Substance Abuse

Many people don't understand why or how other people become addicted to drugs. They may mistakenly think that those who use drugs lack moral principles or willpower and that they could stop their drug use simply by choosing to. In reality, drug addiction is a complex disease, and quitting usually takes more than good intentions or a strong will. Drugs change the brain in ways that make quitting hard, even for those who want to.

What are Substance Use Disorders?

The essential features of substance use disorder is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems. An important characteristic of substance use disorders is an underlying change in the brain circuits that may persist beyond detoxification, particularly in individuals with severe disorders. Overall, the diagnosis of a substance use disorder is based on a pathological pattern of behaviors related to use of the substance. 

From the DSM-5

What causes Substance Use Disorders?

Like many mental health disorders, several factors may contribute to the development of drug addiction. The main factors are:

  • Environment. Environmental factors, including your family's beliefs and attitudes and exposure to a peer group that encourages drug use, seem to play a role in initial drug use.
  • Genetics. Once you've started using a drug, the development into addiction may be influenced by inherited (genetic) traits, which may delay or speed up the disease progression.

Risk Factors

People of any age, sex or economic status can become addicted to a drug. Certain factors can affect the likelihood and speed of developing an addiction:

    • Family history of addiction. Drug addiction is more common in some families and likely involves genetic predisposition. If you have a blood relative, such as a parent or sibling, with alcohol or drug addiction, you're at greater risk of developing a drug addiction.
    • Mental health disorder. If you have a mental health disorder such as depression, attention-deficit/hyperactivity disorder (ADHD) or post-traumatic stress disorder, you're more likely to become addicted to drugs. Using drugs can become a way of coping with painful feelings, such as anxiety, depression and loneliness, and can make these problems even worse.
    • Peer pressure. Peer pressure is a strong factor in starting to use and misuse drugs, particularly for young people.
    • Lack of family involvement. Difficult family situations or lack of a bond with your parents or siblings may increase the risk of addiction, as can a lack of parental supervision.
    • Early use. Using drugs at an early age can cause changes in the developing brain and increase the likelihood of progressing to drug addiction.
    • Taking a highly addictive drug. Some drugs, such as stimulants, cocaine or opioid painkillers, may result in faster development of addiction than other drugs. Smoking or injecting drugs can increase the potential for addiction. 

    How to Recognize Substance Abuse Disorder

    Substance Use Disorder symptoms or behaviors include, among others:

    Feeling that you have to use the drug regularly — daily or even several times a day
    Having intense urges for the drug that block out any other thoughts
    Over time, needing more of the drug to get the same effect
    Taking larger amounts of the drug over a longer period of time than you intended
    Making certain that you maintain a supply of the drug
    Spending money on the drug, even though you can't afford it
    Not meeting obligations and work responsibilities, or cutting back on social or recreational activities because of drug use
    Continuing to use the drug, even though you know it's causing problems in your life or causing you physical or psychological harm
    Doing things to get the drug that you normally wouldn't do, such as stealing
    Driving or doing other risky activities when you're under the influence of the drug
    Spending a good deal of time getting the drug, using the drug or recovering from the effects of the drug
    Failing in your attempts to stop using the drug
    Experiencing withdrawal symptoms when you attempt to stop taking the drug

    Know the Facts


    Over the course of their entire lives, 29.1% of U.S. adults (18 and older) have met criteria for an alcohol use disorder, and 9.9% met criteria for another drug use disorder (e.g., opioid, cocaine, or marijuana use disorder).

    In the past 12 months only – corresponding with “current” substance use disorder – 13.9% of U.S. adults met criteria for an alcohol use disorder, and 3.9% for another drug use disorder.


    For adolescents 12-17 years old, 5.0% met criteria for DSM-IV alcohol or other drug use disorder in the past 12 months.

    Common Forms of Substance Use Disorders


    A pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking. If your pattern of drinking results in repeated significant distress and problems functioning in your daily life you should seek help.


    People use cannabis by smoking, eating or inhaling a vaporized form of the drug. Cannabis often precedes or is used along with other substances, such as alcohol or illegal drugs, and is often the first drug tried.

