A substance use problem is a medical condition. It is substance use that:
It can also involve using or taking a substance in increasing amounts, going to great lengths to obtain the substance, experiencing withdrawal symptoms when the substance is stopped, or being unable to stop or reduce the use of the substance.
Marijuana, synthetic marijuana, depressants (e.g., alcohol, barbiturates, benzodiazepines), stimulants (e.g., amphetamines, cocaine, MDMA, or ecstasy), hallucinogens (e.g., LSD), opioids (e.g., codeine, heroin, and morphine), and over-the-counter medications are the most commonly abused substances. Anabolic steroids are sometimes abused in order to improve athletic performance.
Substance use problems are very complex medical problems. Because they affect the brain, they are not just about willpower. Since there is a lot of stigma (shameful feelings) associated with substance abuse problems, health care professionals are not using terms such as "addiction," "addict," and "drug abuse" as much. Instead, they are using "substance use problems" and "people with substance use problems."
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. Each time the person uses the substance, they feel good, which makes them want to use the substance again. Over time, changes in the brain occur (e.g., less dopamine is produced), which lessens the pleasurable effects of the substance and larger amounts are needed to get the same feeling.
The causes of substance use problems aren’t clear, although there are many factors that are thought to play a role. Heredity (genetics) appears to be involved, as the risk of substance use problems is higher for people with family members with these problems. A person’s environment, such as school, work, friends, family, and cultural and religious beliefs, can also affect substance use problems. Recreational use is typically started in small doses with occasional use and progresses over time to frequent use and sometimes abuse disorder. Some recreational drugs are more addictive than others based on how quickly their effects are felt and whether or not they cause tolerance to build or withdrawal symptoms.
Other mental health conditions such as anxiety and depression may also play a role. Substance use may also start when people try to manage unpleasant feelings and emotions (e.g., anger, stress, sadness). People who are subject to discrimination may also be at risk for substance use problems.
Substance use problems are treatable. Treatment may take a few weeks or months and may involve relapses, but for many, treatment is successful in the long term.
There are various treatment options available. A treatment plan will depend on a person’s needs and will take into consideration such things as the severity of the problem, the person’s support network, and the person’s desire or motivation to enter treatment. The treatment plan may need to be altered as the needs of the person change. Treatment may include support groups, withdrawal or detoxification, counselling, or harm reduction for those who may not be ready to completely quit using substances that are causing problems.
Medications may also be used as part of a treatment plan. People with alcohol use problems can be given naltrexone*, a medication that helps to reduce cravings for alcohol; or acamprosate, a medication used to rebalance certain brain chemicals in people with substance use problems.
In some cases, other medications are used to treat withdrawal symptoms. During withdrawal of some substances, the person is gradually weaned off the substance by being given smaller and smaller doses. They may also be given less harmful substances instead of the ones they’re dependent on. For example, people dependent on heroin are often given methadone. Methadone isn’t as harmful to the brain as heroin or other narcotics.
Treatment plans almost always involve counselling. Counselling helps the person understand their substance use problem and helps them develop effective coping skills.
There are many types of treatment services, and availability may vary depending on where a person lives. Some programs are based in the community, and the person lives at home and comes to a treatment centre on a daily or regular basis. Other programs involve staying at a treatment facility for a certain period of time. The types of services and treatment approaches can vary between programs and centres, and a person with a substance use problem should be comfortable with the approach a program or centre uses.
During recovery, many people will have relapses along the way. These relapses should be viewed as temporary setbacks that can be a source of learning (e.g., what triggered the relapse and how to develop strategies that might help deal with this trigger in the future). Overcoming each relapse will bring the person closer to recovery. Recovery can be a long process for some people, but it is possible.
Many prevention programs (e.g., for schools, families, and the media) have proven to help prevent substance use problems. Helping youths to understand the risks of substance use problems reduces substance use. Fostering and modelling open and respectful communication within families helps to reduce the risk of developing substance use problems. Talk to your family about alcohol and other drugs. If you are not sure how to talk about alcohol and drug use, contact your doctor or community health centre for information and resources.
All material copyright MediResource Inc. 1996 – 2025. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Substance-Use-Problems
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