. These conditions include
substance intoxication
Substance intoxication is a transient condition of altered consciousness and behavior associated with recent use of a substance. It is often maladaptive and impairing, but reversible. If the symptoms are severe, the term "substance intoxicatio ...
,
substance withdrawal, and substance/medication-induced mental disorders (e.g.,
substance-induced delirium,
substance-induced psychosis, and
substance-induced mood disorders).
Substance use disorder
In the DSM-IV, it was formally divided in substance use and in
substance dependence
Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has develop ...
, but in the
DSM-5-TR
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 ...
both were combined into a single condition called "Substance-use disorder".
In this new revision more presenting symptoms are required before a diagnosis is made. It also considers each different substance as its own separate disorder, based upon the same basic criteria. The DSM-5 TR also defines the term "drug addiction" as because of its uncertain definition and its potentially negative connotation.
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 (inflammation of the liver) due to excessive intake of alcohol. Patients typically have a history of at least 10 years of heavy alcohol intake, typically 8–10 drinks per day. It is usually found in association wi ...
,
alcoholic liver disease
Alcoholic liver disease (ALD), also called alcohol-related liver disease (ARLD), is a term that encompasses the liver manifestations of alcohol overconsumption, including fatty liver, alcoholic hepatitis, and chronic hepatitis with liver fibrosi ...
,
alcoholic cardiomyopathy
Alcoholic cardiomyopathy (ACM) is a disease in which the long-term consumption of alcohol (drug), alcohol leads to heart failure. ACM is a type of dilated cardiomyopathy. The heart is unable to pump blood efficiently, leading to heart failure. It ...
.) 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) is a personality disorder characterized by a pervasive, long-term pattern of significant interpersonal relationship instability, an acute fear of Abandonment (emotional), abandonment, and intense emotiona ...
. 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 characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
*
Behavioural sciences
Behavioural science is the branch of science concerned with human behaviour.Hallsworth, M. (2023). A manifesto for applying behavioural science. ''Nature Human Behaviour'', ''7''(3), 310-322. While the term can technically be applied to the st ...
*
Chemical dependency
Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has develope ...
*
Major depressive disorder
Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive depression (mood), low mood, low self-esteem, and anhedonia, loss of interest or pleasure in normally ...
*
Psychological trauma
Psychological trauma (also known as mental trauma, psychiatric trauma, emotional damage, or psychotrauma) is an emotional response caused by severe distressing events, such as Major trauma, bodily injury, Sexual assault, sexual violence, or ot ...
*
Self-medication
Self-medication, sometime called do-it-yourself (DIY) medicine, is a human behavior in which an individual uses a substance or any exogenous influence to self-administer treatment for physical or psychological conditions, for example headaches or ...
*
Shared care
Shared care involves the establishment of partnerships between professionals and laymen in which they share a common goal. Examples are an improvement in the health of a patient where there is patient empowerment to take a major degree of responsi ...
*
Substance use disorder
Substance use disorder (SUD) is the persistent use of drugs despite substantial harm and adverse consequences to self and others. Related terms include ''substance use problems'' and ''problematic drug or alcohol use''. Along with substance-ind ...
*
Drug rehabilitation
Drug rehabilitation is the process of medical or psychotherapeutic treatment for dependency on psychoactive substances such as alcohol, prescription drugs, and street drugs such as cannabis, cocaine, heroin, and amphetamines. The general int ...
*
Dual diagnosis
Dual diagnosis (also called co-occurring disorders (COD) or dual pathology) is the condition of having a mental illness and a comorbid substance use disorder. Several US based surveys suggest that about half of those with a mental illness will ...
References
External links
*National Institute on Drug Abuse:
NIDA for Teens: Brain and Addiction.
{{Psychoactive substance use
Substance dependence