Substance Use Disorder


What is Substance Use Disorder?

Substance Use Disorder involves the chronic difficulties in resisting the desire to drink alcohol or take drugs (Nolen-Hoeksema, p. 396). A substance is any natural or synthesized product that has psychoactive effects; it changes perceptions, thoughts, emotions, and behaviors (Nolen-Hoeksema, p. 396). This disorder is a complex brain disease that causes addictions towards these substances (Substance Use Disorder, 2014). Addictions are the intense and sometimes uncontrollable cravings and compulsive behaviors to obtain the alcohol and or drugs. Addictions exert a long and powerful influence on the brain that manifests in three distinct ways, which are cravings for the object of addiction, loss of control over its use, and continuing involvement with it despite adverse consequences (Understanding Addiction, n.d.).

There are four conditions that have historically been seen as important in defining individuals that use substances, such as intoxication, withdrawal, abuse, and dependence (Nolen-Hoeksema, p. 398). Substance intoxication is a set of behavioral and psychological changes that occur as a result of the physiological effects of a substance on the central nervous system (Nolen-Hoeksema, p. 398). Soon after the substance is ingested, the individual becomes intoxicated and the more they ingest, the more intoxicated they can become. Substance withdrawal is a set of physiological and behavioral symptoms that result when people who have been using substances heavily for prolonged periods of time stop or greatly reduce their use (Nolen-Hoeksema, p. 398). Diagnosis of withdrawal requires significant distress or impairment in a person's everyday functioning. Substance abuse is given when a person's recurrent use of a substance resulted in significant harmful consequence. Finally, substance dependence is closest to the reference of drug addiction and refers to people who are dependent on or "addicted to" a substance (Nolen-Hoeksema, p. 399). People that are dependent on drugs show a tolerance effect, which results them in needing more and more of the drug to feel intoxicated.

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Stimulants activate the central nervous system, causing feelings of energy, happiness, and power; a decreased desire for sleep; and a diminished appetite (Nolen-Hoeksema, p. 406). Cocaine, amphetamines, nicotine, and caffeine are types of stimulants associated with substance use disorders.

Cocaine and amphetamines are associated severely because they both highly influence a psychological lift or rush. This can cause dangerous increases in blood pressure and heart rate, and constrict the blood vessels, which can lead to heart attacks, respiratory arrest, and seizures (Nolen-Hoeksema, p. 406). Cocaine is extracted from the coca plant and is one of the most addictive substances known. People snort or inject the cocaine to get the instant rush of intense euphoria, followed by heightened self-esteem , alertness, energy, and feelings of competence and creativity (Nolen-Hoeksema, p. 407).

Amphetamines are stimulants prescribed for multiple treatments, such as attention problems, narcolepsy, and chronic fatigue. Many amphetamines are used appropriately under supervision of a physician, but a great amount of doses are diverted to illegal use and abuse (Nolen-Hoeksema, p. 409). Teenagers and young adults abuse amphetamines the most, hoping to enhance their cognition or improve their ability to learn (Cite druge abuse). The symptoms of amphetamines are similar to cocaine; euphoria, self-confidence, alertness, agitation, and paranoia (Nolen-Hoeksema, p. 409).

Nicotine and caffeine are not as severe, but widely used across nations. Nicotine is the most addictive substance known, however, is fully legal for use by adults and readily available to adolescents (Nolen-Hoeksema, p. 410). Nicotine is found in tobacco, and cigarettes are the most popular way to get nicotine. Nicotine's physiological effects resembles the fight-or-flight responses because several symptoms in the body are aroused, including the cardiovascular and respiratory systems (Nolen-Hoeksema. p. 410). Nicotine has severe withdrawal symptoms that make the person become depressed, irritable, angry, anxious, frustrated, restless, and hungry; they have trouble concentrating, and they desperately crave another dose of nicotine (Nolen-Hoeksema,p. 410). Smoking cigarettes for an extended period of time can cause lung cancer, bronchitis, and probably coronary heart disease.

Caffeine is by far the most heavily used stimulant, with 75 percent of it ingested in coffee. Other sources include tea, caffeinated soda, over-the-counter analgesics and cold remedies, weight-loss drugs, energy drinks, and chocolate and cocoa (Nolen-Hoeksema, p. 411). Caffeine increases metabolism, body temperature, and blood pressure. It also makes people feel more alert, but if too many dosages are taken, unpleasant symptoms occur, such as restlessness, nervousness, and hand tremors (Nolen-Hoeksema,p. 411). People might get an upset stomach, experience rapid heart beats, or have trouble sleeping.

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(Volkow, 2014)

Causes of Disorder

Almost all substances associated with substance use problems affect the "reward mechanism" in the brain. The main chemical messenger involved in the brain's reward mechanism is dopamine (MedBroadcast Clinical Team, n.d.). Each time the person uses the substance, they feel good, which leads them to want to use the substance again. Over time, less dopamine is produced because of changes in the brain. These changes lead to pleasurable effects lessening because of a tolerance build-up, which leads to larger amounts needed to get the same intoxicated feeling (MedBroadcast Clinical Team, n.d.).

