Psychology: Substance Use Disorders

Substance Use Disorders

• Substance abuse: A pattern of drug or substance use despite knowledge of negative effects, but without full-blown dependency.
• Substance dependency: A cluster of cognitive, behavioral, and physiological symptoms indicating continued use despite significant substance-related problems.
• Substance use disorder (SUD): Where an individual has at least one substance disorder diagnosis, whether it is a general diagnosis of substance dependency or abuse, or a more specific substance category disorder.

General Diagnostic Criteria

• Impaired control: • Substance taken for longer than originally intended. • Reports desire to cut down, but with multiple unsuccessful efforts to quit. • Individual spends a significant amount of time obtaining the substance and recovering from its effects. • In severe cases, virtually all the individual's daily activities revolve around the substance. • Craving is manifested by an intense desire or urge for the substance that may occur at any time.
• Social impairment: • Substance use results in failure to fulfill major role obligations at work, school, or home. • Individual persists with substance use despite recurrent social and interpersonal problems caused by the substance. • The individual may withdraw from family activities and hobbies in order to use the substance.
• Risky use: • Recurrent substance use in situations in which it is physically hazardous. • The individual continues to take the substance despite knowledge of persistent or recurrent physical or psychological problems caused by the substance.
• Pharmacological criteria: • Tolerance is signalled by requiring increasing doses of the substance to achieve the desired effects. • The individual experiences withdrawal symptoms, and continues to take the substance in order to relieve these withdrawal symptoms.

Specific Substance Use Disorders

• Alcohol Use disorder
• Tobacco use disorder
• Cannabis use disorder
• Stimulant use disorder (Cocaine, Amphetamines, Caffeine)
• Sedative use disorders (Opiates)
• Hallucinogen-related disorders (LSD, ecstasy)

Aetiology of Substance Use Disorders

• Experimentation: • Availability of drugs (legality and cost), familial factors (family member use or problematic family environment), peer group influences (group use or peer pressure), media influences (advertising)
• Regular use: • Mood alteration effects (experienced positively), self-medication (done to alleviate perceived or real problems, usually of a psychological nature), long-term expectations and beliefs (positive in nature), cultural variables (how they perceive and advocate for use)
• Abuse and dependence: • Genetic predisposition, long-term substance-induced cognitive deficits (underachievement academically, motivationally, cognitively), concurrent psychiatric diagnoses (comorbid disorders increasing stressors and psychiatric comorbidity results in less likely to consider drugs problematic), poverty

Treatment of Substance Use Disorders

• Community-based programs (e.g.)