Substance Use Disorder

Substance use disorder is widespread and affects a large portion of the population. There is a lot of stigma that surrounds it, we aim to clear the blur that lies around the topic and provide a proper understanding of the ailment. It might seem untreatable, but there’s a plethora of options available for rehabilitation. 

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  • Strong cravings and urges to use the substance.
  • Difficulty controlling or stopping substance use despite negative consequences.
  • Increased tolerance, requiring larger amounts of the substance to achieve the desired effect.
  • Withdrawal symptoms when attempting to quit or cut back on substance use.

  • Genetic predisposition
  • Environmental factors
  • Mental health conditions
  • Social and cultural influences

  • Detoxification
  • Behavioral therapies
  • Family Therapy
  • Medications

  • Psychiatry
  • Psychology
  • Therapy

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Substance Use Disorder

What is Substance Use Disorder (SUD)?

From the humble beginnings of early civilizations, where natural substances were harnessed for medicinal and spiritual purposes, to the modern era of synthetic compounds and recreational indulgence, the human relationship with substances has evolved and transformed. While some substances offer relief, pleasure, or altered states of consciousness, others exact a devastating toll, leading to addiction, physical and mental health disorders, and societal challenges.

Substance use disorder (SUD) is an illness that has affected contemporary society and is still rampant. This illness can involve various substances, including but not limited to alcohol, tobacco, prescription drugs, illegal drugs, and even certain behaviors like gambling. Also referred to as addiction, it is a multifaceted condition that involves a person's compulsive and uncontrollable reliance on substances despite its negative consequences. 

It is crucial to understand that addiction is not a moral failing or a lack of willpower; it is a complex disease that affects the brain's reward system, leading to persistent cravings and a loss of control over substance use. The consequences of substance use disorder can be severe and far-reaching, affecting not only the individuals struggling with addiction but also their families, friends, and communities. 

Fortunately, there is hope. It is a treatable illness, and recovery is possible with the right support, treatment, and lifestyle changes. Through a combination of medical interventions, therapy, support groups, and behavioral modifications, individuals can reclaim their lives, rebuild relationships, and regain control over their actions and choices.

Substance Use Disorder Symptoms:

The symptoms that come along with substance use can vary from person to person and are generally based on their level of addiction and dependency on the substance. However, some common signs and symptoms include:

  • Strong cravings and urges to use the substance.
  • Difficulty controlling or stopping substance use despite negative consequences.
  • Increased tolerance, requiring larger amounts of the substance to achieve the desired effect.
  • Withdrawal symptoms when attempting to quit or cut back on substance use.
  • Neglecting responsibilities at work, school, or home due to substance use.
  • Continued substance use despite relationship problems or interpersonal conflicts.
  • Physical and psychological health issues related to substance abuse.
  • Loss of interest in previously enjoyed activities and hobbies.
  • Changes in behavior, mood swings, and irritability.
  • Engaging in risky behaviors or illegal activities to obtain the substance.

Please note that the presence of these symptoms do not ultimately indicate the presence of a substance use disorder. For a proper diagnosis, do consult a mental health care professional.

Having gone through the symptoms, there is also one more thing that we need to make sure you know. When a person chooses to abstain from substances after a long time of being exposed to it, they will be susceptible to what is called Withdrawal Symptoms. 


The process of cutting back on addictive substances is referred to as withdrawal. Withdrawal symptoms on the other hand are what arises during this process, because if your body reaches a point of physical dependence on the substance, a lack of it can cause the body to react. These symptoms can be mild or serious.

Symptoms For Withdrawal

Mild symptoms include:

  • not being able to sleep
  • irritability
  • changing moods
  • depression
  • anxiety
  • aches and pains
  • cravings
  • tiredness
  • seeing things that are not there (hallucinations)
  • nausea and vomiting
  • diarrhea
  • sweating
  • shaking

Severe symptoms include (especially in the case of drugs and alcohol):

  • paranoia
  • confusion
  • tremors
  • disorientation
  • seizures

Substance Use Disorder Causes:

The underlying mechanisms that contribute to substance use disorders are intricate and diverse, combining environmental, genetic, and psychological elements. While the exact causes can vary from person to person, here are some common factors that contribute to the development of substance use disorders:

  • Genetic predisposition: Certain individuals may have a genetic vulnerability to developing substance use disorders. Family history of addiction can increase the risk, suggesting a genetic component in the susceptibility to substance abuse.

  • Environmental factors: The environment in which a person grows up and lives can play a significant role. Factors such as peer pressure, exposure to substance use at an early age, lack of parental supervision or support, and living in a community with high substance abuse rates can increase the likelihood of developing a substance use disorder.

  • Mental health conditions: People with certain mental health disorders, such as depression, anxiety, or attention-deficit/hyperactivity disorder (ADHD), may be more prone to substance abuse as a way to self-medicate or cope with their symptoms.

  • Social and cultural influences: Societal and cultural factors, including glamorization of substance use in media, normalization of drug use in certain social circles, and societal acceptance or tolerance of substance use, can contribute to the development of substance use disorders.

