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Questions About Substance Use Disorder
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
- 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
- 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