Substance Use Disorder

Substance use disorder is when a person’s use of alcohol or another substance (drug) leads to health issues or problems at work, school, or home.

Substance use disorder (SUD), is the repeated and persistent use of substances (alcohol inclusive) despite its later severe effects.

Substance use disorders are known by several mental, social,  physical, and behavioral symptoms, which may lead to problems relating to impaired muscle coordination, loss of control, impaired judgment, the wreckage of one’s social life, and interpersonal relationship, drug tolerance, and withdrawal symptoms.

Classification of drugs often involved

This is a simple classification of drugs that are mostly involved in Substance Use Disorders, and they include:

  1. Tobacco
  2. Caffeine
  3. Alcohol
  4. Inhalants
  5. Hallucinogens (arylcyclohexylamines)
  6. Cannabis
  7. Sedatives
  8. Other hallucinogens (LSD)
  9. Stimulants
  10. Hypnotics
  11. Opioids
  12. Anxiolytics
  13. Other unknown substances

Category of substance use disorders

There are only two categories of substance use disorders, and they are;

  • Substance abuse
  • Substance dependence

In 2013, “Substance abuse” and “substance dependence” were merged and started housing under the same umbrella called – “substance use disorder”. This was due to the realization that both substance abuse and substance dependence are disorders that involves substance.

One can be diagnosed with substance use disorder, and the severity of the disorder varies widely; this can be classified as mild, moderate, or severe, depending on the number of the diagnostic criteria checked.

However, the term “substance addiction” is similar to a severe substance use disorder.

Substance Dependence

Substance dependence, also known as Drug dependence, is the physical and mental state of a person whereby the person’s behavior and other responses are as a result of the feeling that the person should compulsorily take a particular kind of drug continuously or periodically, just to have the psychic effect of the drug and many at times the person takes it to run away from the discomfort and irritation that comes with its absence.

Drug dependence happens to a person when the person feels the intense need to take one or more kinds of drugs in order to basically function.

Drug abuse

Drug abuse, also is called Substance abuse, is a chronic brain disorder that is characterized by persistent consumption of drugs (alcohol inclusive) despite the unpleasant effects.

Drug abuse is often considered mild. It is also taken to be the early phase of using drugs inappropriately. This always leads to dependence. Frankly, dependence is often considered a more severe disorder than Substance abuse. Dependence is a result of drug abuse.

Drug dependence and drug addiction

Although “addiction” and “dependence” have been used interchangeably by people, but “Dependence” is distinct from “addiction.”


Addiction is the physical and mental inability to quit consuming a particular substance, drug or chemical, or to stop engaging in a specific activity even though the person is fully aware of the harm the substance, drug, chemical or activity can cause to the physical and psychological well-being of the individual.

The term “addiction” is not only referred to as one’s dependence on substances such as cannabis or cocaine. Someone who cannot quit himself/herself from consuming a particular drug has a substance dependence.

That is to say that one can be addicted to the drug and still not be dependent on the drugs.

The difference between addiction and dependence

As explained above, addiction and dependence are distinct. One can be dependent on a particular drug, but that does not mean that one is addicted. You may be wondering how. This is how;

Addiction may involve:

  1. The use of drugs despite their effects
  2. Not being able to quit the consumption of drugs
  3. The person neglects occupational and social obligations because of the consumption of the drug.


There is a possibility that one can be dependent on drugs and not be addicted to drugs. Dependence involves the physical response to a drug or substance.

This happens when a person depends on medications to manage a medical condition, which can be chronic or acute.

The conditions may include:

  • Diabetes
  • High Blood Pressure
  • Glaucoma

A good example is a person suffering from diabetes who needs to be periodically taking insulin shots and other medications as prescribed in order to manage the medical condition.

Even if the person starts experiencing some side effects which could be severe or mild, the person would be forced to continue with the medications until the doctor prescribes medications with little or no side effects.

Here, the person depends on the medications and can not stop consuming them because physically, the person is dependent on the function of the medications.

If the person ever had the chance to quit taking the medications, the person would gladly discontinue because the person is not addicted but is dependent, the person can not stop consuming it even if he/she wanted to.

Substance dependence may not be the same as substance addiction, but they have similar symptoms, and they include:

  1. The person’s body adapts to the consumption of the substance, thereby developing a high tolerance for the drugs. This can lead to a continuously rising desire to take larger doses, more often.
  2. There are withdrawal symptoms: This is when the person starts manifesting physical symptoms, which may include irritation and discomfort when the person tries to stop the consumption of the drugs for a long time.

How can drug abuse lead to substance dependence?

A lot of people are in need to be assisted in treating a drug, substance, or alcohol problem.

Some people take prescribed medications to manage pain or for any other condition. In some cases, people may take prescribed medication for pain or another medical condition.

Sometimes, these people can develop physical and mental states whereby the person becomes dependent or addicted to the substance; this can be called “substance use disorder.”

