The document provides an overview of substance use disorders, defining key concepts like addiction, dependence, and tolerance, while outlining various criteria for substance use disorders as per DSM-5. It discusses different types of substance abuse including alcohol, opioids, cannabis, and cocaine, along with their psychological and physiological impacts. The document also covers causes, screening methods, treatment options, and statistical data on substance use and treatment in 2019.

1. Substance Abuse

2. INTRODUCTION
Substance use refer to condition arising from the abuse of alcohol,
psychoactive drugs and other chemicals such as volatile solvents.
ABUSE- It refer to maladaptive pattern of substance use that impairs health
in a broad sense.

3. ADDICTION
Addiction is a physiologic and psychologic dependence on alcohol or other drugs of abuse.
DEPENDENCE
It refers to certain physiological and psychological phenomenon induced by the repeated taking of
a substance.
TOLERANCE
It is a state in which after repeated administration ,a drug produce decreased effect, or increasing
doses are required to produce the same effect.

4. DEFINITION OF SUBSTANCE ABUSE
ACCORDING TO R SREEVANI
“Maladaptive recurring use of a substance accompanied by repeated
detrimental effect as a result of continued use’’

5. CRITERIA FOR SUBSTANCE USE DISORDERS DSM-5
Substance use disorders span a wide variety of problems arising from substance
use, and cover 11 different criteria:
 Taking the substance in larger amounts or for longer than you’r meant to.
 Wanting to cut down or stop using the substance but not managing to.
 Spending a lot of time getting, using, or recovering from use of the substance.
 Cravings urges to use the disorder.
 Not managing to do what you should at work, home, or school because of substance
use.
 Continuing to use, even when it causes problems in relationships.
 Giving up important social, occupational, or recreational activities because of
substance use.
 Using substances again and again, even when it puts you in danger.
 Continuing to use, even when you know you have a physical or psychological problem
that could have been caused or made worse by the substances.
 Needing more of the substance to get the effect you want (tolerance).
 Development of withdrawal symptoms, which can be relieved by taking more of the
substance.

6. TYPES OF SUBSTANCE ABUSE
 Alcohol dependence
 Opioids
 Cannabis
 Cocaine
 Caffeine and other stimulants

7. ALCOHOL DEPENDENCE SYNDROME
Alcoholism refers to the use of alcoholic beverages to the point of causing
damage to the individual, society or both.

8. IMPACTS OF LONG TERM ALCOHOL USE
Psychiatric disorders due to alcohol
dependence.
• Major depression
• Depersonalization
• Mania
• Panic disorder
• Phobias
• Anxiety disorder
• Personality disorder
• Schizophrenia
.
Physiologic effects of long term
alcohol use.
• Cardiac myopathy
• Vitamin deficiency.
• Heart failure
• Stomach ulcers
• Alcoholic liver disease
• Chronic pancreatitis
• Sexual dysfunction

9. OPIOID USE
DISORDER
The commonly abused opioids in our
country are heroin(brown sugar) and
synthetic preparation like pethidine.
The drugs that are injected through
needle are heroin.

10. CANNABIS USE DISORDER
Cannabis is derived from the plant cannabissative,which grows in the wild all
around the world. It is used in various form such as
• Bhang
• Ganja

11. COCAINE USE DISORDER
Common street name is ‘crack’ it can be administered orally, intranasally by
smoking.
BARBITURATES
These are sedatives and are used for the sedation of aggevated patients to
relief pain.

12. CAUSES OF SUBSTANCE ABUSE
Biological Factor
Psychological factor
Social factor

13. BIOLOGICAL FACTORS
GENETIC FACTORS-Family
history of substance use
disorder.
BIOCHEMICAL FACTOR-For
example role of dopamine and nor
epinephrine have been implicated in
cocaine, ethanol and opioids
dependence.

14. PSYCHOLOGICAL FACTORS
 Sense of inferiority.
 Poor impulse control
 Low self esteem
 Desire of escape from
reality
 Pleasure seeking
 Sexual immaturity

15. SOCIAL FACTORS
 Peer pressure
 Urbanization
 Unemployment
 Over crowding
 Poor social support.
 Religious reasons

16. IMPACTS OF USING DRUGS
Decreased Academic performance
Physical and psychological
impact
Financial impact
Legal Considerations

17. COMORBIDITY
Up to 50% of addicts have comorbid
psychiatric disorder.
 Antisocial Disorder
 Depression
 Suicide

18. SCREENING AND ASSESSMENT
• SCREENING – Screening is the
process of identifying individuals who
have or may be at risk for a substance use
disorder.
• ASSESSMENT-Assessments are used
to clarify the nature of substance use
behavior to help determine appropriate
treatment. Assessments usually require
specialized skills , and are longer to
administer than screeners.

19. SCREENING TOOLS
1. DRUG ABUSE SCREEN TEST(DAST 10)-This test contains 10 yes or no questions about how
much and how often you take drugs. The answers are scored on a point system. A score of 8 or
more may indicate a drug problem.
2. CUT DOWN ANNOYED, GUILTY, EYE OPENER(CAGE)-This also contains yes or no
questions. Two or more yes answers may indicate a drug problem .
3. CAR, RELAX, ALONE FORGET, FRIENDS, TROUBLE(CRAFT)- This test is designed for
teens and includes yes or no questions about drug and alcohol use. Two or more yes answers to
these questions may indicate a drug problem.

20. TREATMENT
PSYCHOLOGICAL
MEDICATION
• Behavioral interventions
• Group therapy
• Individual therapy
• Self help recovery groups
• Aversion therapies
• Family therapy
• Cognitive behavioral
therapy.
A number of medicines have
been approved for the treatment
of substance abuse, such as
BUPRENORPHINE and
METHADONE.

21. DATA ACCORDING TO THE NATIONAL SURVEY ON DRUG USE AND
HEALTH (NSDUH) , CONDUCTED BY THE SUBSTANCE ABUSE AND
MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA).
Among people aged 12 or older in 2019, 60.1%(165.4 million) used substance .
ALCOHOL- Among people aged 12 or older in 2019 , 50.8% (139.7 million ) used Alcohol.
TOBACCO- Among people aged 12 or older in 2019, 21.1%(58.1 million) used tobacco.
OTHER ILLICIT DRUGS- Among people aged 12 or older in 2019, 14% used illicit
drugs .
ABOUT TREATMENT-
 Among people aged 12 or older in 2019, 2.1 million received substance use treatment at a Self
Help Group.
 1.7 million received treatment at a mental health centre as an outpatient.
 1.0 million received treatment at rehab facility as an inpatient.