Substance use disorder: explained

Substance use disorder (SUD) is a complex and often misunderstood condition that affects millions of people worldwide. It is crucial that patients are provided with accurate information to help them understand this disorder.  Distinguished consultant in adult mental health and addiction psychiatry Dr Christos Kouimtsidis explains its causes, symptoms, and available treatments, and offers clarity and support for those who might be grappling with SUD or have loved ones who are affected.

What is substance use disorder?

Substance use disorder is a medical condition characterised by an inability to control the use of a substance despite harmful consequences. These substances can include alcohol, prescription medications, and illicit drugs. The disorder affects the brain's reward system, making it difficult for individuals to resist the urge to use the substance.

Causes and risk factors

The development of SUD can be attributed to a combination of genetic, environmental, and psychological factors. Some people may have a genetic predisposition, meaning their family history increases their likelihood of developing the disorder. Environmental factors, such as peer pressure, exposure to drug use, and stressful life events, can also contribute to the onset of SUD. Additionally, mental health disorders like depression and anxiety are commonly linked with substance use, as individuals may turn to substances as a form of self-medication.

Recognising the symptoms

Recognising the symptoms of substance use disorder is essential for early intervention. Common signs include:

• Cravings: An intense desire or compulsion to consume the substance.
• Loss of control: The inability to cease substance use despite the intention to do so.
• Tolerance: The requirement for increased amounts of the substance to attain the same effect.
• Withdrawal: The occurrence of physical or psychological symptoms when the substance is not used.
• Neglecting responsibilities: Neglecting duties and obligations at work, school, or home.
• Continued use despite problems: Persisting with substance use despite knowing it is causing harm.

The impact on health

Substance use disorder can lead to numerous health problems, ranging from mild to severe. Physically, it can cause damage to vital organs, such as the liver, heart, and brain. Psychologically, it can exacerbate mental health issues, increase the risk of accidents and injuries, and lead to social isolation. The impact on one's personal and professional life can be profound, affecting relationships and employment.

Treatment options

Treatment for substance use disorder is multifaceted and tailored to the individual’s needs, including severity of the disorder and patient’s wishes to achieve abstinence of controlled use.  Everything starts with an assessment using a motivational interviewing approach to identify the above risk and protective factors, assess the severity of the disorder, underlying mental health disorder/s and agree treatment goal and steps. It often includes a combination of the following approaches:

• Structured preparation for abstinence: A pre-habilitation based approach to empower the patient and the family to prepare for abstinence.  
• Detoxification: The medically supervised process of safely eliminating the substance from the body.
• Counselling and therapy: Cognitive-behavioural therapy (CBT) and other forms of counselling help address the underlying psychological factors and develop coping strategies.
• Medication-assisted treatment (MAT): Medications that help alleviate cravings and withdrawal symptoms.
• Support groups: Participating in groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) provides community support and shared experiences.
• Lifestyle changes: Adopting a healthier lifestyle, including exercise and proper nutrition, can support recovery.

Seeking help

If you or someone you know is struggling with substance use disorder, it is important to seek help promptly. Consulting a healthcare provider can be the first step towards recovery. Remember, SUD is a treatable condition, and with the right support and treatment, individuals can regain control of their lives and achieve lasting recovery.

If you would like to book a consultation with Dr Kouimtsidis, do not hesitate to do so by visiting his Top Doctors profile today