Substance Use Disorder Treatment (SUD)

​Substance use disorder is a diagnostic term referring to recurrent use of alcohol or other drugs that causes clinically and functionally impairment, such as health problems, disability, and failure to meet major school, work or home responsibilities. 

Addiction

Risk Factors for Substance Use Disorders

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Addiction Treatment

The most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug. In the DSM-5, the term addiction equals the classification of severe substance-use disorder.

Keep in mind that substance use disorders are neurobiological disorders, not a choice to abuse or become dependent on toxic substances.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines substance use disorders as a group of recurrent pathological cognitive, behavioral, and physiological symptoms arising from the ongoing use of a substance. In an effort to combat stigma, previously used terms of abuse and dependence are not recommended now when describing persons with substance use disorders.

Risk Factors for Substance Use Disorders

The risks factors are complex. They include a combination of biologic and social factors, such as: Family history (both genetic and shared environmental factors), Social factors (socioeconomic status, race, social network, education), mental health conditions and…

Neurobiological differences

Even though each drug produces different effects on a person, dysregulation of brain reward pathways in conjunction with an overactive brain stress system reinforce use of the substance to achieve a pleasurable high or to avoid pain, even if pursuing these effects incurs awful consequences for the addict.

Neurobiological differences in self-control often become evident in early childhood and may correlate with the subsequent development of a substance use disorder.

Although no specific neurological testing, imaging, or laboratory evaluation can accurately predict who will develop a substance use disorder, accurate identification of predictive markers remains a field of constant research.

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Addiction and its Numbers

Substance Use Statistics

The primary source of statistical information for substance use disorders in the general United States population originates from the National Survey on Drug Use and Health (NSDUH), which is an annual survey of the civilian, noninstitutionalized population of the United States aged 12 years and older. The survey is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) within the Department of Health and Human Services, and was most recently conducted in 2018, with results published in August 2019.
A major limitation of the National Survey is the fact that it does not sample from jails and is therefore prone to underestimate the prevalence of substance use disorder in the country.

Levels of Substance Use Disorder

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The DSM-5 has combined the DSM-IV categories of substance abuse and substance dependence under the single heading of substance use disorders.

The diagnosis of substance use disorder is based on scoring from a total of 11 symptom criteria included in four major groups: Impaired Control, Social Impairment, Risk Use of a Substance, and Pharmacologic Criteria.

The seriousness of the substance use disorder is based on the number of 11 symptoms criteria that are met: mild (2 to 3 criteria), moderate (4 to 5 criteria), and severe (more than 6 criteria). 

Impaired Control

  • Taking the substance in larger amounts and for longer than intended
  • Wanting to cut down or quit but not failing to do it
  • Spending a lot of time getting, using, or recovering from use of the substance
  • Intense craving for the substance

Social Impairment

  • Repeatedly unable to carry out major obligations at work, school, or home
  • Continued substance use despite persistent or recurring social or interpersonal problems caused or made worse by substance use
  • Diminishing or stopping important social, occupational activities and hobbies due to substance use

Risk Use of the Substance

  • Recurrent use of the substance in physically hazardous situations
  • Consistent use of the substance despite acknowledgment of persistent or recurrent physical or psychological harsh consequences 

Types of Substances

The DSM-V recognizes substance-related disorders resulting from the use of ten separate classes of drugs: Opiates, tobacco, anxiolytics, sedative hypnotics, inhalants, cannabis, hallucinogens, caffeine, alcohol, and other stimulants.

Number of Persons Age 12 and Older with a Past Year Substance Disorder, 2018 (7.4% of population)

Alcohol

14.8%

Illicit Drugs

8.1%

Marijuana

4.4%

RX Pain Reliever Misuse

1.7%

Methamphetamine

1.1%

Cocaine

1%

RX Stimulant Misuse

1%

Heroin

1%

Data from the 2018 National Survey on Drug Use and Health (NSDUH) found that almost 21 million people aged 12 years and older in the United States had a substance use disorder in the past year, which represented almost 8% of the population aged 12 or older. In the same year, according to the NSDUH, 58.8 million people (almost 22% of the population) were current tobacco users, including 47 million current cigarette smokers and 12.2 million current cigar smokers. 

Smoking estimates were not as high in the National Health Interview Survey (NHIS), another annual nationally representative survey, which reported that 13.7% of adults in the United States were current smokers in 2018. This discrepancy is likely due to differences in the age range included in the surveys—NHIS collects data only for adults aged 18 years and older, whereas the NSDUH collects data for persons beginning at age 12. Both of these surveys likely underestimate the prevalence of substance use disorders because they leave out homeless and incarcerated people that have higher rates of substance use disorders.

Addiction Treatment in San Diego at Refresh Recovery

At Refresh Recovery, our team of clinicians are trained to treat you in a caring and compassionate manner through substance use disorders while taking in consideration mental health and dual diagnosis. Your personalized rehab program will be designed according to the substance you have been trying to quit and to your special needs. Read more on our blog or visit our privacy policy.

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