Substance-Related Addictions, also known as chemical use or substance use disorders, are understood as disorders that involve activation of the brain reward system that reinforces repeated use of alcohol and/or other drugs despite negative outcomes. One such consequence, loss of control, represents a failure to resist the urge or craving to use. It is a prominent feature of addiction. When able to resist temporarily, restlessness and irritability is often experienced, leading one to relapse. Like other chronic disorders, prevention and treatment are generally favorable due to an increase in knowledge and treatment approaches.
Addiction is generally characterized by:
- preoccupation
- use to escape or relieve negative moods
- needing more engagement to achieve the desired effect (tolerance)
- continuing the behavior despite psychosocial problems
- giving up other hobbies and activities
- loss of control
- continuing despite negative consequences (e.g., jeopardize or lose relationship, job, educational or career opportunity)
- not being honest about use (deception)
- symptoms when unable to engage in the behavior (withdrawal)
Alcohol-Related Disorders – characterized by excessive misuse of alcohol (like beer, wine, or liquor)
Caffeine-Related Disorder – characterized by excessive misuse of caffeine (like coffee, soda, or energy drinks)
Cannabis-Related Disorders – characterized by excessive misuse of cannabis (like marijuana or cannabis products)
Hallucinogen-Related Disorders – characterized by excessive misuse of hallucinogens (like LSD, PCP, or mushrooms)
Inhalant-Related Disorders - characterized by excessive misuse of inhalants (like gas, paint, or glue)
Opioid-Related Disorders - characterized by excessive misuse of opioids (like heroin or pain medications like Vicodin)
Sedative, Hypnotic, or Anxiolytic-Related Disorders - characterized by excessive misuse of sedatives, hypnotics, or anxiolytics (like sleeping pills, Xanax, or Valium)
Stimulant-Related Disorders - characterized by excessive misuse of stimulants (like cocaine, Ritalin, or Adderall)
Tobacco-Related Disorders – characterized by excessive misuse of tobacco (like nicotine cigarettes or chewing tobacco)
Other Substance-Related Disorders - characterized by excessive misuse of other substances of abuse (like nitrous oxide or steroids)
Diagnostic Considerations:
Clinicians treat people who describe their experiences with substance-related disorders. They appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in a chapter with behavioral addiction (APA, 2013).
Substance-related disorders are included in the International Classification of Diseases, 11th Revision (ICD-11; World Health Organization, 2018).
Treatment: Treatment for substance-related disorders vary dependent on factors including co-occurring disorders. Common psychotherapeutic approaches support conscious awareness of feelings, emotion regulation enhancement, coping and calming strategies, communication and other skills that increase social support and relationships, appropriate responses to physical and psychological cues such as triggers to drink alcohol or use other substances.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.
World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.). https://icd.who.int/