Substance Use Disorder 

Substance use disorder occurs when a person's use of alcohol or another substance (drug) leads to health issues or problems at work, school, or home. Substance use may lead to a fatal overdose. The exact cause is not known.  A person’s genes, the action of the drug, peer pressure, emotional distress, and environmental stress can all be factors. 1 

Dual Diagnosis (also known as co-occurring disorders)

Dual Diagnosis is a term for when someone experiences a mental illness and a substance abuse problem simultaneously.  Dual Diagnosis is a very broad category. It can range from someone developing mild depression because of binge drinking, to someone's symptoms of bipolar disorder becoming more severe when that person abuses heroin during periods of mania.  

Either disorder (substance abuse or mental illness) can develop first.  A person experiencing a mental health condition may turn to drugs and alcohol as a form of self-medication to improve the troubling mental health symptoms they experience. 2

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Tolerance

Tolerance happens when a person no longer responds to a drug in the way they did at first. So it takes a higher dose of the drug to achieve the same effect as when the person first used it. This is why people with substance use disorders use more and more of a drug to get the “high” they seek. 3

 

Dependence 

Dependence means that when a person stops using a drug, their body goes through withdrawal. Many people who take a prescription medicine every day over a long period of time can become dependent; when they go off the drug, they need to do it gradually, to avoid withdrawal discomfort. But people who are dependent on a drug or medicine aren’t necessarily addicted. 3

Addiction

Unlike tolerance and dependence, addiction is a disease;; but like tolerance and dependence, addiction can result from taking drugs or alcohol repeatedly. If a person keeps using a drug and can’t stop, despite negative consequences from using the drug, they have an addiction (also called a severe substance use disorder). But again, a person can be dependent on a drug, or have a high tolerance to it, without being addicted to it. 3

 

Additional Information:

  1. https://medlineplus.gov/

  2. https://www.nami.org/

  3. https://www.drugabuse.gov/


 

About Substances

To learn more about various substances, how they are commonly used, and their effects on the human body, see the list below:

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Prescription Opioids

What is it?

Opioids are a class of drugs naturally found in the opium poppy plant. Some prescription opioids are made from the plant directly, and others are made by scientists in labs using the same chemical structure. Prescription opioids are used mostly to treat moderate to severe pain.

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Common Prescriptions

  • Hydrocodone (Vicodin®) oxycodone (OxyContin®, Percocet®)

  • Oxymorphone (Opana®)

  • Morphine (Kadian®, Avinza®)

  • Codeine

  • Fentanyl

How it's Used

People misuse prescription opioids by taking the medicine in a way other than prescribed, taking someone else's prescription, or taking the medicine to get high. When misusing a prescription opioid, a person may swallow, inject, or snort the drug

Short & Long Term Effects

Opioids bind to and activate opioid receptors on cells located in the brain, spinal cord, and other organs in the body, especially those involved in feelings of pain and pleasure, and can strongly reinforce the act of taking the drug, making the user want to repeat the experience.

People who use prescription opioids can feel relaxed and happy, but also experience drowsiness, confusion, nausea, constipation, and slowed breathing

Addictive?

Yes, Prescription opioids have effects similar to heroin. While prescription opioid misuse is a risk factor for starting heroin use, only a small fraction of people who misuse opioid pain relievers switch to heroin.

Possibility of Overdose?

A person can overdose on prescription opioids. Naloxone (Narcan) is a medicine that can treat an opioid overdose when given right away.

Heroin

What is it?

Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of various opium poppy plants. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin.

How it's Used

People can inject intravenously (IV), sniff, snort, or smoke heroin

Short & Long Term Effects

  1. ​​​​​Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing.

  2. Short term: People who use heroin report feeling a "rush" (or euphoria). Other common effects include dry mouth, heavy feelings in the arms and legs, and clouded mental functioning.

  3. Long-term effects may include collapsed veins, infection of the heart lining and valves, abscesses, and lung complications.

Addictive?

Heroin is highly addictive. Withdrawal symptoms include severe muscle and bone pain, sleep problems, diarrhea and vomiting, and severe heroin cravings

Possibility of Overdose?

A person can overdose on heroin. Naloxone is a medicine that can treat a heroin overdose when given right away, though more than one dose may be needed.

Cocaine

What is it?

Cocaine is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America

How it's Used

People snort cocaine powder through the nose, or rub it into their gums. Others dissolve the powder and inject it into the bloodstream, or inject a combination of cocaine and heroin, called a Speedball. Another popular method of use is to smoke Crack cocaine

Short & Long Term Effects

Cocaine increases levels of the natural chemical messenger dopamine in brain circuits related to the control of movement and reward

Addictive?

Yes, as with other drugs, repeated use of cocaine can cause long-term changes in the brain’s reward circuit and other brain systems, which may lead to addiction.

Possibility of Overdose?

A person can overdose on cocaine, which can lead to death

Methamphetamine (Crystal Meth)

What is it?

Methamphetamine is a powerful, highly addictive stimulant that affects the central nervous system. Crystal methamphetamine is a form of the drug that looks like glass fragments or shiny, bluish-white rocks.

How it's Used

People can take methamphetamine by smoking, swallowing, snorting, or injecting the drug

Short & Long Term Effects

​​Short-term health effects include increased wakefulness and physical activity, decreased appetite, and increased blood pressure and body temperature.

 

Long-term health effects include risk of addiction; risk of contracting HIV and hepatitis; severe dental problems ("meth mouth"); intense itching, leading to skin sores from scratching; violent behavior; and paranoia.

Addictive?

