About Drug Addiction (Substance Use Disorder)

Overview

Drug addiction, also known as substance use disorder (SUD), is a chronic and relapsing disorder characterized by compulsive drug seeking and use despite the negative consequences it may cause. It’s considered a brain disorder because it involves changes in the brain's reward, stress, and self-control circuits. People with drug addiction may experience disordered thinking and behaviors due to these changes. The severity of addiction can vary from mild to moderate to severe. Warning signs of substance use disorder may include misusing substances, increased tolerance, neglecting responsibilities, cravings, failed attempts to quit, and withdrawal symptoms. Drug addiction is similar to other diseases, like heart disease, in that it disrupts normal organ functioning and can have serious harmful effects. However, with proper prevention and treatment, addiction can be managed.

Causes and Risk Factors

The pathophysiologic causes of SUD involve complex biological processes that affect the reward pathways in the brain. These pathways provide feelings of pleasure and release chemicals that reinforce substance use. Additionally, areas of the brain responsible for stress and self-control undergo long-term changes during addiction, making it difficult to abstain from the addictive substance.

Non-modifiable risk factors (factors you can’t change) for SUD include:

• Family history of substance misuse
• Certain mental health conditions, such as depression or anxiety
• Favorable family attitudes toward drug use
• Family rejection, especially due to gender identity or sexual orientation
• History of abuse, especially sexual abuse

Modifiable risk factors (factors that can be influenced or changed) for SUD include:

• Early drug use, which increases the lifetime risk of addiction
• Lack of supervision from parents or caregivers
• School issues, including a lack of connection to school
• Environmental factors like chronic stress, trauma, and adverse childhood experiences

It's important to remember that these risk factors increase the likelihood of developing addiction but do not guarantee it. If you have concerns about addiction or substance use disorder, consult with a healthcare professional.

Symptoms

Early symptoms of SUD may include:

• Agitation or drowsiness
• Slurred speech
• Constricted (smaller) pupils
• Depression
• Memory problems
• Needle marks (if injecting the drug)
• Runny nose or nose sores (if snorting the drug)
• Constipation
• Reduced sense of pain

Other symptoms that may occur with later stages, progression, or higher severity of SUD include:

• Changes in appearance or decline in personal hygiene
• Changes in behavior, such as sudden secrecy or aggression
• Money issues, such as missing money or needing more and more money without any logical reason
• Problems at school or work
• Risky or dangerous behavior

It is important to note that addiction is a complex condition and symptoms can vary depending on the individual, the substance being used, and personal circumstances. If you suspect you or someone you know may be struggling with SUD, it is important to seek professional help for an accurate diagnosis and appropriate treatment.

Diagnosis

To diagnose SUD, healthcare professionals typically perform the following examinations, tests, and procedures:

• Comprehensive evaluation: This involves assessing a patient's cognitive, behavioral, and physiological symptoms related to substance use.
• Clinical interview: A healthcare professional asks questions about your life, addictive behavior, and patterns of misuse.
• Substance screening evaluations: Validated questionnaires like the Drug Abuse Screening Test (DAST) or the CAGE Adapted to Include Drugs (CAGE-AID) may be used to screen for drug problems.
• Urine drug testing (UDT): UDT is a common tool used to assess substance use and monitor treatment progress.
• Prescription drug monitoring program (PDMP) reports: These reports help identify additional prescriptions for controlled substances.
• Structured diagnostic interviews: Healthcare professionals may use reliable diagnostic interviews like the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-CV) to diagnose substance use disorders.

To determine the stage or severity of SUD, additional examinations, tests, and procedures may include:

• Assessing quantity and frequency of each drug used.
• Asking different screening and interview questions based on the drugs causing the most problems or assessing each drug's quantity and frequency.
• Assessing family history by gathering information about addiction history in 1st to 3rd-degree relatives.
• Assessing present substance using by testing for various substances using in-vitro urine drug screening.

Remember, diagnosis and determining severity are complex processes that require professional evaluation. Consult with a healthcare professional for personalized guidance.

Treatment Options

Treatments for SUD include:

• Detoxification: The first goal is to safely manage withdrawal symptoms and help the individual stop using the drug. This may involve gradually reducing the dose of the drug or temporarily substituting it with a medication that has milder withdrawal symptoms.
• Comprehensive Evaluation: A thorough assessment is conducted to identify the various factors contributing to the addiction, including medical, psychological, and social aspects. This evaluation helps tailor the treatment plan to address the individual's specific needs.
• Counseling and Behavioral Therapies: These interventions aim to modify behaviors, address underlying psychological issues, and develop coping strategies to prevent relapse. Counseling can be done on an individual or group basis, and therapies like cognitive-behavioral therapy (CBT) help individuals identify and change negative thought patterns and behaviors.
• Medications: Certain medications may be prescribed to aid in recovery from drug addiction. These medications can help reduce cravings, manage withdrawal symptoms, or block the effects of drugs if they are used again. It is important to consult with a healthcare professional to determine if medication is appropriate for an individual's situation.
• Health Behavior Changes: Treatment for drug addiction often involves promoting overall health and well-being. This may include encouraging healthy lifestyle changes such as regular exercise, proper nutrition, and stress management techniques.

It's important to note that treatment for drug addiction should be tailored to meet each individual's specific needs. The combination of medication, therapies, behavioral changes, and other treatments will vary depending on factors such as the type of substance used, severity of addiction, and individual circumstances.

Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation.

Other side effects can occur. Check with your healthcare professional or read the information provided with your medication for additional side effect information.