Understanding Dependence Disorders: Substance Use Disorder

What is the difference between substance abuse and substance use dependency? Can they be used interchangeably? It is important to clarify these terms to better understand substance use disorder and how it is treated. In this article, we will go over what these terms refer to and when to use them to distinguish the different levels of addiction. We will also outline the symptoms and treatment for substance use disorders to better help ourselves or our loved ones struggling with addiction.

Defining Terms

Substance Use Disorder

This is a term used by the American Psychological Association (APA) in the DSM V as the medical term for addiction. Addiction has a more negative connotation. Substance use disorder is a more inclusive term that can better identify people struggling with substance use. It also segments out other addictive behaviours addictions like gambling or shopping. Substance use disorder is a mental disorder that causes biochemical changes in the brain and changes to behaviour, potentially causing harm to themselves or others.

Substance Abuse

Substance abuse and substance dependence are often used interchangeably; however, they refer to two different, but linked effects of substance use. Substance Abuse refers to a pattern of behaviour caused by substance use leading to distress or starting to impact daily life. These behaviours can include but are not limited to missing work or school, legal problems, or involvement in dangerous activities (impaired driving). Continued substance use can also interfere with personal and professional relationships.

Substance Dependence

Substance dependence is marked by the continued use of substances even after significant problems have occurred. This repetitive and sustained use can change the user's brain chemistry, creating a greater tolerance for alcohol and/or drugs and developing withdrawal symptoms from decreased use. This results in the need for an increased amount of the substance to achieve the desired effect and a physical deterrence stopping the user from quitting use. Withdrawal symptoms can range from insomnia, anxiety, and tremors to more life-threatening symptoms that require medical observation and hospitalization. Substance dependence increases alcohol/drug-seeking behaviour and can cause dependant individuals to spend less time working or participating in social or recreational activities and instead spend more time doing, getting, using, and recovering from the effects of alcohol/drug use. Dependence requires an awareness of the interference with physical, psychological, and social problems caused by substance use paired with the inability to stop.

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Substances frequently abused include:

• Alcohol
• Marijuana??
• Stimulants (Cocaine, Amphetamines, Methamphetamine)
• Sedative–Hypnotics
• Anabolic Steroids
• Opiates
• Hallucinogens?
• Inhalants
• Phencyclidine
• Nicotine

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Symptoms

People experience symptoms differently. Some common signs and symptoms are:

• Increased substance use over time (frequency and amount)
• Cravings or a strong desire to use the substance
• Unsuccessful attempts to cut down or control substance use
• Change in behaviour and attitude
• Declining school or work performance
• Mood swings
• Weight loss or weight gain
• Increased risk-taking behaviours (impaired driving, sexual risks)
• Avoidance of friends and family
• Legal problems
• Disinterest in socialization or personal hygiene
• Depressed, hopeless, or suicidal feelings

Treatment

Like the symptoms, the treatment for substance use disorders varies, and treatment plans are based on the individuals' specific circumstances. This includes your age, health, medical history, extent of your symptoms and dependence, the type of substance(s) used, and how long the substance has been used/tolerance. Most programs include a combination of:

Detox

A controlled, medically supervised environment to safely withdraw from substances.

Therapy

Behavioural therapies (i.e.: psychotherapy) identify triggers, modify behaviour, and develop coping mechanisms.

Medications

Substance use disorders can often be paired with other mental health disorders, and medication can help address those symptoms. Medications can also be used to ween off the alcohol/drugs as well, to prevent relapse.

Support groups

A mutual support system of peers who have been through similar experiences can help decrease the sense of shame and isolation that can lead to relapse while also providing individuals with additional tools for living life, without the need for substances (i.e.: 12 Step Meetings, SMART Recovery Meetings)

If you or someone you love needs help with a substance use disorder, call your local Nomina Integrated Health clinic for community support, or Nomina Wellness for our comprehensive stay treatment.