Triggers for substance use disorders:

  1. Social environment: This is when one is living and/or socializing in an environment where there is easy access to illicit substances, and these substances are frequently used and abused.
  2. Family history: When there is a family history that is recorded and showed addiction of a relative who had abused and has been addicted to drugs, one stands a chance of being a victim of drug addiction.
  3. History of anxiety: Persons who suffer from anxiety the most are most likely to abuse drugs and get addicted. Some substances are suppressants that aid in easing stress and anxiety. Some of these substances can lift the user to a state of euphoria. This makes the user to continuously use it while he/she gets addicted.
  4. History of some mental health conditions: Some mental health conditions always pushes the person to the point of using drugs. Sometimes, the person gets addicted.
  5. History of depression: Depression is an awful state of mind that most people do not like being in. This state of mind pushes one to abuse drugs as an escape from depression itself. These people tend to run from the battle of depression to the war of drug addiction.

Stages of substance

There are certain stages substance users go through to becoming drug dependent.

Healthcare providers often describe these stages with the “Jellinek Curve,” which helps to outline the disease model of addiction, showing how an individual can start up casually, then move to a destructive phase, then to the addicted state before getting to clean recovery.

This helps us to understand that substance abuse (alcohol inclusive) is like a disease that can progressively worsen if the right course treatments are not administered.

This also expresses that a crack head or a person with this disorder can live a healthier life after recovery. That is to say that all hope is not lost; recovery is possible. These stages – occasional use, regular use, substance abuse, disorders, and rehabilitation.

The stages

  1. Occasional use: This is when the person starts using the substance infrequently and only in settings that coerce him/her to substance abuse. Maybe when the person finds himself/herself in a social setting where people engage in activities that makes them abuse drug and other substances. This propels the person to engage in these activities. The person can not use his/her money on a normal day to get involved in the use of these substances. This is only for recreational purposes.
  2. Regular use: This is where the person graduates to the level whereby he/she uses substances regularly. This gradually leads to substance abuse.
  3. Substance abuse: At this level, the drug user could wreck his/her social life, deserting family, and friends for substance use. One becomes more concerned about his/her access to drugs more than loved ones.
  4. Disorders – substance dependence and addiction: You become dependent on drugs and unable to live without them. Your physical and mental health deteriorates. This is the level where one is said to be addicted because the person’s body has become more tolerant of their psychological and physical effects.
  5. Rehabilitation: Adding to this is rehabilitation. This is the stage whereby one decides to quit drug abuse and come clean. This stage requires professional help to help deal with the withdrawal symptoms until the person is no longer addicted nor dependent on the substance.

Symptoms of drug dependence

One can rightly determine whether another has become worse than addicted and has become substance dependent by just observing his/her behavior.

It’s good to know what when a person is said to be substance-addicted has not consumed the particular substance for some time, one can uncomfortably start manifesting physical reaction.

These physical reactions are due to the withdrawal symptoms which occur when the body is stressed without the use of drugs, which it has become dependent on. The symptoms include:

  1. Depression
  2. Nightmares
  3. Sweating
  4. Nausea
  5. Body aches
  6. Vomiting
  7. Anxiety
  8. Muscle weakness

Treatment for substance dependence

Substance dependence can come as an advanced result of drug abuse, and when this happens, treatment is difficult.

To treat this, one must decide and accept to quit using the substance. Sounds so easy, but there is a huge problem – withdrawal syndrome. When an addict or a person who is dependent on a substance stops the use of drugs abruptly. This can trigger physical reactions, which are highly unpleasant.

One can not go through this unpleasant journey alone; thus, one may need the professional and caring help of a healthcare provider in order to rid the body of these substances so that the person can come out healthy, free, and clean.

This can be organized and carried out on an out-patient or in-patient basis according to the one which seemed best.

The use of substances that gives similar effects to these harmful and illicit drugs may aid in the reduction of withdrawal symptoms during treatment.

Detox programs make use of an organized combination of treatment-therapy to help treat the disorder relieving the person’s dependency on drugs. After the treatment program, the patient is encouraged to take part in therapy sessions if needed.

But in case of extreme withdrawal, intoxication,  or even overdose, one would need emergency care in order to ease the effects and symptoms before the main problem is being tackled, and that is; the treatment of substance use disorders – addiction and dependence.

Frankly, the only treatment for substance use disorders is rehabilitation.

The long-term outlook for people with substance use disorders

Substance use disorders are huge problems that pose a threat to the well-being of the individual if not treated

Due to the body’s adaptation to the drug and increase intolerance for the drug, one may gradually increase the quantity of the substance taken into the body because of this. This may lead to overdose or death.

Fortunately, treatment can reverse substance dependence and its effects, but one must first be willing to give drug up and offer himself/herself for treatment. This is so because treatment may be successful the first time, but one is likely to relapse. Although there are people who willingly go for treatment, and after successful treatment, one may still relapse.

It is never a pleasant nor easy journey, but ongoing therapy sessions can aid one’s recovery and take care of relapse syndromes. Joining at least a support group can help one go a long way in the journey of recovery, and they caringly help one to stay on track.

Have you ever had to deal with the above condition before? Or was it a close member of the family? How were you able to manage the situation?

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