Overview
Substance use disorder is a complex medical condition characterized by compulsive substance consumption that disrupts daily functioning. This condition applies to both prescription medications and illicit substances.
Previously termed “drug abuse,” the medical community now recognizes this condition more accurately as substance use disorder or addiction, distinguishing it from physical dependence alone.
The consequences of substance misuse extend beyond individual health, significantly impacting public welfare. CDC data shows over 70,000 U.S. overdose deaths in 2017, while excessive alcohol consumption claims about 88,000 American lives annually.
Substance misuse contributes to numerous public health crises, including impaired driving incidents, increased violence, family dysfunction, and elevated risks of child maltreatment.
Needle sharing among intravenous drug users heightens transmission risks for infectious diseases like HIV and hepatitis.
The APA defines substance use disorder as a brain disease involving continued substance use despite harmful consequences, resulting from complex biological and social factors.
Education serves as the foundation for prevention, equipping individuals with knowledge to make informed decisions about substance use and promoting awareness of this widespread health issue.
Risk Factors
While substance misuse can affect anyone, certain factors increase vulnerability to developing substance use disorders.
Genetic predisposition accounts for 40-60% of addiction risk, according to research findings.
Environmental and psychosocial risk factors include:
- History of physical, sexual, or emotional abuse
- Exposure to trauma
- Family or peer substance use
- Easy access to substances
- Co-occurring mental health conditions
- Early initiation of substance use
Understanding these risk factors enables targeted prevention and intervention strategies.
Adolescent Substance Misuse
Adolescents’ developing brains make them particularly susceptible to substance misuse. Risk factors include:
- Family history of substance misuse
- Childhood trauma or neglect
- Peer pressure
- Bullying or gang involvement
- Co-occurring conditions like ADHD or depression
Early intervention can prevent experimental use from progressing to addiction.
Common Substances of Misuse
Depressants
CNS depressants slow brain activity, producing relaxation and drowsiness. Effects vary by dose and individual response, ranging from euphoria at low doses to impaired coordination at higher doses.
Alcohol
Rapidly absorbed into the bloodstream, alcohol affects all organ systems. Moderate consumption may fit within a balanced diet, but excessive use leads to:
- Liver disease
- Stroke
- Various cancer types
- Impaired daily functioning
NSDUH data shows 51.1% of Americans 12+ reported past-month alcohol use in 2018.
Heroin
This opioid induces euphoria followed by sedation. Risks include:
- Heart complications
- Overdose
- Withdrawal symptoms
Stimulants
These substances increase CNS activity, boosting energy and confidence. Misuse can cause:
- Insomnia
- Cardiovascular issues
- Seizures
Cocaine
This powerful stimulant elevates:
- Body temperature
- Blood pressure
- Heart rate
Chronic use may lead to heart attacks, strokes, or death.
Methamphetamines
This potent stimulant causes prolonged wakefulness and physical activity. Long-term effects include:
- Mood disturbances
- Violent behavior
- Severe dental problems
Marijuana
Derived from cannabis, marijuana produces euphoria and altered perception. While 43.5 million Americans reported use in 2018, it shows medical potential for conditions like glaucoma and chemotherapy side effects.
Club Drugs
Common in party settings, these include:
- GHB
- Ketamine
- MDMA (Ecstasy)
- LSD
- Rohypnol (used in date rape)
Risks include delirium, rapid heart rate, and fatal dehydration.
Other Substances
Anabolic Steroids: Synthetic testosterone analogs causing:
- Aggression
- Liver damage
- Infertility
Inhalants: Chemical vapors from household products that can cause:
- Brain damage
- Heart failure
Prescription Drugs
Commonly misused medications include:
- Opioid pain relievers
- Anti-anxiety medications
- Stimulants
Misuse can lead to respiratory depression, seizures, or overdose.
Stages of Substance Use Disorder
- Experimental Use: Recreational use in social settings
- Regular Use: Using substances to cope with negative emotions
- Risky Use: Substance use becomes primary life focus
- Dependence: Inability to function without the substance
Treatment Approaches
Effective treatment follows these principles:
- Recognizing addiction as a treatable medical condition
- Providing individualized treatment plans
- Ensuring treatment accessibility
- Addressing multiple needs comprehensively
- Incorporating mental health care
- Encouraging sustained treatment engagement
- Providing relapse support
Treatment typically involves:
- Detoxification
- Counseling (individual and group)
- Medication-assisted therapy
- Rehabilitation programs
Prevention Strategies
Key prevention methods include:
- Comprehensive education programs
- Mental health support services
- Community outreach initiatives
- Harm reduction programs
- Open family communication
Support Resources
- Above the Influence: Youth-focused substance use information
- SAMHSA: 24/7 helpline at 800-662-HELP (4357)
- National Institute on Drug Abuse for Teenagers: Research-based information
- National Association for Children of Alcoholics: Support for affected youth
- Al-Anon: 888-4AL-ANON (888-425-2666) for families
- Alateen: Support for teens affected by others’ alcohol use
- Alcoholics Anonymous: Recovery support groups
- Narcotics Anonymous: Recovery support for narcotic addiction
These resources provide critical support for individuals and families navigating substance use challenges.