Substance Use Disorder

Because there is a lot of stigma attached to misusing drugs and alcohol, people often do not see addiction as a real medical disorder. But research shows that addiction is not just about making poor decisions — it is actually a complex disease caused by biological changes in the brain.

If you struggle with substance use disorder, know that your addiction is not some kind of moral failing; it is a real illness. And just like any other illness, you can seek medical attention to get treatment for your addiction. Use the resources below as a place to start.

What is substance use disorder?

Substance use disorder is a brain disorder and mental illness. People with substance use disorder compulsively seek drugs or alcohol and often lose control over their actions. The most extreme form of substance use disorder is addiction.

The most common kind of substance use disorder is alcohol use disorder. Many people also have a drug use disorder.

Substances vary by how dangerous and addictive they are. These are some of the most commonly used substances:

  • Opiates, e.g. heroin, opium, codeine, narcotic pain medicines
  • Stimulants, e.g. cocaine and amphetamines
  • Depressants, e.g. alcohol, barbiturates, benzodiazepines
  • Hallucinogens, e.g. LSD, mescaline, psilocybin
  • Marijuana

If you struggle with addiction, you are not alone. According to the 2018 National Survey on Drug Use and Health, 20.3 million American adults have a substance use disorder; that is about 6 percent of the population. Of these, 14.8 million have an alcohol use disorder and 8.1 million have an illicit drug use disorder.

Many people with substance use disorders also suffer from mental illness — 9.2 million, to be exact. Fortunately, a lot of treatment centers and behavioral health centers are equipped to treat substance use disorder along with other mental illnesses.

What does addiction do to your brain?

The first time someone uses a substance, they are using it voluntarily. Normally, the brain uses a neurotransmitter called dopamine to reward good behaviors like exercising or eating. But drugs take over the normal brain systems so that when you use a drug, your brain’s system is flooded with dopamine, which feels like a reward. This makes you want to repeat your drug use.

Over time, as addiction grows, your ability to resist the drug is physically impaired. Repeated drug use damages the brain’s prefrontal cortex, which is the part of the brain that helps you make decisions.

Who is at risk for addiction?

Although nothing guarantees that you will get a substance use disorder, Medline Plus lists a few factors that put you at higher risk:

  • Your biology: how you react to drugs
  • Pre-existing mental health problems
  • Unstable or unhappy home life
  • Trouble in school or work
  • Being around other people who use drugs
  • Starting to use drugs when you’re still young

How can I tell if someone has a drug or alcohol problem?

Symptoms may vary for drug and alcohol use, but the basic principle is the same: when someone becomes obsessive about consuming a substance, they may have a substance use disorder. Here are a few behaviors to look for, according to Medline Plus:

  • Changing friends a lot
  • Spending a lot of time alone
  • Losing interest in favorite things
  • Not taking care of yourself
  • Being tired or sad
  • Eating more or less than usual
  • Being energetic, talking fast, saying things that don’t make sense
  • Being in a bad mood
  • Quickly changing between feeling good and bad
  • Sleeping at strange hours
  • Missing important appointments
  • Having problems at work or school
  • Having problems in personal or family relationships

If you suspect you may have an alcohol use disorder, this article from Medline Plus has some questions to ask yourself to help you self-diagnose.

If you or someone you know is showing any of these warning signs, you may want to consider seeking treatment.

How do I find treatment?

Once you are ready to seek treatment, it is important to find the type of treatment that will work best for you. Talk to your doctor about the different factors that could influence your treatment, including your substance of choice, your usage patterns, and any mental health issues you might have.

Research shows that substance use treatment is most successful when it combines medication and therapy. Especially with opioid addiction, Medication-Assisted Treatment is key to helping reduce your cravings and restore your brain systems to how they normally function. Therapy and 12-step programs can help you deal with the more emotional aspects of recovery like learning how to deal with your problems without using drugs.

Here are some good resources for seeking treatment:

What happens if I relapse?

Because addiction actually changes the brain, substance use disorder is a relapsing disease. About 40 to 60 percent of people with an SUD who quit using substances will relapse. This is not because they lack the motivation to quit, but because of damages to the prefrontal cortex.

However, relapse does not mean that treatment has failed or is impossible. It just means that the person may need to return to treatment or try a different kind of treatment.

Here are some tips for how to avoid relapse:

  • Avoid triggering situations and people
  • Don’t get bored
  • Develop a positive support network
  • Take your medications

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