Substance Abuse: An Informational Overview
Substance Abuse Basics
Substance use disorders - perhaps more commonly referred to as substance abuse - are addictions to alcohol or drug use. Though addiction as a condition can involve process dependencies as well (porn, love, sex, work, etc.), overuse of substances is the most common. The National Institute on Drug Abuse describes substance addiction as "compulsive drug seeking despite negative consequences." Substance abuse and dependencies can involve illicit drugs, prescription drugs, and alcohol.
Substance Abuse Statistics
According to the 2018 National Survey on Drug Use and Health, 19.3 million Americans 18 or older (that's 7.8% of the US adult population) faced some sort of substance use disorder. Of those 19.3 million, 9.2 million were also dealing with a co-occurring mental health disorder.
In 2017, the CDC reported that 11.2% of Americans over the age of 11 admitted to using an illegal drug at least one time within the last month.
In 2018, over 67,000 Americans died of a drug overdose.
Each year, substance abuse takes a significant toll on finances. Overall, the National Institute on Drug Abuse estimates that misuse and abuse of alcohol, illegal drugs, prescription drugs, and tobacco cost the United States over $750 billion each year. This includes substance abuse-related healthcare costs, work productivity loss, and crime costs.
The Stigma of Substance Use Disorders
In years past, the stigma surrounding substance abuse (and addiction of all kinds) was debilitating for many of those contemplating seeking treatment. To put it bluntly, substance abuse was considered by many - especially in the general public - to be a bad choice by people that either didn't want to handle the stress of their lives or weren't "mature enough" to recognize the importance of navigating life sober-minded.
As research on substance use disorders continues to grow, the consensus among the medical and mental health community has greatly changed. The majority of medical and mental health providers now argue that addiction is a disease. In the category of disease rather than "irresponsible choice," the validity of any remaining stigma crumbles.
Though the stigma of admitting addiction should no longer exist, the reality is, it still does. So we take action. Books have been written, non-profits have been founded, and campaigns have been launched to help both the medical community and the general public understand the intricacies of stigma and its far-reaching effects.
The goal? To shatter the stigma of drug addiction and break down barriers to treatment, recovery, and life after substance abuse.
Substance Use Disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM)
Though general addiction does not hold an official place in the DSM-5, substance use disorder does. In its previous version, substance use disorders were split into two categories: substance abuse and substance dependence. The DSM-5 Substance-Related Disorders Work Group reviewed results and feedback from over 20,000 study participants to conclude that a single category of "Substance Use Disorders" would be more accurate and useful than two.
The DSM-5 categorization of substance use disorders exists to help professionals diagnose substance use disorder. Substance abuse should never be self-diagnosed. However, if you suspect that you or a loved one may be struggling with substance abuse, call or make an appointment with a professional for evaluation.
DSM-5 Criteria for Substance Use Disorder
Professionals use the following criteria to determine the existence of substance use disorder and if it should be classified as mild, moderate, or severe.
- Using the substance in higher quantities or for longer periods of time than you meant to
- Desiring to decrease or stop using the substance, without success
- Taking up quite a bit of time to obtain, use, and/or recover from using the substance
- Craving the substance
- Neglecting or not completing tasks at work, home, or school due to use of the substance
- Continuing use of the substance despite it negatively affecting relationship dynamics and relational health
- Neglecting or letting go of significant social, work, or recreational activities because of substance use
- Continuing to use the substance even when it puts you in harm's way
- Continuing use of the substance despite physical or psychological issues which may be aggravated or even caused by the substance
- Developing a tolerance to the substance so that more of it is needed to create the desired effect
- Developing and experiencing withdrawal symptoms that are diminished by using more of the substance
Additional Signs of a Substance Use Disorder
Ryan Soave, the Clinical Director for Telehealth at All Points North Lodge says, "There are some obvious signs of substance abuse. If someone shows up acting drunk or high or you can smell something on their breath, that is an indication that there may be a problem. But there are also things that might not be so overt. You have to really look at the person's life. The signs may be similar to those which signal that a person may need professional help. If someone isn't sleeping, is missing appointments, is frequently disheveled, has unexplained hospital admittances, is going to the doctor much more frequently than normal, or other occurrences like this that put someone outside of their normal behavior, these are all potential signs of substance abuse."
Risk Factors for Substance Addiction
According to Mayo Clinic, the following factors may increase your risk for substance abuse or addiction:
- History of addiction in the immediate family
- Existing mental health conditions
- Pressure from peer influences
- Use of drugs that are more highly addictive (including opioids, stimulants, and cocaine)
- Drug use at an early age
- Low involvement with family
Mayo also explains that genetics and your environment can increase risk of substance use.
Substance Abuse Treatment Options
Substance use disorders have both physical and mental effects, so they typically require both physical and mental treatment interventions. The severity of substance abuse is used as a guide to determine what level of care is best for each individual. Outpatient sessions, intensive outpatient programs, partial hospitalization programs, residential treatment, and inpatient treatment offer substance abuse treatment at different levels of involvement. In many cases, withdrawal management (formerly called detox) may be a necessary first step in the treatment of substance use disorders.
References & Resources
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