Substance Abuse / Chemical Dependency

What is substance abuse/chemical dependence?

There are three different terms used to define substance-related disorders, including the following:

• substance abuse
  Substance abuse is used to describe a pattern of substance (drug) use leading to significant problems or distress such as failure to attend work/school, substance use in dangerous situations (driving a car), substance-related legal problems, or continued substance use that interferes with friendships and or family relationships. Substance abuse, as a disorder, refers to the abuse of illegal substances or the abusive use of legal substances. Alcohol is the most common legal drug of abuse.

• substance dependence
  Substance dependence is used to describe continued use of drugs or alcohol, even when significant problems related to their use have developed. Signs include an increased tolerance or need for increased amounts of substance to attain the desired effect, withdrawal symptoms with decreased use, unsuccessful efforts to decrease use, increased time spent in activities to obtain substances, withdrawal from social and recreational activities, and continued use of substance even with awareness of physical or psychological problems encountered by extent of substance use.

• chemical dependence
  Chemical dependence is also used to describe the compulsive use of chemicals (drugs or alcohol) and the inability to stop using them despite all the problems caused by their use.

What substances are most often abused?

Substances frequently abused include, but are not limited to, the following:

• alcohol

• marijuana

• hallucinogens

• cocaine

• amphetamines

• opiates

• anabolic steroids

• inhalants

• methamphetamine 

• tobacco

What causes substance abuse/chemical dependence?

Cultural and societal norms influence acceptable standards of substance use. Public laws determine the legal use of substances. The question of whether there is a normative pattern of substance use remains controversial. Substance-related disorders are caused by multiple factors including genetic vulnerability, environmental stressors, social pressures, individual personality characteristics, and psychiatric problems. However, determining which of these factors are primary and which are secondary has not been determined, in all cases.

What are the symptoms of substance abuse/chemical dependence?

The following are the most common behaviors that indicate an individual is having a problem with substance abuse. However, each individual may experience symptoms differently. Symptoms may include:

• getting high on drugs or getting intoxicated (drunk) on a regular basis

• lying, especially about how much they are using or drinking

• avoiding friends and family members

• giving up activities they used to enjoy such as sports or spending time with non-using friends

• talking a lot about using drugs or alcohol

• believing they need to use or drink in order to have fun

• pressuring others to use or drink

• getting in trouble with the law

• taking risks, such as sexual risks or driving under the influence of a substance

• work performance suffers due to substance abuse before, after, or during working or business hours

• missing work due to substance use

• depressed, hopeless, or suicidal feelings

The symptoms of substance abuse may resemble other medical problems or psychiatric conditions. Always consult your physician for a diagnosis.

How is substance abuse/chemical dependence diagnosed?

A psychiatrist or qualified mental health professional usually diagnoses substance abuse. Clinical findings often depend on the substance abused, the frequency of use, and the length of time since last used, and may include the following:

• weight loss

• constant fatigue

• red eyes

• little concern for hygiene

Treatment for substance abuse/chemical dependence:

Specific treatment for substance abuse/chemical dependence will be determined by your physician based on:

• your age, overall health, and medical history

• extent of the symptoms

• extent of the dependence

• type of substance abused

• your tolerance for specific medications, procedures, or therapies

• expectations for the course of the condition

• your opinion or preference

A variety of treatment programs for substance abuse are available on an inpatient or outpatient basis. Programs considered are usually based on the type of substance abused. Detoxification (if needed, based on the substance abused) and long-term follow-up management are important features of successful treatment. Long-term follow-up management usually includes formalized group meetings and developmentally age-appropriate psychosocial support systems, as well as continued medical supervision. Individual and family psychotherapy are often recommended to address the developmental, psychosocial, and family issues that may have contributed to and resulted from the development of a substance abuse disorder.