Substance-Related Disorder

What is substance-related disorder?

The term substance-related disorder is a blanket term for a variety of conditions that develop as a result of prolonged usage of any substance. What is commonly referred to as substance-related disorder can be broken down into two larger categories: substance abuse and substance dependence.

These two broad categories differ in terms of symptoms but commonly share in causes. This disorder is said to affect millions of people throughout the world and can be related to almost any substance of common use. Typically, substances that are considered to be abused or cause dependence are prescription or illegal drugs.

However, two of the of the primary drugs of abuse, nicotine and alcohol, are completely legal and are controlled only by age requirements. Another common drug of abuse, caffeine, is available to anyone and is typically not age restricted.

Previously, the two categories were considered separate but shared related diagnoses. It was widely recognized that substance abuse would typically lead to dependence, but they were not considered to be the same condition. Recently, this was changed in the Diagnostic and Statistics Manual published by the American Psychological Association. The two conditions are now considered to be on a spectrum with substance abuse being on one end and developing into dependence as the disorder progresses.

At any rate, substance-related disorders rank among the highest of preventable diseases throughout the world. It is certainly a disease of affluence as many substance addictions require significant amounts of money to maintain in many cases. However, for those suffering from dependence with little financial means, the likelihood of social problems such as unemployment and homelessness is increased dramatically.

Symptoms of a substance-related disorder

The signs and symptoms of a substance-related disorder usually vary based on the substance being used. However, there are common symptoms that are indicative of most substance-related disorders.

Common symptoms include:

  • Changes in mood or behavior
  • Lying or deception regarding daily habits
  • Impairment of typical social activities

This list is far from comprehensive and is very general in scope. The more specific signs of a substance disorder will depend on the nature of the substance.

In broad categories, some symptoms of a substance-related disorder include:

  • A need for stimulants
  • Shaking, tremors
  • Irritability
  • Clenched teeth (bruxism)
  • Constricted pupils
  • Opiates
  • Drowsiness, nodding
  • Enlarged pupils
  • Impaired motor skills
  • Mental confusion
  • Alcohol dependency
  • Impaired coordination
  • Slurred speech
  • Inability to focus

This is just a small sampling of the symptoms of the most commonly abused types of drugs provided for illustrative purposes. Each particular substance has its own effects that manifest into symptoms. For the scope of this article, individual substances will not be discussed.

As mentioned previously, substance-related disorders belong to two broad categories. The symptoms above describe the symptoms of abuse. The symptoms of dependence are similar, the most important being the presence of withdrawal symptoms.

Withdrawal is the condition that arises once the substance user has been using for a prolonged period of time and moved into dependence on the substance. The withdrawal symptoms vary from substance to substance, but generally speaking, they manifest as irritability and erratic behavior for most substances such as nicotine, caffeine, and cocaine. For drugs belonging to the opioid family, withdrawal symptoms also frequently involve nausea, vomiting, and diarrhea.

In addition to the symptoms of use and withdrawal, there are also a number of complications that will arise from the absent or inadequate treatment of the disorder.

Complications will also vary from substance to substance, but typically include:

  • Damage to internal organs such as liver, kidneys, and lungs
  • Damage to central nervous system (CNS)
  • Permanent changes in personality and behavior

The above complications are typically developed over a long period of time and usage. Most, if not all of these complications, can be avoided by discontinuing use of the substance and seeking treatment.

Causes of substance-related disorder

The specifics of what causes a substance-related disorder are still somewhat mysterious and require much more further research. However, most research points to a substance-related disorder being a symptom of an underlying psychological condition.

Such psychological conditions can include but are not limited to:

  • Depression
  • Bipolar Disorder
  • Borderline Personality Disorder
  • Attention Deficit Disorder
  • Asperger’s Syndrome

There are a number of other causes behind substance-related disorders that may not necessarily be psychological. In some cases, a substance-related disorder may occur as a result of taking a legally prescribed medication for a legitimate medical condition. Examples of such situations include opiate dependence resulting from opiate use to treat a chronic pain condition. Additionally, in some cases, the substance used to treat an underlying psychological condition may become drugs of abuse, such as amphetamine-related substances that are used to treat attention deficit hyperactive disorder.

While some problems can occur as a result of the administration of prescription medication, many addicts report that they began using a particular substance in order to self-medicate for an apparent (real or not) psychological condition. For example, many schizophrenic patients report heavy cigarette smoking in order to cope with symptoms present from the disorder.