Types of Substance Abuse Disorder:

Before we get into the sea of information that is to follow, there’s something we would like you to keep in mind.

The words dependence and addiction do not mean the same thing. Yes, they have been used interchangeably, but let’s look at what they actually mean.


The term dependence usually refers to a physical dependence on a substance. This dependence is characterized by symptoms of tolerance and withdrawal. Although it is possible to be dependent on a substance without actually being addicted to it, addiction is almost always right around the corner.


Addiction on the other hand is identified through a change in behavior caused due to biochemical changes in the brain after prolonged substance use. Using substances tends to become the main priority of addicts regardless of whether it is of any harm to them or others. Leading them to act irrationally when they do not have access to the substance they’re addicted to.

We’ll be seeing these terms used quite a lot, so it's best to know this beforehand.

Substance use disorder is the medical term for addiction and can be split into multiple types according to the excessive and problematic use of a particular substance or group of substances. 

According to the Global Drug Survey that was conducted in 2021, three of the most used substances are as follows:

Alcohol Use Disorder (AUD)

With 29.5 million people, ages 12 and older, having an AUD worldwide and 1/12th of India’s population having the same, it takes the highest prevalence in the list and is an issue that needs to be addressed. 

The disorder is characterized by the consumption of alcohol above regular limits on a daily basis and the compulsive need to consume it regardless of the ill-effects it may have on the person’s life. The excessive consumption of alcohol can lead to health problems, impaired judgment, and can even cause relationship issues.

Drinking alcohol in small amounts does not affect the body, but the problem arises when the level of consumption exceeds normal limits. If you’re wondering what that limit is, it’s 

two drinks or less. Let's quantify this a little better.

What is Considered to be One Drink?

According to the National Institute on Alcohol Abuse and Alcoholism, one drink is defined as:

  • 355ml (12 ounces) of regular beer (about 5% alcohol)
  • 237ml to 266 (8 to 9 ounces) of malt liquor (about 7% alcohol)
  • 148ml (5 ounces) of wine (about 12% alcohol)
  • 44ml (1.5 ounces) of hard liquor or distilled spirits (about 40% alcohol)

Drinking more than this on the regular is something that should blare a few alarms in your head. Not only is alcohol addictive, but it can also reduce your appetite, and may even lead to the formation of an ulcer in your stomach.

Tobacco Use Disorder

Tobacco contains a highly addictive substance called nicotine. Nicotine causes the brain to release chemicals called endorphins into your system which activates the reward center in your brain. This release of happy chemicals is what primarily makes it extremely easy to get addicted to.

The disorder encompasses the addiction towards tobacco products and involves a strong physiological and psychological dependence on nicotine. The numbers indicate just how rampant it is as well, with 22.3% of the world’s population using tobacco.

Cannabis Use Disorder

There’s a lot of debate about the benefits of Cannabis, yet no one denies that it is still ultimately addictive. Out of all the people who use Cannabis, 3 in 10 people get addicted to it. It’s also considered known to be a gateway drug, a substance that leads a person to try more intense types of substances.

The disorder involves the problematic use of marijuana or cannabis products. Where individuals with cannabis use disorder may experience difficulties in controlling their consumption to a point where it detriments daily function.

Here are some more disorders that are not as prevalent:

  • Opioid Use Disorder (OUD): OUD is characterized by the misuse of opioids, including prescription painkillers like oxycodone and illegal substances like heroin. It is often marked by intense cravings, tolerance, and withdrawal symptoms.

  • Stimulant Use Disorder: This disorder encompasses the abuse of stimulant drugs such as cocaine, amphetamines, and methamphetamine. It is characterized by increased energy, heightened euphoria, and potentially severe physical and psychological consequences.

  • Hallucinogen Use Disorder: This disorder involves the persistent misuse of hallucinogenic substances, such as LSD (lysergic acid diethylamide) or psilocybin (magic mushrooms), resulting in significant distress or impairment.

  • Inhalant Use Disorder: This disorder refers to the misuse of volatile substances like aerosol sprays, gasoline, or glue, which are inhaled to produce mind-altering effects. Inhalant use disorder can lead to severe health consequences, including damage to the brain, liver, and other organs.

Diagnosis and Treatment:


Before an expert starts the process of diagnosis, it is highly likely that they are going to thoroughly evaluate your medical history and behaviors surrounding drug abuse, since substance use disorder can not be diagnosed through a single test. 

After which, they may order drug tests and evaluate the reports from any prior drug monitoring program that you may have been in. It is also in practice for them to ask you about your mental health as it is common to have a mental health condition along with SUD.


The diagnosis of Substance Use Disorder is typically made based on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). To receive a diagnosis, an individual must have at least two signs from the symptoms section over 12 months.

