244 Substances
Substance-Related Disorders
1. Introduction to the Substance-Related Disorders
- The Substance-Related Disorders include disorders brought about by taking the drug of abuse (including alcohol), the side effects of a medication, or by the exposure of toxins. In the DSM-IV, the word substance can refer to a drug of abuse, a medication, or a toxin one is exposed to (4th ed., text rev.; DSM–IV–TR; American Psychiatric Association, 2000).
- Substance-Related Disorders involve various forms of indulgence of drugs or chemicals that could lead to the demise of an individual’s physical or mental health status. A substance use disorder can affect anyone; rather they be rich or poor, male or female, employed or unemployed, young or old, and any race or ethnicity. The etiology is unknown, however; the chance of developing a substance use disorder depends partly on genetics, which are biological traits passed down through families. Although person’s environment, psychological traits, and stress level can also play a significant role in the use of alcohol or drugs. These substances can include nicotine in the form of tobacco, alcohol, hallucinogens, steroids, inhalants as well as opioids. The use of these substances can affect cognitive, behavioral, and psychological symptoms that occur due to repetitive use and abuse of the substance that can often lead to tolerance, withdrawal, and dependency. An individual’s need to continue to use the substances despite their awareness of negative side affects is a key factor in determining dependency. They feel like they have to use the substance to function day to day in society. There are many documentaries that have been made revealing the seriousness of substance use, case in point the new MTV documentary “Steve-O Demise and Rise“.
2. Substance Abuse vs. Substance Dependence
- DSM-IV-TR Substance Dependence Criteria
- A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
- tolerance, as defined by either of the following:
- (a) a need for markedly increased amounts of the substance to achieve intoxication or desired effect
- (b) markedly diminished effect with continued use of the same amount of the substance
- withdrawal, as manifested by either of the following:
- (a) the characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets for Withdrawal from the specific substances)
- (b) the same (or closely related) substance is taken to relieve or avoid withdrawal symptoms
- the substance is often taken in larger amounts or over a longer period than was intended
- there is a persistent desire or unsuccessful efforts to cut down or control substance use
- a great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-s