Substance Use Disorders
What are Substance Use Disorders?
SUD's are a cluster of cognitive, behavioral, and physiological symptoms whereby an individual continues using the substance, despite significant substance-related problems.
Categories:
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) recognizes 10 different categories of substance use disorders:
Alcohol-Related Disorders
A problematic pattern of alcohol use leading to clinically significant impairment or distress. DSM-5 listed disorders include:
Alcohol Use DisorderAlcohol IntoxicationAlcohol WithdrawalOther Alcohol-induced DisordersUnspecified Alcohol-Related Disorder
Caffeine-Related Disorders
Caffeine intoxication requires recent consumption of caffeine with five or more signs or symptoms that develop during or shortly after caffeine use (as listed in the DSM-5). These symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. DSM-5 listed disorders include:
Caffeine IntoxicationCaffeine WithdrawalOther Caffeine-Induced DisordersUnspecified Caffeine-Related Disorder
Cannabis-Related Disorders
A problematic pattern of cannabis use leading to clinically significant impairment or distress. DSM-5 listed disorders include:
Cannabis Use DisorderCannabis IntoxicationCannabis WithdrawalOther Cannabis-Induced DisordersUnspecified Cannabis-Related Disorder
Hallucinogen-Related Disorders
A pattern of phencyclidine (or a pharmacologically similar substance) use—such as magic mushrooms—leading to clinically significant impairment or distress. DSM-5 listed disorders include:
Phencyclidine Use DisorderOther Hallucinogen Use DisorderPhencyclidine IntoxicationOther Hallucinogen IntoxicationHallucinogen Persisting Perception DisorderOther Phencyclidine-induced DisordersOther Hallucinogen-induced DisordersUnspecified Phencyclidine-Related DisorderUnspecified Hallucinogen-Related Disorder
Inhalant-Related Disorders
A problematic pattern of use of a hydrocarbon-based inhalant substance (e.g. solvents, paints, glues, or fuels) leading to clinically significant impairment or distress. DSM-5 listed disorders include:
Inhalant Use DisorderInhalant IntoxicationOther Inhalant-Induced DisordersUnspecified Inhalant-Related Disorder
Opioid-Related Disorders
A problematic pattern of opioid (e.g. heroine or fentanyl) use leading to clinically significant impairment or distress. DSM-5 listed disorders include:
Opioid Use DisorderOpioid IntoxicationOpioid WithdrawalOther Opioid-induced DisordersUnspecified Opioid-Related Disorder
Sedative, Hypnotic, or Anxiolytic-Related Disorders
A problematic pattern of sedative, hypnotic, or anxiolytic (e.g. benzodiazepines, barbiturates, or chloral hydrate) use leading to clinically significant impairment or distress. DSM-5 listed disorders include:
Sedative, Hypnotic, or Anxiolytic Use DisorderSedative, Hypnotic, or Anxiolytic IntoxicationSedative, Hypnotic, or Anxiolytic WithdrawalOther Sedative·, Hypnotic-, or Anxiolytic-Induced DisordersUnspecified Sedative-, Hypnotic-, or Anxiolytic-Related Disorder
Stimulant-Related Disorders
A pattern of amphetamine-type substance (e.g. amphetamines, methamphetamine, cocaine, or other stimulant) use leading to clinically significant impairment or distress. DSM-5 listed disorders include:
Stimulant Use Disorder Stimulant IntoxicationStimulant WithdrawalOther Stimulant-Induced DisordersUnspecified Stimulant-Related Disorder
Tobacco-Related Disorders
A problematic pattern of tobacco use leading to clinically significant impairment or distress. DSM-5 listed disorders include:
Tobacco Use DisorderTobacco WithdrawalOther Tobacco-Induced DisordersUnspecified Tobacco-Related Disorder
Other or Unknown Substance
A problematic pattern of use of an intoxicating substance not able to be classified within the alcohol; caffeine; cannabis; hallucinogen (phencyclidine and others); inhalant; opioid; sedative, hypnotic, or anxiolytic; stimulant; or tobacco categories and lead ing to clinically significant impairment or distress. DSM-5 listed disorders include:
Other (or Unknown) Substance Use DisorderOther (or Unknown) Substance IntoxicationOther (or Unknown) Substance WithdrawalOther (or Unknown) Substance-Induced DisordersUnspecified Other (or Unknown) Substance-Related Disorder
Addiction
Especially when used as a coping mechanism, substance use often leads to addiction. While unhealthy coping mechanisms such as substances may provide immediate relief, they are short-term solutions that may lead to a number of harmful addictions. It is important to know the types of addictions, how they manifest themselves, how they can be treated, and most importantly, how they can be avoided.
Most Used Drugs by College Students
Symptoms & Diagnosis:
In order to be diagnosed with a substance use disorder, an individual must demonstrate a problematic pattern of use of a substance, with at least two of the below symptoms (also listed in the associated section of the DSM-5) occurring within a 12-month period.