The causes of substance use problems are not fully clear, but many scientists and theorists believe biological and environmental aspects play a role. Heredity appears to be involved because substance use disorders are higher for people that have a family history with these problems (MedBroadcast Clinical Team, n.d.). Also a person's environment, such as school, work, friends, family, and cultural and religious beliefs, can affect substance use problems (MedBroadcast Clinical Team, n.d.). Peer pressure happens daily, which is a big instigator in substance use. Also, children and adolescents may learn substance use behaviors from their parents or important others (Nolen-Hoeksema, p. 418). Finally, mental health problems can lead to people using substances. Individuals that have anxiety or depression issues try to manage their unpleasant feelings and emotions by using drugs (MedBroadcast Clinical Team, n.d.).

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Know the Signs!!

It is important to know the symptoms of substance use problems to help others or yourself. Recognizing the symptoms early can help in treatments before the painful addiction sets in too deeply. Since these drugs interfere with the part of the brain that allows good judgment, a person might not recognize their health issues. This is called denial of the problem and a symptom of the disorder (Substance Use Disorder, 2014). Also, tolerance and withdrawal are two symptoms that are a result of the biological changes in the brain and nervous system from continual use of a substance. On the other hand, some individuals understand the consequences of their disorder, but cannot over come the urges and strong desires of the substance. This symptom is known as cravings (Substance Use Disorder, 2014). Finally, a related symptom is the feeling that a person "has lost control" over the urge to use drugs and this is usually accompanied by an uncomfortable irritability and anxiety (Substance Use Disorder, 2014). Noticing these five symptoms is important because it can help someone you love or even yourself. If any of these symptoms appear, proper treatments should be advised.
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Treatment Plans

There are multiple treatment plans to help with substance use disorder, which consist of biological and psychosocial treatments. Biological treatments are medication based that help reduce the individuals desire for the substance (Nolen-Hoeksema, p. 420). One medication is antagonist drugs. These block or change the effect of the addictive drug, reducing the desire for it. To help with nicotine addictions, there are two pharmacological treatment approaches. The most common is nicotine replacement therapy, which is the use of nicotine gum or a nicotine patch that helps prevent withdrawal effects (Nolen-Hoeksema, p. 420). The other approach is the use of prescription medications that reduce the cravings for nicotine. Two types of drugs commonly used are antidepressant bupropion and varenicline (Nolen-Hoeksema, p. 420).

Psychosocial treatments, such as behavioral and cognitive techniques have been proven to help in the treatment of substance use disorders. These techniques are driven by five main goals. First is to motivate the individual to stop using the addictive drug. Secondly, it is used to teach patients new coping skills to replace the use of substances to cope with stress. Third goal is to change the reinforcements for using substances. The fourth is to enhance the individual's support from non-using friends and family members. Finally, the last goal often is to foster adherence to pharmacotherapies in conjunction with psychotherapy (Nolen-Hoeksema, p. 421).

Getting help today can benefit you or your loved one in the future! It is important to seek treatment immediately before health issues get worse. Follow the link below for more information and how to receive proper help.


There are many myths or misconceptions of drug users. Myths tend to frighten individuals because they do not want to be associated with the negative beliefs. One myth is known as, you cannot force someone into treatment (Common Drug Misconceptions and the Truth, 2010). This myth is false because treatments do not have to be voluntary. People who are forced into treatment by the legal system or by friend/family member can be just as successful as those who enter treatment voluntarily. Sometimes they do better because they remain in treatment longer, since they have to, and complete the program (Common Drug Misconceptions and the Truth, 2010). It is important to know if there is a loved one you know that needs treatment, forcing them is just as good or better.

Another myth is, people do not need treatment, they can stop using drugs if they really want to (Common Drug Misconceptions and the Truth, 2010). This myth is incorrect as well because addictions are extremely difficult for people to overcome and maintain long-term abstinence. Research shows long-term drug use actually changes a person's brain function, causing them to crave the drug even more (Common Drug Misconceptions and the Truth, 2010). It is very important to stop substance abuse early because of this long-term effect on the brain. It is vital to know the consequences of drug abuse and admit when having a problem (Common Drug Misconceptions and the Truth, 2010). Admitting to having an addiction is the first step to recovery.

Follow the link below to see multiple more myths about substance use. Do not let the fear of knowing that you might have an addiction stop you from getting help today!


Common Drug Misconceptions and the Truth. (2010, September 27). In The Catholic University of America. Retrieved September 14, 2014, from

Cycle of Addiction. (2014). In Recovery Connection. Retrieved September 15, 2014, from

MedBroadcast Clinical Team. (n.d.). Substance Use Problems. In CHealth. Retrieved September 14, 2014, from

Mental Health and Substance Use Disorder. (n.d.). In Mental Health. Retrieved September 15, 2014, from

Nolen-Hoeksema, S. (2011). Abnormal Psychology (6th ed., pp. 394-421). New York, NY: McGraw-Hill.

Substance Use Disorder. (2014). In Sutter Health - Alta Bates Summit Medical Center. Retrieved September 14, 2014, from

Understanding Addiction. (n.d.). In Help Guide - Harvard Health Publications. Retrieved September 14, 2014, from

Volkow, N. D. (2014, July). Drug Abuse and Addiction. In National Institutes on Drug Abuse. Retrieved September 15, 2014, from

By: Jason Hockemeyer