Substance Use Disorder (SUD) is a recognized medical condition where subjects cannot control their substance use, even as they recognize the negative consequences. Although SUDs are complex, they are treatable. With proper care and treatment, individuals can overcome substance use problems and discover a new way to live.

At DeCoach Rehabilitation Centre, we provide clients with a private space for withdrawal while ensuring that the process is safe and comfortable. During withdrawal management (WM), our interdisciplinary team guarantees the highest standard of medical care and a safe transition to aftercare.

Here, we discuss the types of substance use disorders.

How Do People Develop Substance Use Disorders?

Continuous substance use can impact and change brain functioning. These changes can last long after the acute effects of the substance have worn off, or after the period of intoxication has passed. The immense pleasure, euphoria, calm, enhanced perception and sense, and other emotions generated by the substance are referred to as intoxication. The symptoms of intoxication depend on the substance used.

Tolerance develops in people with substance use disorders, meaning they require more of the substance to experience the same high.

According to the National Institute on Drug Abuse, people take substances to:

  • Experience a pleasurable “high”
  • Relieve anxiety and numb themselves to past traumas.
  • Improve performance or thinking.
  • Experiment – they may be curious or succumb to peer pressure to try a substance.

What are the Problems Associated with SUD?

Dependence on substances can cause a number of dangerous and damaging complications, such as:

  • Impaired control

Any substance use affects the brain, central nervous system, and other organs. Regular substance use changes the brain’s function well after the effects of intoxication wear off.

Changes in brain structure and function cause cravings, abnormal movements, and personality changes. In addition, metabolism and/or brain chemistry, which impacts vital functions such as blood pressure, circulation, heart rate, and respiration, can be affected.

Studies of brain imaging show areas relating to memory, decision-making, learning, and behavioral control are affected, which makes it hard for the individual to stop using the substance(s) and lessens chances of recovery after frequent long-term use.

  • Drug effects

Tolerance means there is a need for more of the substance to recreate the original effect. Even recreational users need more each time to achieve a high. Ultimately, increases in substance use can result in dependency and financial burdens, often to the extent that basic needs like housing, nutrition, and personal well-being take a backseat.

  • Withdrawals

These are different for each substance, with possible symptoms including anxiety, irritability, fatigue, night sweats, vomiting, insomnia, paranoia, and hallucinations. Professional, empathetic withdrawal management may be recommended to reduce the discomfort of withdrawal, monitor complications, and build trust as an essential first step before psychosocial treatment commences.

  • Mental health issues

Substance use may be triggered by the user’s attempts to balance mood swings, dull emotions, or escape reality. Often, another psychiatric disorder may precede substance use disorder, or the use of a substance can trigger or worsen an existing psychiatric condition, affecting emotional well-being as the body inhibits the natural production of vital compounds like serotonin, dopamine, and glutamate as it relies on the external source.

  • Risky use

Those with SUD focus on using a substance(s) (alcohol, prescription, or illicit drugs such as cocaine) despite awareness that their everyday function is impaired. The substance may also be used in risky settings

  • Social problems

Physical and mental health problems tend to become increasingly apparent, and interpersonal problems with family members, friends, or work colleagues emerge as the individual fails to perform tasks at work, home, or school.

Due to substance use, occupational and leisure/social activities often take a back seat. This plays into society’s overall negative perception and can make the individual feel like an outcast. When someone with a substance use disorder feels ostracized, they are prone to hide their symptoms and less likely to seek help.

Categories for Diagnosis of SUDs

Eleven criteria have been developed by The American Psychiatric Association (APA) for SUD diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

If someone is diagnosed with mild SUD, this means a person displays two or three of the symptoms mentioned below. Moderate points to four or five symptoms, and severe refers to more than six. The most severe SUDs are generally referred to as addictions.

The DSM-5 Criteria for Substance Use Disorders include:

  • Taking a substance for extended periods or in greater amounts than intended.
  • Finding it difficult to cut back or stop.
  • Spending a lot of time obtaining the substance, using it, and recovering from its effects.
  • Craving the substance.
  • Failing to fulfill obligations due to substance use.
  • Continuing to use despite problems caused or exacerbated by substance use.
  • Continuing use of the substance despite associated physical or mental problems.
  • Relinquishing work and social or recreational activities due to substance use.
  • Using the substance in dangerous circumstances.
  • Needing more of the substance to create the usual effect.
  • Unpleasant symptoms or withdrawal if use is discontinued.

