substance abuse disorders; What is substance abuse disorder (drug addiction)?

Substance abuse disorder, or drug addiction, can be defined

as a progressive disease that causes people to lose control of the use of some substance despite worsening consequences of that use.
Substance use disorder can be life-threatening. Addictions are not problems of willpower or morality. Addiction is a powerful and complex
disease. People who have an addiction to drugs cannot simply quit, even if they want to. The drugs change the brain in a way that makes
quitting physically and mentally difficult. Treating addiction often requires lifelong care and therapy. What are drugs of abuse? Drugs that are
commonly misused include: Alcohol., Club drugs, like GHB, ketamine, MDMA (ecstasy/molly), flunitrazepam (Rohypnol®).,Stimulants, such
as cocaine (including crack) and methamphetamine (meth).,Hallucinogens, including ayahuasca, D-lysergic acid diethylamide (LSD), peyote
(mescaline), phencyclidine (PCP) and DMT.,Inhalants, including solvents, aerosol sprays, gases and nitrites (poppers).,Marijuana., Opioid pain
killers such as heroin, fentanyl, oxycodone, hydrocodone, codeine and morphine., Prescription drugs and cold medicines. Sedatives, hypnotics
and anxiolytics (anti-anxiety medications). Steroids (anabolic).,Synthetic cannabinoids (K2 or Spice).,Synthetic cathinones (bath
salts).,Tobacco/nicotine and electronic cigarettes (e-cigarettes or vaping).While these drugs are very different from each other, they all strongly
activate the addiction center of the brain. That is what makes these substances habit-forming, while others are not. Why do people with
substance use disorder need more and more drugs over time? People feel intoxicated after using drugs of abuse. Over time, the brain is
changed by drugs of abuse. The brain becomes desensitized to the drug of abuse so that more of the drug must be used to produce the same
effect. As the person consumes more, drugs start to take over the person’s life. One may stop enjoying other aspects of life. For many people,
social, family and work obligations fall to the side. The person with SUD starts to feel like something’s wrong if he or she isn’t under the
influence of the substance. They may become consumed with the need to recapture that original feeling. Who is at risk for substance use
disorder? Anyone can develop a substance use disorder. No one thing can predict whether a person may develop an addiction. You may be
more prone to drug use due to: Biology: The person’s genetic makeup, gender, ethnicity and mental health issues may raise his or her risk for
developing an addiction. About two-thirds of people in addiction treatment are men. Particular ethnicities are at higher risk for substance abuse
disorder. This is true for Native Americans. Environment: Surroundings can affect the likelihood of developing substance use disorder. For
example, stress, peer pressure, physical or sexual abuse and early exposure to drugs can raise the risk. Age: Teenagers who start taking drugs
are especially at risk. The parts of the brain that control judgment, decisions and self-control are not fully developed. Teens are more likely to
engage in risky behaviors. In a developing brain, drugs can cause changes that make addiction more likely. How common is substance use
disorder? Substance use disorder and alcohol use disorder are the leading causes of preventable illness and early death. Research has shown
that about 1 in 9 Americans uses illicit drugs (about 11% of the population). The most commonly misused drugs are marijuana and prescription
medications. How might substance use disorder affect me? Drugs affect the brain, especially the “reward center” of the brain. Humans are
biologically motivated to seek rewards. Often, these rewards come from healthy behaviors. When you spend time with a loved one or eat a
delicious meal, your body releases a chemical called dopamine, which makes you feel pleasure. It becomes a cycle: You seek out these
experiences because they reward you with good feelings. Drugs of abuse send massive surges of dopamine through the brain, too. But instead
of feeling motivated to do the things you need to survive (eat, work, spend time with loved ones), such massive dopamine levels can lead to
damaging changes that change thoughts, feelings and behavior. That can create an unhealthy drive to seek pleasure from the drug and less
from more healthy pleasurable experiences. The cycle revolves around seeking and consuming drugs to get that pleasurable feeling. Addiction
to drugs changes the brain over time. It affects how the brain works and even the brain’s structure. That’s why healthcare providers consider
substance use disorder a brain disease. The first use of a drug is a choice. But addiction can develop, creating a very dangerous condition. Drugs
affect your decision-making ability, including the decision to stop drug use. You may be aware there’s a problem but unable to stop. With
addiction, stopping drug use can be physically uncomfortable. It can make you sick and even become life-threatening.

Substance abuse chart

This chart compares the relative danger of particular substances based on the dependence level developed and the potential physical harm to
the user and others. Heroin, with an extremely high dependence and high potential for physical harm, is an extremely dangerous substance.