Here’s the general criteria that will be looked into while diagnosing:

1. Impaired control: Difficulty in controlling substance use, such as unsuccessful attempts to quit or cut back.

2. Social impairment: Substance use leading to problems in social, occupational, or educational functioning.

3. Risky use: Continued substance use despite physical or psychological harm caused.

4. Pharmacological criteria: Development of tolerance (needing more of the substance to achieve the desired effect) or experiencing withdrawal symptoms upon reducing or discontinuing substance use.


Effective treatment for substance use disorder typically involves a combination of interventions tailored to an individual's needs. Treatment options may include:

  1. Detoxification: The initial phase of treatment involves managing withdrawal symptoms and safely removing the substance from the body. This process is usually conducted under medical supervision to ensure safety and comfort.

  1. Behavioral therapies: Various evidence-based therapies are used to address the psychological and behavioral aspects of substance abuse. These may include:

         A. Cognitive Behavioral Therapy (CBT): Focuses on identifying and modifying unhealthy thoughts, emotions, and behaviors associated with substance use.

          B. Motivational Interviewing (MI): A person-centered approach to enhance motivation and commitment to change.

         C. Contingency Management: Reinforces positive behaviors and abstinence through rewards and incentives.

  1. Family Therapy: Involves the participation of family members to improve communication, support, and address family dynamics that may contribute to substance abuse.

  1.  Medications: Medications may be prescribed to manage cravings, reduce withdrawal symptoms, or prevent relapse. Examples include medications for alcohol dependence (such as naltrexone or acamprosate), opioid agonists (like methadone or buprenorphine) for opioid use disorder, or medications for nicotine addiction (like nicotine replacement therapy or bupropion).

  1.  Support groups and self-help programs: Participation in support groups, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), can provide a supportive community, guidance, and accountability during recovery.

  1.  Dual diagnosis treatment: If an individual has a co-occurring mental health disorder, integrated treatment addressing both the Substance Use Disorder and the mental health condition is essential for successful recovery.

How are Withdrawal Symptoms Treated?

Support, care, and medication that help reduce symptoms and avoid potential problems are all part of the treatment for withdrawal. With some drugs, individuals can abruptly stop using them and handle their withdrawal symptoms on their own. For instance, a person might be able to stop using coffee on their own and endure the side effects until they pass.

However, quickly stopping drugs like benzodiazepines (a chemical used in medicine that is used to treat anxiety and insomnia) or alcohol might be potentially deadly; as such, always speak with your doctor to develop a detox strategy. Medically aided withdrawal can help to minimize unpleasant withdrawal symptoms while ensuring your safety.

Quick Self Assessment

If you’d like to quickly check whether you may be at risk of developing an SUD, try answering these questions.

  • Do most or all of your social activities include the use of substances?
  • Have you ever had regrets revolving around your decisions on drinking or using?
  • Do you find yourself having to drink or use more than you used to for the same effect?
  • Have you ever forgotten all or most of your time spent after drinking or using?
  • Have you ever missed out on work, homework, classes or a meeting because of drinking or using?
  • Has drinking or using ever led to personal, financial or legal problems in your life?
  • Does anyone in your family have a drinking or using problem?
  • Have you ever tried to stop using or cut down but were not successful?

Answering “Yes” to 2 or more of these questions may indicate that you’re at risk of developing unhealthy drinking or using habits and we advise that you meet with a mental health expert for a proper diagnosis.

Living With Substance Use Disorder

Having to go on about your daily life with an SUD can be difficult, we know. It may be rough, but at the end of the day, you are trying and that’s what really matters. Let’s look at a few things you could do to cope better with the issue:

Take Your Time

Recovery is a journey that takes time and effort. It’s advised to be patient and know that setbacks may occur but that it does not ultimately define your worth or ability to recover. Learn from these obstacles and use them as opportunities for growth.

Avoid Triggers

One major factor that pushes people to use are triggers. Try and avoid all triggers that may make you feel like using again. It could be that one friend that you grab drinks with everyday after work, or a place that you often go to for cigarettes. Replace your environment with things that encourage your recovery, you’ve got this!

Manage Stress

Excess stress can make people feel like falling back on substances. Our experts recommend utilizing healthier coping mechanisms to manage these challenges. Mindfulness, meditation and deep breathing exercises are the way to go!

Build a Support Network

Build a network of friends, family or individuals who are willing to see you through the process of recovery. They need to be people who can understand challenges and offer encouragement and understanding. Something else that you could do is joining a support group, it’s a place where you’ll find that you’re not alone in your struggles and can even learn how others cope with their SUDs!


Ideally, the best course of action would be to seek professional help. Mental health professionals are trained to help you deal with the situation that you are currently in. They are sure to provide guidance, support and appropriate treatment options tailored to your specific needs.

Keep in mind to follow through with your treatment plan, attend therapy sessions, take prescribed medications as directed, and engage in aftercare programs. Consistency in treatment and support is vital for long-term recovery.

Additionally, set achievable short-term and long-term goals for yourself. Celebrate milestones and accomplishments along the way, reinforcing your motivation to stay on the path of recovery. We really don’t want to chew off more than we can bite.

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Substance Use Disorder

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