Another substance that is typically used for self-medicating is cannabis or marijuana. While the legal restrictions are loosening and the potential medical benefits are being recognized, it must be kept in mind that this is a substance with some potential for abuse. The physiological effects of use may be less than that of drugs such as cocaine or opiates, but negative effects can still occur with prolonged inappropriate use. Anyone considering cannabis for medicinal use should consult their physician and observe the local laws of their state or municipality.

When considering substance-related disorders, it is important to remember that there is very rarely only one cause. In most cases, there is a combination of psychological and social factors that can contribute to abuse and dependence. These may be independent factors, but they are normally related to one another.

Treatment of a substance-related disorder

The treatment options for substance use disorder vary and typically involved a multifaceted approach since the causes are typically multifaceted as well. In order to successfully treat a substance use disorder, the patient must be willing and ready to actively participate in treatment.

Some of the components of substance use disorder treatment include but are not limited to:

  • Individual and group counseling
  • Peer support
  • Specialized medication for specific addiction (methadone for opiate addiction)
  • Inpatient or residential care
  • Intensive outpatient treatment

A typical treatment program will include several of these approaches. It is important to remember that substance-related disorders are typically chronic conditions. This means that treatment and recovery can take a prolonged amount of time, possibly the entire lifetime of the patient.

As mentioned previously, some treatment programs will include medication that is specific to the substance of abuse. Opiate addiction is typically treated with methadone and naltrexone as a substitute for the opioid being abused. These two medications are used because they are able to satisfy the chemical craving for opiates without producing the euphoric high that a user typically seeks. This makes them ideal for recovery since the dose can be slowly reduced to prevent the unpleasant symptoms of withdrawal. However, this approach is sometimes criticized due to the fact that many users in this type of treatment often find themselves unable to discontinue methadone during their lifetime. Many others find themselves right back on their drug of choice after failing rehabilitation.

In the case of other substance dependencies, there are some medications that have shown some efficacy in treatment. For those who are unable to quit using tobacco products, the medication sold under the name Chantix has shown to be effective in breaking nicotine addiction. However, the medication is not without side effects. Some of the side effects include severe depression, mood swings, and terrifying dreams. In most cases, nicotine replacement therapy is a far better option.

For some other substances, the “cold turkey” method is the best option. This is the case with common drugs of abuse like caffeine. There is currently no accepted pharmaceutical treatment for caffeine dependence. Most medical professionals recommend simply discontinuing use of caffeine products and the withdrawal symptoms will usually subside within one week. Additionally, the withdrawal symptoms are very light and include grogginess, irritability, and headaches.

As with any medical problem, it is always recommended that medical care is procured. For substance-related disorders, this typically means consulting a mental health professional first. This can be a counselor or therapist for those who are not seeking inpatient treatment. If your counselor or therapist deems it necessary, the patient may be referred to an inpatient facility or a psychiatrist for effective pharmaceutical intervention.

Prevention of a substance-related disorder

Generally speaking, there is no one way to prevent a substance-related disorder from developing. The first step to take in prevention efforts is to recognize the potential for a problem to develop. Many people who find themselves in the midst of an addiction failed to recognize that their use could become a serious medical problem. In these cases, it is very helpful for a person to have a solid family and social circle to rely on for support.

For the individual, one can prevent a problem from developing by simply avoiding substances that they may abuse. If you feel like you may be developing an addiction, consider meeting with a counselor to discuss any mental or emotional issues you may be experiencing. Most people will experience several traumatic events in their lifetime and coping with these events can be difficult. In many cases, a person may turn to drugs or alcohol in order to ignore or subdue emotional distress resulting from these experiences.

Experiences such as the death of a close friend or family member can set someone on a destructive path of substance abuse. It is important to seek counseling or some type of emotional support to prevent the substance from becoming a crutch.

For the families and friends of those at risk of developing a substance-related disorder, it is important to try to be uncritical in your approach. Abuse of such substances is typically instigated by a series or mass of negative emotions and mindsets. Being critical or uncaring in your approach may further drive your loved one down the path of addiction. If your loved one is currently going through a traumatic experience, show your support and be there for them as much as you can.

If you know that your loved one has a propensity toward substance use, then check your household for any substances of abuse and dispose of them properly. In some cases, removing the temptation is enough.

Regardless of your situation or that of your loved one, it is completely possible to prevent a substance use disorder from developing. However, it takes both willpower and cooperation on the part of the patient, as well as patience from his or her family and friends. Substance use disorders affect millions across the globe but can be prevented by simply paying attention and caring.

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Last Reviewed:
September 12, 2017
Last Updated:
April 01, 2018
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