Substance Use Disorder
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Signs and Symptoms
A substance use disorder is when an individual uses alcohol or another substance in a problematic way that results in impairment in daily life or ongoing distress. A person with this disorder will often continue to use the substance despite consequences (DSM-IV).
The person must have at least two of the following for a given substance within the same 12-month period:
- Drinking or using a drug in an amount that is greater than the person originally sets out to consume
- Worrying about cutting down or stopping; or unsuccessful efforts to control use.
- Spending a large amount of time using a substance, recovering from it, or doing whatever is needed to obtain it.
- Common use of a substance resulting in (1) failure to take care of things at home, work, school (or to fulfill other obligations); and/or (2) giving up once-enjoyed recreational activities or hobbies.
- Craving, a strong desire to use alcohol or another substance.
- Continuing the use of a substance despite problems caused or worsened by it — (1) in areas of mental (e.g., blackouts, anxiety) or physical health; or (2) in relationships (e.g., using a substance despite people’s objections or it causing fights or arguments).
- Recurrent alcohol/substance use in a dangerous situation (such as driving or operating machinery).
- Building up “tolerance” as defined by either needing to use noticeably larger amounts over time to get the desired effect or noticing less of an effect over time after repeated use of the same amount.
- Experiencing withdrawal symptoms (e.g., anxiety, irritability, fatigue, nausea/vomiting, hand tremor or seizure in the case of alcohol) after stopping use.
Reference: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition.
Headspace reports that effective treatment options cognitive behaviour therapy, multidimensional family therapy, functional family therapy, and group CBT , contingency management and brief interventions like motivational interviewing. Family behaviour therapy and individual cognitive problem-solving therapy are effective approaches for young people with a dual diagnosis . In general, psychosocial treatment is more effective than no treatment, although there are some approaches that have been found to have negative effects. Overall, little is known about the effectiveness of using medications to treat substance use disorders.