Substance abuse disorders generally involve the persistent use of psychoactive substances that can lead to dependence and addiction over time. As addiction progresses, it is characterized by craving, tolerance, withdrawal symptoms, and decline in personal and social functioning. The development of addiction is influenced by personality traits like sensation-seeking and impulsivity, as well as hereditary and environmental factors. Abused drugs impact the brain by interfering with neurotransmitters like glutamate, GABA, dopamine, and opioids, disrupting the normal balance. Management of substance abuse disorders involves stages of precontemplation, contemplation, and decision/action, utilizing therapies like counseling, pharmacology, family support, occupational activities, and relapse prevention.

1. Substance(drug) abuse disorders- general part I Substance(drug) abuse disorders- general part I

2. Substance abuse: It is a persistent use of one or more psychoactive substance. Dependence (addiction): untreated, persists and progresses, it ends in dependence: craving, tolerance, withdrawal symptoms, social and personal decline.medical complications .

3. Craving: a strong and an irresistible desire. Tolerance: more amount of the drug to obtain the same effect (dose escalation). Physical dependence: withdrawal syndrome. Psychological dependence: urge to use the drug, thinks about it, likes it and he can not abstain.

4. Personality factors: Predisposition to experiment with both licit and illicit drugs is more likely in those with sensation-seeking or impulsive behaviour traits, and in extroverts rather than in introverts. Herditary factors: alcoholic father. Age: Adolescence and puberty

5. How abused drugs affect the brain? primary neurotransmitter:glutamatestimulatory ,gamma amino butyric acid(GABA) inhibitory, appropriate balance . Secondary transmitters:dopamine, serotonin, noradrenalin, acetylcholine, endogenous opiates, emotion to the primary processes. All drugs act by interfering with these neurotransmitters.

6. Types according to the ICD-10: Alcohol, opiates, cannabinoids, sedatives (benzodiazepines and barbiturate), Stimulants (caffeine, amphetamine),cocaine, hallucinogens, nicotine , volatile substances (adhesives, aerosols, fuel gases, paints,multiple

7. 1.Risk route of use: infection (hepatitis ,HIV), increased rate of brain entry,opiateintox. respiratory depression 2.Risk of the drug itself. 3.Addictiveness : opiates,cocaine. A. pleasure.b. physical suffering of abstinence.c.the psychological suffering, drug to relieve symotoms. 4. Ease of stopping.

8. Management 1. precontemplation stage: there is no recognition of a need for treatment. 2. contemplation stage: treatment is being considered, the patient is helped to clarify his views and to build his motivation to change. 3 .Decision and action stage

9. Therapy 1. medical complications: 2. Treatment primary psychiatric disease if present. 3. Psychotherapy, motivational interviewing, psycho education client-centered therapy, cognitive behavior therapy. 4. Pharmacological , detoxification maintenance Therapy: aversion , anti-craving

10. 4.Sociotherapy, family and marital therapy. 5. Occupational therapy. 6. Stress management and relaxation treatment. 7.Relapse prevention. 8. Self-help group