Alcohol Use Disorder

Alcohol depresses the central nervous system, diminishes control over your actions, and makes you drowsy. Over-indulging affects speech, muscle coordination, and vital brain centers. Binge drinking can even cause a life-threatening coma or death. (This is more likely if on medication that depresses brain function.)

Alcohol is responsible for approximately 88 000 deaths annually in the US, and analyses that refer to the overall harm to users and others due to drugs, show it is the most harmful.

About one-third of adults in the US fulfill the criteria for alcohol use disorder sometime during their lifetime. Alcohol use can start in the teenage years, but alcohol use disorder is identified more frequently in the 20s and 30s.

A pattern of drinking where a man has five drinks or more in one day, or more than 14 per week, is referred to as binge drinking. For women, this means more than three drinks a day or more than seven a week. 

Risk Factors

Risk factors for developing an alcohol use disorder include the following:

  • Steady drinking regularly for an extended period or binge drinking often.
  • Drinking from an early age—especially binge drinking—poses a higher risk of alcohol use disorder.
  • Genetics: If a close relative has problems with alcohol, the risk of alcohol use disorder is higher.
  • People with depression and other mental health problems, such as depression, anxiety, schizophrenia, or bipolar disorder, commonly experience problems with alcohol.
  • A history of emotional trauma poses an increased risk of alcohol use disorder.
  • Social and cultural factors: If you have friends or family members who drink regularly, it could increase your risk of alcohol use disorder. Youngsters are influenced by parents, peers, and other role models. The glamorous portrayal of alcohol in the media may signal that excessive drinking is acceptable.

Safety Risks

The lowering of inhibitions can lead to poor choices and dangerous situations such as:

  • Motor vehicle accidents or drowning
  • More likelihood of committing violent crimes or becoming the victim of a crime
  • Legal problems and employment or financial troubles
  • An increased chance of using other substances
  • Engaging in unprotected sex or becoming the victim of sexual assault or rape
  • Higher risk of attempted or completed suicide

Health Risks

Drinking too much on a single occasion or over time can cause various health risks such as:

  • Liver disease
  • Bone loss
  • Weakened immune system
  • Increased cancer risk
  • Issues with sexual function
  • Interruption of menstruation
  • Birth defects such as fetal alcohol spectrum disorders
  • Eye problems
  • Neurological complications including memory loss and dementia
  • Digestive and heart problems

Alcohol also increases the risk of hypoglycemia, which is dangerous for diabetics who are already taking diabetes medications to lower their blood sugar levels.

Some medications increase the toxicity of alcohol and can increase or decrease their effects with dangerous results.

Treatment

Mild or moderate alcohol use disorder can usually be successfully reduced without treatment, but those with more severe alcohol use disorder should seek treatment.

Cocaine Use Disorder

Cocaine is a Schedule II stimulant frequently abused, most notably by people between 18 and 25. Some users report experiencing euphoria and feeling more energetic and mentally alert, able to perform simple physical and intellectual tasks more quickly. In contrast, others report feelings of restlessness, irritability, and anxiety.

Cocaine use disorder is highly addictive, leading to extensive physiological and psychological problems. Binge cocaine use, where the drug is taken at increasingly higher doses over several hours, can see the user losing touch with reality in a state of paranoid psychosis.

Occasionally, sudden death occurs during the first use of the drug or afterward, usually a result of seizures or cardiac and respiratory arrest. Cocaine is available in powdered and freebase forms.

The powdered form is a hydrochloride salt that dissolves in water; freebase is a compound that can be smoked, as in “crack” cocaine. However it is used – inhaled (snorted), injected, or smoked – it can cause a fatal overdose, and regular use reduces the stimulation period.

Smoking the drug causes an intense, immediate high as heightened doses of the drug are delivered to the brain fast. But the faster the absorption, the shorter the duration of the high, so smokers of the substance are more likely to develop a compulsive habit than those who inhale it. Users who inject cocaine are at risk of HIV/AIDS and Hepatitis C if they share needles.

