Patient education: Substance use disorder (The Basics)

What is substance use disorder? — This is a term for when a person's use of drugs or alcohol, also called "substances," causes problems. This can include mental or physical health issues as well as other problems in a person's life.

In the past, people called this disorder "drug abuse" or "substance abuse." The preferred term is "misuse." Some people only misuse 1 type of substance, while others misuse more than 1.

Substance use disorder can have a serious impact on important parts of a person's life. For example, it might cause the person to miss work or school or have trouble getting along with friends or family. People with substance use disorder might be aware of their problem, but not be able to stop on their own even if they want to.

Substance use disorder can be life-threatening. But there are help and treatments available.

What are commonly misused substances? — People can misuse both legal substances (including alcohol, marijuana, and prescription medicines) and illegal drugs. Different substances can be swallowed like a pill, smoked like a cigarette, inhaled into the lungs, or injected into skin, muscle, or the bloodstream.

Alcohol, nicotine, and marijuana are examples of commonly misused drugs. Others include:

●Heroin, opioids, or related drugs used to treat severe pain

●Cocaine, methamphetamine, or other stimulants that make a person feel alert and focused

●Benzodiazepines, or drugs that make a person feel more calm and relaxed

●LSD, PCP, or drugs that cause hallucinations, cause intense excitement or happiness, or change how a person feels

●"Inhalants" or other drugs that you breathe in

Is drug addiction a substance use disorder? — Yes. "Drug addiction" is a severe form of a substance use disorder.

A person might start by experimenting with a substance, then use it regularly. When a person starts using enough of the drug to have health effects, it is considered risky use. The substance use can become a habit. The person might need more of the drug or need to use it more frequently. If they stop using the drug, they can feel physically sick and have very strong cravings for it. These are signs of addiction.

What are the signs of a substance use disorder? — There are common behaviors that can be signs of substance abuse. The more of these a person has, the more severe their substance use disorder.

Signs can include:

●Using more drugs than they planned to, or using them for longer than they planned to

●Needing more drugs to get the same effects that they used to get with less. This is called "tolerance."

●Wanting to stop cut down or stop using drugs, but not being able to

●Spending a lot of time trying to get drugs, using them, or recovering from using them

●Having cravings or a strong desire to use drugs

●Being unable to do their tasks or responsibilities because of their drug use. For example, a person might have trouble going to work or school, remembering important events, or taking care of their home.

●Stopping or cutting back on important social, work, or fun activities that they used to do

●Taking risks because of drug use, such as driving under the influence, selling drugs, or sharing needles

●Continuing to use drugs even if it affects their relationships or interactions with others

●Continuing to use drugs even when they realize that the drugs are causing physical or mental problems

●Having "withdrawal symptoms" if they stop using drugs after using them for a long time. Withdrawal can make a person feel physically sick. It can also make them feel anxious, restless, or sad.

What is withdrawal? — When people take drugs for a long time and then suddenly stop or reduce the dose a lot, they often get symptoms. These symptoms are called "withdrawal."

Depending on the drug or drugs, withdrawal symptoms might include:

●Feeling anxious or restless

●Trouble sleeping

●Nausea or vomiting

●Diarrhea

●Feeling sad or depressed

●Headache

●Fast or uneven heartbeat

●Sweating

●Shaking

●Behaviors like pacing, fidgeting, or tapping the hands or feet

●Feeling tired or drowsy

●Seizures

If you have any of these symptoms after stopping a drug, talk with your doctor or nurse. They can prescribe medicines to treat these symptoms. Medicines can prevent more severe symptoms, such as seizures. Your doctor or nurse can also suggest other ways to help you cope.

Should I see a doctor or nurse? — If you are worried that you have a problem with drugs, talk to your doctor or nurse. They can recommend treatments that can help.

Getting professional help is important. That's because different people need different types of treatment and support. Also, in some cases, stopping or cutting back on drugs on your own can be dangerous.

How is substance use disorder treated? — Treatment is based on the substances that are being misused. Treatment often involves counseling and support groups. In some cases, treatment might also include medicines.

●Counseling – In counseling, people talk with a doctor, counselor, or other specialist to better understand their problem. They learn new ways to live that do not involve drugs. Counseling can be 1 on 1, in a group, or with family members.

●Support groups – In support groups, people with substance use disorder share their experiences with each other. This can help with feelings of shame or isolation.

●Medicines – There are medicines that can help reduce cravings for drugs. They can also keep a person from getting high if they do use drugs. Medicines play a big part in helping people overcome addiction. When used the right way, they are safe and effective, and they do not get people high. Some people prefer to go to counseling and support groups but not take medicines. Those people are more likely than people who take medicines to start using drugs again.

When you are first getting off of drugs, you might need treatment in a hospital. There, you can get medicines to help with withdrawal symptoms. Some people do better with a more structured treatment program that includes specific types of therapy, behavioral exercises, and routine drug testing.

For specific situations, there are other treatments. An example is family therapy, which can be especially helpful for children or teens with addiction whose families are willing to participate in treatment.

More on this topic

Patient education: Opioid use disorder (The Basics)
Patient education: Cannabis use disorder (The Basics)
Patient education: Prescription drug misuse (The Basics)
Patient education: Alcohol use — when is drinking a problem? (The Basics)
Patient education: Alcohol poisoning (The Basics)
Patient education: Alcohol withdrawal (The Basics)
Patient education: Alcohol and your health (The Basics)
Patient education: Managing acute pain at home (The Basics)
Patient education: Taking opioids safely (The Basics)

Patient education: Alcohol use — when is drinking a problem? (Beyond the Basics)