Substance related disorders are a very common form of disorder which causes severe medical, social and psychological problems with the individuals that abuse the substance as well as individuals involved with those individuals. In this paper, we will discuss history, symptoms, influences and treatment. In the United States alone, a staggering 13. 8% of Americans will have an alcohol related substance abuse disorder in their lifetime. “An estimated 7. 1% (15. 1 Million) of Americans 12 years or older were current users of illicit drugs in 2001.
The cost to the nation exceeds $275 billion annually” (Mack, Frances, 2003). The DSM describes several substance abuse disorders. Substance abuse disorders occur when an individual is intoxicated by a substance, withdrawing from a substance, using a substance, abusing a substance or dependent upon a substance. “The two most common forms of substance related disorders are substance abuse and substance dependence” (Sparknotes Editors 2005). Dependence and alcohol abuse are two very different concepts that are often misinterpreted.
The difference is quite simple. In terms of treatment the individual that is dependent upon a substance must abstain from using that substance and the individual that abuses the substance may or may not become dependent. It is important to make the correct distinction because the treatment plan is incredibly different. When speaking about alcoholism, two terms to become familiar with include primary and secondary alcoholism. Primary alcoholism refers to dependence that has led to psychopathology and/or a mood disorder.
Secondary alcoholism refers to dependence as a result of self medication for an underlying psychiatric disorder, most commonly schizophrenia and bipolar disorder (Mack, Frances, 2003). Symptoms of alcohol induced disorders include intoxication, withdrawal, seizures, dementia, amnestic disorder, psychotic disorder, hallucinations and sexual dysfunction. Intoxication is of course reversible with time, as your body metabolizes the alcohol. Symptoms of substance induced disorders by sedatives, hypnotics and anxiolytics generally mimic those of alcohol. However, they are more predictable in the sense of pharmacokinetics.
One can anticipate the length of symptoms. Seizures are more common in withdrawal, as much as 20%-30% of untreated individuals experience them. Life threatening delirium may also be present. Opioids are also prevalent in substance induced disorders. However, tolerance is an issue when dealing with opioids. Most opioid users have a very high tolerance for the drug and very intense withdrawal symptoms. Flulike symptoms are common. Withdrawal symptoms begin almost immediately upon the drug wearing off. Cannabis is not a substance that we typically view as being a substance of abuse in the American culture. However, this is not the case.
Symptoms of substance abuse disorders by cannabis include cannabis induced delusional disorder. Users will experience delusions, anxiety, depersonalization, and emotional liability. Cannabis induced delusional disorder may be wrongfully diagnosed as schizophrenia. Amnesia of the event may also occur. Generally speaking, women need to be much more careful when speaking about substance use. Women suffer greater rates of secondary medical morbidity rate and suffer higher mortality rates than men. Women generally will start abusing substances later in life than men, but abuse for a shorter time before becoming dependent.
It is difficult to assess the adolescent age range, as they are much less likely to report symptoms of withdrawal. However, the rate of substance abuse is higher today than ever before in America’s youth. Substance abuse rates in the elderly are much less, maybe due to the fact that many substance dependent individuals die prematurely. There are many environmental factors that play a role in substance dependence. Cultural norms, social policy, variations in symptoms and reasons for drug use are all factors. Biological factors also play a role.
There is a lot of research being done, and much has already been done in regards to genetics and substance abuse. It is true that traits such as impulsivity are inherited, so naturally, substance abuse follows the impulsive trait. Genes may also play a role in dopamine in the brain. Even with no genetic markers for substance abuse, after a long period of time, things like dopamine in the brain will be affected, ultimately changing the individuals overall biology. Treatment of substance related disorders is plentiful. Individuals have many resources available to them, and doctors have bountiful knowledge on the subject.
There are even several different specialists for each specific disorder. “The primary goal of substance dependence treatment is abstinence from all substances” (Mack, Frances, 2003). “For substance-dependent patients, recovery is a never-ending process; the term cure is avoided. Relapse is a process of attitudinal change that usually results in reuse of alcohol or drugs. In any one 12-month period after initiating abstinence, more than 90% of patients will likely use substances; of these, 45%—50% will return to pretreatment levels of use (83). As a result, a great deal of the field’s attention is focused on behavioral, psychological (e. . , reduction of guilt and shame), and pharmacological approaches to relapse prevention. ” (Mack, Frances, 2003) Generally speaking, treatment has a lot to do with environmental influence. Support groups are an incredible part of this. The individual has a higher chance of success with the ability to maintain employment, a stable personal relationship with a significant other as well as key people such as parents and siblings. Of course biologically speaking, the individual has a better chance of success if there is no family history of abuse or dependence.
Different kind of therapies include intensive out patient treatment, out patient treatment, in patient treatment, self help treatment, counseling, and of course pharmacotherapy, or a mixture of both psychotherapy and pharmacotherapy. Some pharmacotherapy drugs include naltrexone, methadone and levo-alpha acetyl methadol, buprenorphine, disulfiram, lithium and mood stabilizers, antidepressants and acamprosate. Rehabilitation is of course the key to any substance abuse related disorder. Maintenance of symptoms, and knowledge of how to face them will insure the ability for success.
Treatment providers must have a solid understanding of substance related disorders, and understand the difference between abuse and dependence within individuals. America is currently taking substance related disorders much more seriously than ever before, as a large percentage of emergency room visits are in fact substance abuse or dependence related. There will always be ongoing studies done to investigate how solutions can be found relative to treatment of these individuals. The future of addictions counseling is certainly a necessity to help address all of the issues related to substance related disorders.