Etiology and Management of Substance Related Disorders PDF

Etiology and Management of substance related disorders Muhammed shihas k  What is substance use disorder(SUD)?  WHO definition of drug : any substance that, when taken into the living organism, may modify one or more of its functions.  Substance use disorder (SUD) is a problemat...

Etiology and Management of substance related disorders Muhammed shihas k  What is substance use disorder(SUD)?  WHO definition of drug : any substance that, when taken into the living organism, may modify one or more of its functions.  Substance use disorder (SUD) is a problematic pattern of substance use that affects your health and well-being.  Dopamine released by the psychoactive substances creates a temporary "feel-good" effect, leading to cravings that can harm emotional well-being, relationships, and careers, and can even be life-threatening.  Major psychoactive substances  Alcohol  Hallucinogens  Opioids  Sedatives and Hypnotics  Inhalants  Cannabinoids  Nicotine  Cocaine  Other stimualnts(caffeine)  Amphetamine and other sympathomimetics Symptoms There are two groups of symptoms based on when or if the substance is in your body. These include: INTOXICATION Intoxication is the immediate, short-term effect of a substance on the body. Symptoms include drowsiness, calmness, excitement, or intense emotions. It can impair judgment, decision-making, and physical or mental functioning WITHDRAWAL Symptoms occur as the short-term effects of a substance wear off. Unpleasant symptoms may include: Nausea, mood swing, difficulty in sleeping, vomiting, muscle cramps Causes and Factors Biological factors Genetic vulnerability (e.g., family history, type II alcoholism) Co-morbid medical disorders Reinforcing effects of drugs (explains continued use) Withdrawal effects and craving (explains continued use) Psychological Factors Curiosity; need for novelty seeking Early initiation of alcohol and tobacco Poor impulse control Poor stress management skills Escape from reality Lack of interest in conventional goals Social Factors Peer pressure Modelling (imitating behavior of important others) Ease of availability of alcohol and drugs Strictness of drug law enforcement Religious reasons Poor social/familial support Rapid urbanisation. Risk factor Substance use disorder affects people of all ages, races, sexes, genders and socioeconomic levels You may be more at risk of developing it if you Have an underlying mental health condition. Have a biological relative with a SUD. Have a history of adverse childhood experience Have exposure or easy access to substances  Complications The complications of SUD are wide-ranging and depend on the type and severity. Common issues may include Cancer Depression Infections (Hepatitis B,&C, HIV etc) Memory loss Interpersonal relationship difficulties. Diagnosis There’s no single test for diagnosing substance use disorder. Healthcare providers evaluate your medical history, substance use behaviors, may order drug tests and check about your mental health condition According to DSM-5 a person must have at least two signs in the symptoms section over 12 months to be diagnosed with substance use disorder Two to three signs indicate a mild substance use disorder. Four or five signs indicate a moderate substance use disorder. Six or more symptoms indicate a severe substance use disorder. Management and Treatment In the first place we stop taking all the substances (withdrawal management). Allowing the substance to leave the body completely. Depending on the severity, a healthcare provider may offer medications to lessen the effects of withdrawal symptoms, as they can be rough physically and mentally. After the detox we can start the treatments, that includes Medication ( including antidepressant, antianxiety, antipsychotic along with therapies) Psychotherapy ( Behavioral therapy, family therapy, motivational enhancement therapy etc.) Limiting the using substance slowly stopping within 2-4 weeks ( on benzodiazepine) Reference Ahuja, N., (2011). A Short Textbook of Psychiatry. India, Jaypee.