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Substance Use

Common questions about substance use and how therapy can help. 

General Questions

What Is Substance Use Disorder?

Substance use disorder (SUD) involves a pattern of using a certain substance, such as alcohol, tobacco, marijuana, or prescription or illicit drugs. The use of this substance is uncontrolled and often interferes with a person’s ability to function in day to day life. People with SUD will keep using in spite of the harm the use may cause to themselves or others. People with a substance use disorder may also have altered thought patterns and behaviors, such as strong cravings, changes in mood and personality, and abnormal movements or actions. SUD has been shown to cause changes in the areas of the brain that control judgment, decision making, learning, memory, and behavior. SUDs can lead to risky behavior, relationship problems, legal trouble, physical harm, and even death.

Why Use the Term Substance Use Disorder Instead of Substance Abuse?

The fifth edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) retired the terms “substance abuse, addiction or alcoholism” in favor of Substance Use Disorder (SUD). Terms such as “substance abuse” and “addiction” can carry a heavy stigma, and labels like “addict” or “alcoholic” define a person by their condition. “Substance Use Disorder” recognizes SUD as a medical condition.

What Causes Substance Use Disorder, and How Does SUD Progress?

While there are a variety of genetic and environmental factors that can contribute to a substance use disorder, anyone is capable of developing a SUD. For some, SUD starts with experimental or social use of a substance before the use becomes increasingly more frequent. For others, SUD may begin with a prescribed medication. This is often the case with opioid painkillers. The progression of SUD is complex, and it heavily depends on the substance, user, and setting. Some substances, such as opioids, have a higher risk and can cause dependence more quickly than others.

What Are the Signs and Symptoms of Substance Use Disorder?

Physical Signs of SUD

  • Bloodshot or jaundiced eyes
  • Unusually dilated pupils
  • Runny nose or sniffling
  • Sudden or drastic changes in weight
  • Changes in appetite or sleep patterns
  • Dishevelled physical appearance or poor personal grooming
  • Tremors, twitching or slurred speech
  • Poor coordination or balance
  • If in withdrawal, symptoms such as nausea, insomnia, sweating, shaking and weakness

Psychological Signs of SUD

  • Appearing fearful, anxious, nervous or paranoid without a clear reason
  • Seeming tired or unable to focus
  • Poor memory or periods of “blackout”
  • Periods of unusually high energy or instability
  • Sudden mood swings, irritability or outbursts
  • Lack of motivation or interest in life
  • Unexplained changes in personality or attitude

Behavioral Signs of SUD

  • Secretive or suspicious behavior
  • Neglecting responsibilities or obligations
  • Sudden changes in friends, habits, interests or hobbies
  • Financial problems or an unexplained need for money
  • Irresponsible or risky behavior, such as fights, accidents, driving while impaired or having unprotected sex
  • Loss of control over substance use
  • Increased substance tolerance or misusing substances to avoid withdrawal symptoms
  • Planning life or changing routines to accommodate substance use
  • Sacrificing important things, like a career or family relationships, to keep using
How Common Are Substance-Related Disorders?

According to data from a 2017 study by the Substance Abuse and Mental Health Services Administration, approximately 18.7 million adults in the United States have a substance use disorder. That’s 1 in 12 adults.

Are There Personal Risk Factors for Developing Substance Use Disorder?
A family history of substance use is considered the most important risk factor for an individual developing SUD. Our genes help determine how we metabolize drugs, which in turn affects how susceptible we are to addiction and dependence. Mental illnesses also have a strong genetic component and are directly tied to SUD. Other risk factors include how early in life an individual starts using substances, stressful or traumatic experiences, major life changes, and an individual’s culture or environment. While all of these points may contribute, heavy drinking or misuse of prescription pills or drugs are universal risk factors. These behaviors cause changes to your brain that are directly tied to SUD.

Effects of SUDs

How Does Substance Use Affect Families?

Substance use disorder is an illness that affects the whole family. Children who grow up with a parent who suffers from SUD often have compromised emotional and mental health, leading to challenges with self-confidence, physical health and social development. Children of individuals with SUD are more likely to use substances and to start at an earlier age. There is also a correlation between a parent with a SUD and an increased risk of child abuse and neglect. Other members of the household may suffer from a loss of trust, financial hardship, increased stress and anxiety and emotional or physical abuse. Relationships are often strained by SUD and can end in separation if the issues are not addressed and resolved. Family and marriage counseling can be a helpful tool in navigating the strain of SUD on relationships.

How Does Substance Use Affect Development?

Substance use is especially risky for teens whose brains are still developing. As an example, heavy drinking during adolescence can lead to impaired memory, attention, spatial skills and executive functioning. Marijuana use during adolescence can lead to decreased cognitive functioning, particularly learning, memory and organization. Overall, substance-using adolescents perform lower on cognitive testing than their non-using peers. They also have lower brain tissue volume. Substance use literally changes the structure and function of the developing brain.

