Patient education: Treatment for substance use disorder (The Basics)

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

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

What are commonly misused substances? — People 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 substances. Other substances people frequently misuse include:

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

●Cocaine, methamphetamine, or other "stimulants" – These are drugs that make a person feel alert and focused.

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

●LSD, PCP, or related drugs – These can cause hallucinations, cause intense excitement or happiness, or change how a person feels.

●"Inhalants" or other drugs that are breathed in

Why does substance use disorder need to be treated? — Substance use disorder can have a serious impact on a person's life. For example, it might cause them 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 and can be a lifelong problem. But help and treatment are available. With the right care, people can recover and live a healthy life. Getting help is the first step to recovery.

How is substance use disorder treated? — Treatment is based on the substances that are being misused and will depend on the situation. Treatment tries to help a person:

●Stop using substances

●Develop skills and behaviors to deal with feelings, cope with cravings, and stay away from substances

●Address other problems, such as depression or anxiety

Many people choose treatment on their own. Other people might start treatment after it is ordered by the court. Or they might have a family member or friend who wants them to get treatment. Treatment for a substance use disorder can help save lives.

What happens during treatment? — The first step in many treatment plans is to stop using the substance. This is sometimes called "detoxification," or "detox."

Detox can be difficult, but there are medicines and people available to help. When a person uses a substance for a long time and suddenly stops or reduces the dose, they often have symptoms. These symptoms are called "withdrawal." Depending on the substance or substances, physical 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 hands or feet

●Feeling tired or drowsy

●Seizures

These symptoms can last for just a few days or, in some cases, more than a week. This depends on how much of a substance the person was using, how they were taking it, and if they were using more than 1 substance.

Working through the emotions that go along with substance use can take much longer. This part of treatment often involves counseling and support groups:

●Counseling – In counseling, people can talk with a doctor, therapist, or other specialist to better understand their problem. They learn new ways to life without substances. 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 can also play a big part in helping some people with substance use disorder. When used in the right way, they are safe and work well. For some substances, there are medicines that can help reduce cravings. Medicines can also keep a person from getting high if they do use drugs. People who take medicines as a part of their treatment are less likely to start using substances again than those who only go to counseling and support groups.

Another part of treatment involves finding ways to prevent "relapse," or going back to using substances again. There are strategies that can help a person learn what might lead to a relapse. There are also tools to help prevent a relapse.

Where does treatment happen? — Treatment can happen in different places and in different ways. For example:

●Some people take part in an "inpatient" or "residential" program. This involves staying at a hospital or center the whole time during treatment, even overnight.

●Some people start their recovery in a hospital. This way, they can get help with withdrawal symptoms. Then, when they are ready, they move to another center or program.

●Some "outpatient" treatment programs meet for 7 to 8 hours each day. With this type of program, people return to their home at night. Other outpatient treatment programs meet during the day or evening 1 or more days a week.

●There are also "sober living" communities. A group of people, who are all in recovery, live together and support each another.

Some types of treatment are more structured than others. Treatment might include specific types of therapy, behavioral exercises, and routine drug testing. For specific situations, there are other treatments. An example is family therapy. This can be especially helpful for children or teens with substance use disorder who have families that want to participate in treatment.

What if I relapse? — There is always a chance of relapse when someone is in treatment or stops using a substance. A relapse happens when a person returns to the unhealthy behaviors of substance use. Relapse can cause a person to feel shame or guilt. It is important to work through these feelings.

It can help to see a return to old behaviors as a common part of the recovery process. Instead of abandoning the progress made towards recovery, a relapse can help strengthen the commitment to recovery.

By learning what triggered the relapse, a person can learn to avoid or manage "high-risk" situations. A high-risk situation might include people, places, or feelings that led to substance use in the past.

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

Getting professional help is important. Stopping or cutting back on alcohol or drugs on your own can be dangerous. Also, different people need different types of treatment and support.

More on this topic

Patient education: Substance use disorder (The Basics)
Patient education: Alcohol use — when is drinking a problem? (The Basics)
Patient education: Prescription drug misuse (The Basics)
Patient education: Opioid use disorder (The Basics)
Patient education: Cannabis use disorder (The Basics)

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