​​​Yes, it can be highly addictive. When people stop taking it, withdrawal symptoms can include anxiety, fatigue, severe depression, psychosis, and intense drug cravings.

Possibility of Overdose?

​​Yes, people can overdose on methamphetamine.  Because methamphetamine overdose often leads to a stroke, heart attack, or organ problems, first responders and emergency room doctors try to treat the overdose by treating these conditions

CNS Depressants

What is it?

​​​Central Nervous System (CNS) depressants are medicines that include sedatives, tranquilizers, and hypnotics. These drugs can slow brain activity, making them useful for treating anxiety, panic, acute stress reactions, and sleep disorders.

Common Prescriptions

Benzodiazepines

  • Diazepam (Valium®)

  • Clonazepam (Klonopin®)

  • Alprazolam (Xanax®)

  • Ativan®

Barbiturates

  • Mephobarbital (Mebaral®)

  • Phenobarbital (Luminal®)

  • Pentobarbital sodium (Nembutal®)

How it's Used

Most prescription CNS depressants come in pill, capsule, or liquid form, which a person takes by mouth.

Short & Long Term Effects

People who start taking CNS depressants usually feel sleepy and uncoordinated for the first few days until the body adjusts to these side effects.

Addictive?

Yes, use or misuse of prescription CNS depressants can lead to problem use. Those who have become addicted to a prescription CNS depressant and stop using the drug abruptly may experience withdrawal

Possibility of Overdose?

Yes, a person can overdose on CNS depressants.

Vaping

What is it?

​​​Electronic cigarettes, also known as e-cigarettes, e-vaporizers, or electronic nicotine delivery systems, are battery-operated devices that people use to inhale an aerosol, which typically contains nicotine (though not always), flavorings, and other chemicals.

How it's Used

They can resemble traditional tobacco cigarettes (cig-a-likes), cigars, or pipes, or even everyday items like pens or USB memory sticks. Other devices, such as those with fillable tanks, may look different. Regardless of their design and appearance, these devices generally operate in a similar manner and are made of similar components.

 

Most e-cigarettes consist of four different components, including:

  • a cartridge or reservoir, which holds a liquid solution (e-liquid or e-juice) containing varying amounts of nicotine, flavorings, and other chemicals

  • a heating element (atomizer)

  • a power source (usually a battery)

  • a mouthpiece that the person uses to inhale

Short & Long Term Effects

  1. ​​In addition to the unknown health effects, early evidence suggests that e-cigarette use may serve as an introductory product for preteens and teens who then go on to use other tobacco products, including cigarettes, which are known to cause disease and premature death.

  2. Because nicotine affects the development of the brain's reward system, continued e-cigarette use can not only lead to nicotine addiction, but it also can make other drugs such as cocaine and methamphetamine more pleasurable to a teen's developing brain

Addictive?

​Yes, e-cigarettes can lead to nicotine addiction and increased risk for addiction to other drugs.

Possibility of Overdose?

Marijuana

What is it?

Marijuana refers to the dried leaves, flowers, stems, and seeds from the Cannabis sativa or Cannabis indica plant. The plant contains the mind-altering chemical THC and other similar compounds.

How it's Used

People smoke marijuana in hand-rolled cigarettes (joints) or in pipes or water pipes (bongs). They also smoke it in blunts—emptied cigars that have been partly or completely refilled with marijuana.

Short & Long Term Effects

T​HC over activates certain brain cell receptors, resulting in effects such as:

  • altered senses

  • changes in mood

  • impaired body movement

  • difficulty with thinking and problem-solving

  • impaired memory and learning

  • Marijuana use can have a wide range of health effects, including:

  • hallucinations and paranoia

  • breathing problems

  • possible harm to a fetus's brain in pregnant women

Addictive?

In severe cases, marijuana use can lead to the development of a substance use disorder

Possibility of Overdose?

There aren’t any reports of teens and adults dying from using marijuana alone, but marijuana use can cause some very uncomfortable side effects, such as anxiety and paranoia and, in rare cases, extreme psychotic reactions

Alcohol

What is it?

​​All of the following examples represent one standard drink:

  • 12 Fluid ounces of beer

  • 8-9 fluid ounces of malt liquor

  • 5 fluid ounces of table wine

  • 1.5 fluid ounces shot of distilled spirits (gin, rum, tequila, vodka, whiskey)

How it's Used

​Alcohol enters your bloodstream as soon as you take your first sip. Alcohol’s immediate effects can appear within about 10 minutes. As you drink, you increase your blood alcohol concentration (BAC) level, which is the amount of alcohol present in your bloodstream.  

Short & Long Term Effects

These effects can include:

  • Reduced inhibitions

  • Slurred speech

  • Motor impairment

  • Confusion

  • Memory problems

  • Concentration problems

  • Coma

  • Breathing problems

  • Death

Addictive?

Yes, Alcohol is extremely addictive. There are significant long term effects of alcohol. Problem drinking that becomes an addiction is often characterized by compulsive use, loss of control over intake, and a negative emotional state when not drinking.

 

Based on National Cancer Institutes research, there is a strong scientific consensus of an association between alcohol drinking and several types of cancer including:

  • Esophageal

  • Liver

  • Breast Cancer

  • Colorectal

Possibility of Overdose?

Yes, you can overdose from Alcohol.  It occurs when there is so much alcohol in the bloodstream that areas of the brain begin to shut down.  Alcohol overdose can lead to permanent brain damage or death. 

Information was gathered from the National Institute on Alcohol Abuse and Alcoholism. 

 

For more information on alcohol please visit:

https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

https://www.niaaa.nih.gov/