SYMPTOMS AND CAUSES why do people take drugs? People may begin using drugs for several reasons. They may: Enjoy the pleasurable
experience. Want to change or blunt their unpleasant feelings. Want to improve their performance at work, school or athletics. Be curious or
give in to peer pressure. What are symptoms of substance use disorder? Symptoms of drug addiction include: Bloodshot eyes and looking
tired. Changes in appetite, usually eating less. Changes in physical appearance, such as having a poor complexion or looking ungroomed.Craving
drugs. Difficulty completing tasks at work, school or home. Engaging in risky behaviors, despite knowing negative consequences (such as driving
while impaired or having unprotected sex).Inability to reduce or control drug use. Issues with money. Weight loss. DIAGNOSIS AND TEST Show
is substance use disorder diagnosed? The first step to diagnosing a drug addiction is recognizing the problem and wanting help. This initial step
may start with an intervention from friends or loved ones. Once someone decides to seek help for addiction, the next steps include: Complete
exam by a healthcare provider. Individualized treatment, either inpatient or outpatient. MANAGEMENT AND TREATMENT what are treatments
for drug addiction? Several therapies exist for treating substance use disorder. Even for a severe disorder, treatment can help. Often, you’ll
receive a combination of these therapies: Detoxification: You stop taking drugs, allowing the drugs to leave the body. You may need healthcare
supervision to detox safely. Medication-assisted therapies: During detox, medicine can help control cravings and relieve withdrawal symptoms.
Behavioral therapies: Cognitive behavioral therapy or other psychotherapy (talk therapy) can help deal with addiction’s cause. Therapy also
helps build self-esteem and teaches healthy coping mechanisms. What medications are available to help with substance use disorder?
Medication may be part of your treatment plan. Your care team figures out the best medications for you. Medication-assisted treatments are
available for: Opioids: Methadone, buprenorphine and naltrexone are FDA-approved for the treatment of Opiate Use Disorder. Alcohol: Three
FDA-approved drugs include naltrexone, acamprosate and disulfiram (Antabuse®) Tobacco: A nicotine patch, spray, gum or lozenge can help. Or
your doctor might prescribe bupropion (Wilburton®) or varenicline (Chantix®).Is treatment for drug addiction inpatient or outpatient? Both
inpatient and outpatient treatment plans are available, depending on your needs. Treatment typically involves group therapy sessions that
occur weekly for three months to a year. Inpatient therapy can include: Hospitalization.Therapeutic communities or sober houses, which are
tightly controlled, drug-free environments. Self-help groups such as Alcoholics Anonymous and Narcotics Anonymous can help you on the path
to recovery. Self-help groups are also available for family members, including Al-Anon and Nar-Anon Family Groups. Participation in 12-step
based recovery work has been proven to improve outcomes. Is there a cure for substance use disorder? There is no cure for drug addiction.
People can manage and treat addiction. But there is always a risk that the addiction will return. Managing substance use disorder is a lifelong
job.PREVENTIONCan I prevent substance use disorder?Yes. Preventing drug addiction starts with education. Education in schools, communities
and families helps prevent misusing a substance for the first time. Other ways to prevent substance use disorder:Don’t try illegal drugs, even
one time.Follow instructions for prescription medications. Don't ever take more than instructed. Opioid addiction, for instance, can start after
just five days.Dispose of unused prescriptions promptly to reduce risks of misuse by others.Are there conditions that raise the risk for
substance use disorder?Many people have both a mental health condition and a substance use disorder. Sometimes, mental illness is there
before the addiction happens. Other times, the addiction triggers or worsens a mental health disorder. When both conditions are treated
properly, the chances for recovery improve.OUTLOOK / PROGNOSISWhat is the outlook for people with substance use disorder?Addiction is a
lifelong disease. But people can recover from addiction and lead full lives. Getting help is essential to recovery. Different tools work for different
people, but ongoing therapy and self-help groups such as Narcotics Anonymous help many.Are there long-term effects of addiction?If you
continue to misuse drugs, brain structures and functions can change. Substance use disorder alters how you:Behave,.Deal with
stress.,Learn.,Make judgments and decisions,Store memories.Can addiction come back?Substance use disorder is a “relapsing disease.” People
who are in recovery from this disease have a higher chance of using drugs again. Recurrence can happen even years after you last took
drugs.Because of the possibility of relapse, you need ongoing treatment. Your healthcare provider should review your treatment plan with you
and change it based on your changing needs. If you have a problem with prescription drugs, including opioids, inform your healthcare providers.
They can help you find other options to manage pain.Is drug addiction fatal?Substance use disorder can kill. If left untreated, you could die
from overdose or engaging in dangerous behavior under the influence of drugs. Treatment can help people recover from addiction and prevent