    Sedatives, Hypnotics, and Anxiolytics 

    Barbiturates, benzodiazepines and hypnotics are prescription central nervous system depressants. They're often used and misused in search for a sense of relaxation or a desire to "switch off" or forget stress-related thoughts or feelings.

    • Barbiturates. Examples include phenobarbital and secobarbital (Seconal).
    • Benzodiazepines. Examples include sedatives, such as diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin) and chlordiazepoxide (Librium).
    • Hypnotics. Examples include prescription sleeping medications such as zolpidem (Ambien, Intermezzo, others) and zaleplon (Sonata).


    Stimulants are often used and misused in search of a "high," or to boost energy, to improve performance at work or school, or to lose weight or control appetite. Stimulants include amphetamines, meth (methamphetamine), cocaine, methylphenidate (Ritalin, Concerta, others) and amphetamine-dextroamphetamine (Adderall, Adderall XR, others).


    Use of hallucinogens can produce different signs and symptoms, depending on the drug. The most common hallucinogens are lysergic acid diethylamide (LSD) and phencyclidine (PCP).


    Some commonly inhaled substances include glue, paint thinners, correction fluid, felt tip marker fluid, gasoline, cleaning fluids and household aerosol products. Due to the toxic nature of these substances, users may develop brain damage or sudden death.


    Opioids are narcotic, painkilling drugs produced from opium or made synthetically. This class of drugs includes, among others, heroin, morphine, codeine, methadone and oxycodone. 

    Treatment Options

    Although there's no cure for drug addiction, treatment options explained below can help you overcome an addiction and stay drug-free. Your treatment depends on the drug used and any related medical or mental health disorders you may have. Long-term follow-up is important to prevent relapse.

    Chemical dependence treatment programs

    Treatment programs usually offer:

    • Individual, group or family therapy sessions
    • A focus on understanding the nature of addiction, becoming drug-free and preventing relapse
    • Levels of care and settings that vary depending on your needs, such as outpatient, residential and inpatient programs


    The goal of detoxification, also called "detox" or withdrawal therapy, is to enable you to stop taking the addictive drug as quickly and safely as possible. For some people, it may be safe to undergo withdrawal therapy on an outpatient basis. Others may need admission to a hospital or a residential treatment center.

    Behavior therapy

    As part of a drug treatment program, behavior therapy — a form of psychotherapy — can be done by a psychologist or psychiatrist, or you may receive counseling from a licensed alcohol and drug counselor. Therapy and counseling may be done with an individual, a family or a group. The therapist or counselor can:

    • Help you develop ways to cope with your drug cravings
    • Suggest strategies to avoid drugs and prevent relapse
    • Offer suggestions on how to deal with a relapse if it occurs
    • Talk about issues regarding your job, legal problems, and relationships with family and friends
    • Include family members to help them develop better communication skills and be supportive
    • Address other mental health conditions

    Support Groups

    Many, though not all, self-help support groups use the 12-step model first developed by Alcoholics Anonymous. Other support groups include Celebrate Recovery, a Christ centered, 12 step recovery program and Self-Management and Recovery Training (SMART Recovery), a science-based, self-empowered addiction recovery model. 

    Lifestyle Changes

    Overcoming an addiction and staying drug-free require a persistent effort. Learning new coping skills and knowing where to find help are essential. Taking these actions can help:

    From the Mayo Clinic

    See a licensed therapist or licensed drug and alcohol counselor.

    Drug addiction is linked to a number of problems that may be helped with therapy or counseling, including other underlying mental health concerns or marriage or family problems. Seeing a psychiatrist, psychologist or licensed counselor may help you regain your peace of mind and mend your relationships.

    Seek treatment for other mental health disorders.

    People with other mental health problems, such as depression, are more likely to become addicted to drugs. Seek immediate treatment from a qualified mental health professional if you have any signs or symptoms of mental health problems.

    Join a support group.

    Support groups can be very effective in coping with addiction. Compassion, understanding and shared experiences can help you break your addiction and stay drug-free.

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