How Is Substance Use Related to Mental Illness?
Substance use disorder and mental illness often overlap. The combination of these two illnesses is called dual diagnosis, or co-occurring disorders. Either substance use or mental illness can develop first. An individual with mental illness may begin using substances to cope with distressing symptoms. An individual who has SUD may develop a mental illness because of the brain changes caused by substances or because of the negative consequences of their substance use. Because SUD and mental illnesses have many symptoms in common, it can be difficult to separate the two.


Where Can I Get Help for Substance Use Disorder?

Talking to a licensed therapist is a great place to start. You can contact our office at 847-310-8578. The Substance Abuse and Mental Health Services Administration (SAMHSA) also offers a national helpline at 1-800-662-HELP (4357). It is a free, confidential treatment referral and information service, available 24 hours a day, 365 days a year, in both English and Spanish.

How Is Substance Use Disorder Diagnosed?

Diagnosis usually has two parts: a doctor’s evaluation and a person’s self-report. Often, a substance use disorder is diagnosed when a person goes to a medical doctor or therapist for help with a substance use problem. Doctors may suspect an unreported substance use problem if they notice SUD symptoms, like changes in a person’s mood or behavior or physical signs like tremors or track marks. Health care practitioners also use questionnaires to identify the presence and severity of an SUD. In some cases, urine and sometimes blood tests may be done to check for the presence of drugs.

What Is the Treatment for Substance Use Disorder?

Treatment for substance use disorder is complex and will vary for each individual. Depending on the severity of the SUD, you may work with an individual practitioner or with a team of healthcare professionals. Here are the main components that may be present in an individual’s treatment plan: 

Detoxification. If a person with substance use disorder has become physically dependent on a substance, they will need to go through detoxification before beginning a rehab or therapy program. Inpatient detoxification is usually more effective and safer than outpatient. During inpatient detox, trained medical staff will monitor the patient around the clock. The patient may receive gradually decreasing amounts of the substance (or its medical alternative) to wean them off and ease withdrawal symptoms. 

Inpatient Rehabilitation. A person who has severe SUD or co-occurring disorders of a mental illness and substance use disorder may benefit from inpatient rehabilitation, where they can receive full time medical care and mental health support. Inpatient treatment centers provide therapy, support groups, medication and health services to treat both the substance use disorder and its underlying causes. 

Psychotherapy. Psychotherapy is a big part of an effective treatment plan. Talk therapy can help people work through the emotions and experiences that may have contributed to their disorder. Cognitive behavioral therapy (CBT) can help people with dual diagnosis learn how to cope and change ineffective patterns of thinking, which may increase the risk of substance use. Our office offers a variety of psychotherapy options for the treatment of SUD. 

Medications. Certain medications can help people experiencing substance use disorders ease withdrawal symptoms during the detox process. They can also help people who are experiencing a co-occurring mental illness manage their symptoms. 

Supportive Housing. Group homes or sober houses are residential treatment centers that can help newly sober individuals or those trying to avoid relapse. Because sober houses are not required to be run by licensed professionals, you should be careful when choosing supportive housing for yourself or a loved one. Our staff can help you find the best fit for your individual situation. 

Support Groups. Dealing with a substance use disorder or dual diagnosis can be difficult and isolating, but support groups can help a person feel less alone. Members gather to share their stories, celebrate successes, support each other in recovery and find referrals for specialists and resources. Support groups also allow recovering individuals to form healthy friendships with others who understand their experiences and share their goal to stay clean. Alcoholics Anonymous, Narcotics Anonymous, and Smart Recovery are common nationwide programs. Our therapists can help direct you to the best program for your personal needs.

What Is Substance Use Counseling?
The goal of substance use counseling is to guide clients on the recovery journey. A substance use counselor teaches individuals how to modify their behavior, identify issues, create goals and treatment plans and work toward full recovery. A session may involve talk therapy or cognitive behavioral therapy (CBT) as well as practicing positive coping mechanisms. Substance use counseling can also include group or family therapy. Because people with SUD are susceptible to relapses, many substance use counselors continue to work with clients on an on-going basis.

Helping a Loved One

What Resources and Treatment Options Are Available for Someone Living With a Substance Use Disorder?

Because everyone’s experience with substance use disorder is different, the options for each person will vary. See “What is the treatment for substance use disorder?” above to learn more about some of the most common treatment options. If you are looking for resources to give to your loved one, one of our therapists can advise you.

How Can Family and Friends Help a Person With Substance Use Disorder?

Because every situation is unique, there is no one-size-fits-all solution for helping a friend or family member who is struggling with a substance use disorder. One thing that seems to be critical is family support. Family members and close friends may be more likely to notice when their loved ones are experiencing changes in mood or behavior. Family members can then connect those in need with treatment, resources, and services to begin and maintain their recovery journey.

How Can I Cope With My Family Member’s Substance Use Disorder?
When a family member is experiencing a substance use disorder, it will often have a ripple effect on the whole family. One of the best things you can do to help your struggling loved one is to care for yourself. Caring for a loved one with a substance use disorder can be draining, so caregivers need to prioritize their own health and wellbeing to avoid burnout. Self care activities, exercise, mindfulness, engaging in hobbies and connecting with friends are all good ways to care for yourself. Support groups and family or individual counseling can all help you cope while also improving treatment outcomes for your loved one.