Short-term Physical Effects of Cocaine Use

  • Headaches
  • Quicker heartbeat and breathing
  • Blood pressure and body temperature elevation
  • Violence or erratic behavior
  • Chest pain, blurred vision, fever, nausea, muscle spasms, vertigo, and tremors
  • Convulsions can cause death, heart failure, or brain failure.

Long-term Physical Effects of Cocaine Use Disorder

  • Dependence
  • Erratic behavior, irritability, mood swings, restlessness, paranoia, insomnia, and weight loss
  • Isolation from loved ones and emotional instability
  • Psychosis, depression, anxiety disorders, auditory hallucinations, and delusions
  • Damage to the nose and inflamed nasal passages
  • Increased risk of hepatitis and HIV
  • Severe respiratory infections
  • Abdominal pain and nausea, chest pain, heart attacks, respiratory failure, and stroke

Prescription Drug Use Disorder

Widely recognized as a growing problem, prescription drug use disorder affects all age groups and may become a chronic lifelong disorder, with negative outcomes including disability, relapse, and even death.

If you take medicine prescribed for somebody other than yourself, administer more doses than specified, take medicine for a non-medical reason, or use it differently from the way it should be administered, this should be recognized as problematic.

Symptoms of prescription drug use disorder vary depending on the type of drug.

Because they have mind-altering properties, the most commonly misused prescription medications are:

  • Opioids

These drugs are used to treat pain including oxycodone (Oxycontin, Percocet) and hydrocodone (Norco). The negative effects of opioids are nausea, constipation, drowsiness, slowed breathing, confusion, poor coordination, and increased sensitivity, and if needed for pain relief, doses must be increased.

  • Anti-anxiety medicines, sedatives, and hypnotics 

Medications such as alprazolam (Xanax), diazepam (Valium), and zolpidem (Ambien) are used to treat sleep disorders. These drugs can cause poor focus, dizziness, unsteadiness, drowsiness, confusion, slurred speech, memory lapses, and slowed breathing.

  • Stimulants 

These medications are used for the treatment of attention-deficit/hyperactivity disorder (ADHD) and certain sleep disorders include dextroamphetamine-amphetamine (Adderall XR, Mydayis), methylphenidate (Ritalin, Concerta, others), and dextroamphetamine (Dexedrine).

The misuse of stimulants can result in an irregular heartbeat, increased alertness, agitation, anxiety, paranoia, insomnia, high blood pressure and body temperature, and a diminished appetite.

These drugs are problematic since medicines like antihistamines are used to induce euphoria. Taking large doses of cough/cold products containing dextromethorphan can bring similar out-of-body sensations and hallucinations to drugs like ketamine and PCP.

Side effects of cough/cold products include restlessness, itchy skin and redness of the face, nausea and vomiting, stomach pain, paranoia and confusion, excessive sweating, irregular heartbeat, and high blood pressure. Large amounts can cause fevers, seizures, loss of consciousness, brain damage, and death.

How Is Substance Use Disorder Treated?

An important step in treating substance use disorders is the individual’s awareness of problematic substance use.

A doctor should assess the symptoms to identify the presence of a substance use disorder. Whether the SUD is mild, moderate, or severe, patients can benefit from treatment.

SUDs impact many aspects of the user’s life, so multiple types of treatment may be necessary. Generally, a combination of medication and individual or group therapy is effective. Treatment should also address medical, psychiatric, and social problems since these problems are often interlinked.

Withdrawal management is key, and medications are used to control drug cravings, relieve the symptoms of withdrawal, and prevent relapse. Psychotherapy is designed to illuminate behavioral motivations, development of self-esteem and coping strategies, as well as address other psychiatric problems.

Mental Health & Addiction Treatment Services Available in Cincinnati, Fairfield, Hamilton, Xenia, and Fairborn Ohio

DeCoach Rehabilitation Centre provides affordable, professional, and safe Medication-Assisted Treatment for substance recovery from alcohol and opiate addiction, including dependence on heroin. A multidisciplinary team individualizes each patient’s treatment, offering one-on-one counseling in a calm, respectful environment.

Should you, or a loved one, have questions about medication-assisted treatment or are ready to take the first step towards recovery, reach out to the team at DeCoach Rehabilitation Centre for more information.

Call our offices to speak with a member of our team, or reach out to us online today!

Published On: January 13th, 2023 / Categories: Substance Use /