serious consequences.A note from Cleveland ClinicSubstance abuse, or substance use disorder, is a brain disease. Drugs affect your brain,
including your decision-making ability. These changes make it hard to stop taking drugs, even if you want to. If you or a loved one has a
substance use disorder, talk to a healthcare provider. A trained provider can help guide you to the treatment you need. Usually, a combination
of medication and ongoing therapy helps people recover from addiction and get back to their lives.The Difference Between Substance Abuse
and Substance Dependence;The terms “substance abuse” and “substance dependence” are sometimes used interchangeably, but they’re
actually two different conditions. Substance abuse is a pattern of drug or alcohol use that leads to negative consequences. It often brings
about problems in work or school, impacts relationships with friends or family members, and introduces dangerous or potentially life-
threatening situations.Dependence, however, is a physical and mental reliance on drugs or alcohol. People who struggle with substance
dependence are unable to stop using despite the negative consequences, and experience cravings and withdrawal symptoms when they
do.Alcoholics and SmokingWe know from statistics and observations that:Alcoholics smoke more than non-alcoholics,People smoke more in
places where alcohol is served,Smokers are more likely to be binge drink 1Researchers at the Duke University Medical Center believe they have
found one reason why alcohol seems to be so closely linked to smoking. 2 Smoking Can Increase Health Risks in AlcoholicsBehavioral
Link"Epidemiological, clinical, and laboratory evidence clearly indicate a behavioral link between cigarette smoking and alcohol use," said Jed
Rose, PhD, director of the Duke Nicotine Research Program and co-creator of the nicotine patch. "The combined use of cigarettes and alcohol
presents health risks over and above the risks posed by smoking alone, and thus constitutes a serious public health problem which deserves
additional research attention.""In particular, understanding the pharmacological basis of the interaction between alcohol and nicotine could
lead to the development of effective strategies for treating the drugs' dual-use," Rose said.Smoking and Drinking Are Often LinkedAccording to
researchers:If you have more than five drinks a week, you’re two-and-half times more likely to smoke.,Compared to nonsmokers, smokers are
three times more likely to drink to excess.Moderate drinkers who smoke have a higher risk of heart, liver, and lung disease than those who only
smoke or only drink.3Nicotine Offsets Alcohol's EffectsIn the past, investigators have speculated about the alcohol-nicotine association. Some
research has indicated that it is because nicotine offsets the sedative effects of alcohol. Drinking alcohol can slow reaction times and impair the
performance of some visual tasks, but some studies have found that nicotine can counteract these deficits. 4Dopamine LevelsBoth alcohol and
nicotine increase concentrations of dopamine in the brain, so another theory is using nicotine and alcohol together increases the feeling of
pleasure more than using either drug by itself. 5Meanwhile, some neurobiological research has produced conflicting information regarding the
nicotine-alcohol link. "Some have reported that ethanol increases the activity of the brain receptors that respond to nicotine, while others have
indicated a dampened response of certain subtypes of the so-called nicotinic receptors in the presence of ethanol," the Duke researchers
said.To find out, Rose's investigators examined 48 volunteers who were regular smokers and who reported usually drinking at least four
alcoholic beverages per week. The participants were served either an alcoholic beverage or a placebo beverage. In one session, the volunteers
were given a regular cigarette, but in another session, they were given a nicotine-free cigarette. How Smoking and Drinking Affect the
BrainRewarding EffectsCompared to those who drank a placebo beverage, those who had alcohol reported that:Alcohol enhanced the
rewarding effects of nicotine,Alcohol enhanced the calming effects of nicotine,Nicotine-free cigarettes did not elicit the same responseThe
research suggests that it is nicotine itself, not other aspects of smoking, that is the critical ingredient in producing a positive response in people
who drink alcohol.2Effects on Nicotine"A relatively low dose of alcohol—below that required to induce any measurable euphoria—was enough
to increase participants' enjoyment of nicotine significantly," Rose said. 2 "In light of the current finding, it makes sense that so many people
who have quit smoking relapse when they drink."The researchers took the study a step further by giving the participants mecamylamine, a drug
known to be a nicotine antagonist.Mecamylamine"Mecamylamine might offer a novel treatment to help smokers who also drink alcohol quit
both drugs as mecamylamine has been found to counteract the effects of both nicotine and alcohol, said Rose. "Such an approach to smoking
cessation would work especially well for drinkers as it would dampen both desires," Rose said.Such methods would be particularly useful for
heavy drinkers and people with an addiction to alcohol, Rose added. Consideration of taking this medication must be made in close conjunction
with your doctor, however, as it is still experimental.