The DSM-5 divides the 11 symptoms of a substance use disorder into four categories:
Impaired Control
Social Impairment
Risky Use
Pharmacological Criteria
Impaired Control:
Taking the substance in larger amounts or for longer than was intended
Unsuccessful attempts to stop or control the substance use
Spending a lot of time getting, using, or recovering from use of a substance
Cravings or strong urge to use the substance
Social Impairment:
Failure to fulfill obligations at work, home, or school
Continuing use despite recurrent substance-related problems in relationships
Giving up important social, occupational, or recreational activities because of substance use
Risky Use:
Using in physically hazardous situations (e.g. drunk driving)
Continued use despite substance-related physical or psychological problems
Pharmacological Criteria:
Tolerance: Needing more of the substance to get the effect you want OR diminished effect with continued use of the same amount
Withdrawal: The development of withdrawal symptoms, which can be relieved by taking more of the substance
Treatments:
Intensive Outpatient Treatment
Chapter 4: Services in Intensive Outpatient Treatment Programs
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12-Step Fellowship
(e.g. Alcoholics Anonymous)
12 Step Programs for Drug Rehab and Alcohol Treatment
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Environmental Interventions
(e.g. arrangements to alleviate an aversive life situation)
Environmental Strategies for Prevention of Drug Use and Risks in Clubs
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Cognitive Behavioral Therapy
(e.g. skills training such as building healthy coping mechanisms)
What is Cognitive Behavioral Therapy?
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Motivational Interviewing
Collaborative Conversation – moving the individual from ambivalent to action
Motivational Interviewing in Addiction Treatment
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Resources:
Please reach out if you or someone you know needs help!
Substance Abuse and Mental Health Services Administration (SAMHSA)
Hotline for individuals and family members facing mental health and/or substance use disorders.National Helpline (24 hour): 1-800-622-HELP(4357)
TTY: 1-800-487-4889
For more information: www.samhsa.gov
Learn how to save lives at: endoverdose.net
Society for Adolescent Health and Medicine
Or if you need immediate support, please reach out to your local crisis text line:
USA: Text HOME to 741741
UK: Text SHOUT to 85258
Canada: Text CONNECT to 686868 or 741741
For more information: www.adolescenthealth.org
For mental health education and resources: Hope for the Day at hftd.org
National Institute on Drug Abuse
SAMSHA National Helpline (24 hour): 1-800-622-HELP(4357)
SAMSHA TTY: 1-800-487-4889
NIH General Inquiries: 301-443-1124
For more information: www.drugabuse.gov
Learn how to save lives at: endoverdose.net
Alcoholics Anonymous (AA)
National Website: www.aa.org
Washington Area Intergroup Association:
Speak with a live, local person (24 hours): 202-966-9115
For more information: www.aa-dc.org
Gamblers Anonymous (GA)
Washington D.C. Hotline: 855-2CALLGA (225542)
For more information: www.gamblersanonymous.org/ga
Useful Literature:
DSM-5: Diagnostic Statistical Manual of Mental Disorders (5th Edition)
by The American Psychiatric Association (APA)The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) is the product of more than 10 years of effort by hundreds of international experts in all aspects of mental health. Their dedication and hard work have yielded an authoritative volume defines and classifies mental disorders in order to improve diagnoses, treatment, and research. DSM–5 is the standard classification of mental disorders used by mental health professionals in the United States…
Never Enough: The Neuroscience and Experience of Addiction
by Judith GriselJudith Grisel was a daily drug user and college dropout when she began to consider that her addiction might have a cure, one that she herself could perhaps discover by studying the brain. Now, after twenty-five years as a neuroscientist, she shares what she and other scientists have learned about addiction, enriched by captivating glimpses of her personal journey. In Never Enough, Grisel reveals the unfortunate bottom line of all regular drug use: there is no such thing as a….
High Achiever: The Incredible True Story of One Addict's Double Life
by Tiffany JenkinsHigh Achiever spans Tiffany’s life as an active opioid addict, her 120 days in a Florida jail where every officer despised what she’d done to their brother in blue, and her eventual recovery. With heart-racing urgency and unflinching honesty, Jenkins takes you inside the grips of addiction and the desperate decisions it breeds. Tiffany breaks through the stigma and silence to offer hope and inspiration to anyone battling the disease—whether it’s a loved one or themselves…
In the Realm of Hungry Ghosts: Close Encounters with Addiction
by Gabor Maté M.D.Based on Gabor Maté’s two decades of experience as a medical doctor, this book simplifies a wide array of brain and addiction research findings from around the globe and avoids glib self-help remedies, instead promoting a thorough and compassionate self-understanding as the first key to healing and wellness. In the Realm of Hungry Ghosts argues persuasively against contemporary health, social, and criminal justice policies toward addiction and those impacted…
Relation to College Students:
For most students, college offers a wide variety of new experiences and activities such as parties, drinking, nightlife, etc. These types of activities are often directly correlated with the college experience. More often than not, when portrayed in the media, college life is depicted as a bunch of young adults drinking, partying, and sometimes making stupid and/or life-altering decisions. Although these portrayals tend to be exaggerated, they aren’t entirely inaccurate either. At a lot of colleges, there is a culture of binge-drinking and substance use and abuse. A one-time judgment to experiment with a substance can lead to addiction as well as long lasting health issues and health risks. Even if you have already developed a drinking issue, it is not too late. It is never too late. With the adequate help and support, you can have your substance use issues resolved. Yes, being clean in a life-long endeavor and it’s worth it – for the sake of your mental and physical health and overall wellbeing. It is not uncommon for students to experience peer pressure to participate in risky behavior such as obsessive drinking. Know that it is always acceptable to say, “no”. It might not be easy to not give into peer pressure but, in the end, be true to yourself. Lastly, if you do decide to participate in drinking, it is possible to drink in moderation.