Substance use disorder
Substance use disorder occurs when a person's use of alcohol or another substance (drug) leads to health issues or problems at work, school, or home.
This disorder is also called substance abuse.
Substance abuse; Chemical use; Chemical abuse; Drug addiction; Addiction - drug; Dependence on drugs; Illicit drug use; Narcotic use; Hallucinogen use
Many who develop a substance use problem have depression, attention deficit disorder, post-traumatic stress disorder, or another mental problem. A stressful or chaotic lifestyle and low self-esteem are also common.
Children who grow up seeing their parents using drugs may have a high risk of developing substance use problem later in life for both environmental and genetic reasons.
Commonly used substances include:
There are several stages of drug use that may lead to addiction. Young people seem to move more quickly through the stages than do adults. Stages are:
Symptoms and behaviors of drug use may include:
Exams and Tests
Drug tests (toxicology screens) on blood and urine samples can show many chemicals and drugs in the body. How sensitive the test is depends on the drug itself, when the drug was taken, and the testing laboratory. Blood tests are more likely to find a drug than urine tests, though urine drug screens are done more often.
Substance use disorder is a serious condition and not easy to treat. The best care and treatment involves trained professionals.
Treatment begins with recognizing the problem. Though denial is a common symptom of addiction, people who are addicted have far less denial if they are treated with empathy and respect, rather than told what to do or being confronted.
The substance may either be slowly withdrawn or stopped abruptly. Support for physical and emotional symptoms, as well as staying drug free (abstinence) are also key to treatment.
Residential treatment programs monitor and address possible withdrawal symptoms and behaviors. These programs use techniques to get users to recognize their behaviors and learn how not to go back to using (relapse).
If the person also has depression or another mental health disorder, it should be treated. In many cases, a person starts using drugs to try to self-treat mental illness.
Many support groups are available in the community. They include:
Most of these groups follow the 12-Step program used in Alcoholics Anonymous (AA) www.aa.org.
Substance use may lead to a fatal overdose. Some people start taking the substances again (relapse) after they have stopped.
Complications of substance use include:
When to Contact a Medical Professional
Call for an appointment with your health care provider if you or a family member is using a substance and wants to stop. Also call if you have been cut off from your drug supply and are at risk of withdrawal. Most employers offer referral services for their employees with substance use problems.
Drug education programs can be helpful. Parents can have a strong influence on their children by teaching them about the harm of using substances.
American Psychiatric Association. Substance-related and addictive disorders. In: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013:481-590.
Kowalchuk A, Reed BC. Substance use disorders. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 50.
National Institute on Drug Abuse website. Drugs, brains, and behavior: the science of addiction. www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preface. Updated July 2014. Accessed April 25, 2018.
Stager MM. Substance abuse. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 114.
Weiss RD. Drugs of abuse. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 34.
Review Date: 3/26/2018
Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 07/03/2018.
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