substance-useMuch of America still calls it drug abuse, or substance abuse. It refers to dependency and addiction with multiple substances. There are upwards of 25 million Americans with such a problem.

Medical and psychiatric providers now call these cases, “Substance Use Disorders.” That’s due to the guidelines they follow in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

The DSM-5 says substance use disorders occur when repeated use of substances or drugs, cause clinically and functionally significant impairment. This includes medical and behavioral health issues. It also causes failure to manage major life responsibilities. This could manifest as problems at work, school, or home.

Here are the types of substance use disorders established by the DSM-5:


Cannabis (marijuana)

Hallucinogens (LSD, PCP, mushrooms, etc.)

Inhalants (glue, paint, paint thinner, aerosol sprays, etc.)

Opioids (heroin, oxycodone, hydrocodone, fentanyl, etc.)

Sedatives, Hypnotics, or Anxiolytics (valium, benzodiazepines, barbiturates, etc.)

Stimulants (cocaine, methamphetamine)


Causes of Substance Use Disorder

Use of addictive substances gives no official warning. It shows no mercy. A person’s fall can be fast and furious.

There is no one cause of substance use disorder. Instead there are many.  Those suffering from behavioral health issues are especially at risk. People with anxiety, depression, PTSD, and other challenging conditions often turn to addictive substances for relief from their symptoms.

Other potential causes include genetics, stress, low self-esteem, peer pressure, and the action of the substance of choice.With substance use there is almost always a personal choice. But once cravings take over, it becomes a whole other medical story.


Diagnosing Substance Use Disorder

A diagnosis of a substance use disorder is determined by certain criteria. There is a pathological set of behaviors related to the use of that substance. These behaviors have four main categories:

  1. Impaired control
  2. Social impairment
  3. Risky use
  4. Pharmacological indicators (tolerance and withdrawal)

Let’s look at the behaviors determining a diagnosis of a substance use disorder.

Impaired control:

Impaired control shows itself in several ways:

– Cravings which are so intense, a person has difficulty fighting them off, or thinking about anything else.

– Use of an addictive substance for longer periods of time than intended, or larger amounts than intended.

– Being unsuccessful in efforts to reduce substance use.

– Spending excessive time getting/using substances, and recovering from use of them.

Social impairment:

Social impairment is one type of substantial harm. The damage is caused by repeated use of an addictive substance.

– A person continues their substance use despite known problems it causes with life responsibilities. Such problems could be failure to accomplish job duties, school absences, failure to meet family needs.

– A person continues their substance use despite it causing problems with important relationships. Examples could be arguments with loved ones over the substance use, or losing friendships through continued use.

– Important social activities are reduced or stopped because of substance use. A person becomes isolated, avoiding time with family and friends.

Risky Use:

This type of behavior is based on a person’s failure to stop substance use despite the potential dangers caused by it.

A person’s use continues to place them in physically dangerous situations. For example, driving under the influence, getting into fights, or having unprotected sex with multiple partners.

– A person continues to use addictive substances despite knowing it may cause or worsen physical and psychological problems. For instance, smoking marijuana with asthma, or using cocaine with anxiety disorders. Weight loss or weight gain, and higher risk of cancer are other examples.

Pharmacological indicators:

– Tolerance and withdrawal are often highly important indicators. The body attempts to adjust to a person’s use of addictive substances. How exactly it does so can vary by person and substance of choice. Still, the signs are often visible. They often increase in intensity.

– The tolerance issue has a person needing to increase the amount of their substance use to achieve the same desired effect. The goal could be to get high, or to avoid withdrawal. Either way, the problem grew because of chemical and structural changes in the addicted brain. It got used to a lower amount. So, it demands more, and creates cravings to get more.

– Once a person has developed a tolerance to an addictive substance, withdrawal worsens the experience. Saying the body’s response is uncomfortable and unpleasant is putting it mildly. The addicted brain perceives an abrupt stop in behavior. Withdrawal symptoms can feel so painful, the only escape a person can think of is to use more of an addictive substance.

Repeated use makes tolerance and withdrawal more powerful. This explains why trying to overcome withdrawal permanently through detox can be dangerous.

A person must meet 2 or more of these criteria to be diagnosed with a substance use disorder. The severity of their addiction is determined by the number of diagnostic criteria they had. Like alcohol use disorder, substance use disorders, are defined as mild, moderate, or severe.


Substance Abuse Disorder Treatment and Therapies

Substance use disorder is a scary condition. It must be taken seriously. The downward spiral with tolerance and withdrawal can lead to personal destruction or death. Accidental or intentional overdose is always a threat. Relapse is another threat which needs to be managed, and prevented whenever possible.

Treatments and therapies with experienced professionals offer the best hope for recovery. At Integro Health Systems, we treat men and women with substance use disorder. We treat the illness. We treat the person with compassion and respect. There is no judgment. Treatment is not a punishment. “This is the shortest path to stability and success,” said Karen Godwin-Canulla, M.D., Integro Chief Medical Officer. “You’d be amazed how honest and responsive people will be when you establish safety and trust.”

Integro offers an integrated and customized approach. It’s done through an integrated system which includes Urgent Care, Detox, Inpatient Care, and Intensive Outpatient Care. Getting a person stable is always our goal.

Every aspect of treatments and therapies are designed for the needs of the individual. Treatment begins with recognizing where they are with their illness. Since many are comorbid, addressing any other current medical or psychiatric problems is critical. So is diagnosing any underlying issues.

If a person wants to break free, our detox unit meets all their needs. We work with them on developing a plan for weaning them off addictive substances.

Emergency treatment in Urgent Care or Inpatient Care depends on several factors. They include what symptoms the person presents, what substance they used, and how much.

Participation in the Outpatient Care is critical once a person is stable. Substance use disorder requires a team approach to overcome it long-term. Trying to go it alone is too much for one person. An addicted brain needs time to heal. It needs help to maintain balance and healthy function.

Medication may be provided by our trained medical doctors and psychiatrists. Contrary to what some think, this is not simply trading, “one drug for another.” Such an approach can minimize dangerous risks and side effects with withdrawal symptoms, and any pre-existing conditions.

Individual therapy sessions with psychiatrists and counselors are invaluable for staying on the right track. They help to monitor a person’s symptoms and behavior. Concerns are discussed. Coping skills and tools are provided. Triggers for substance use are identified. Establishing a plan for avoiding triggers can help to prevent recurring problems. Healthy lifestyle changes are introduced.

Everything possible is done to avoid relapse, and inspire living. But should a relapse occur, our team is there to teach, not criticize. We’re there to help the person back on their feet, not put them down

Support Groups can serve as an additional lifeline. Those who feel they are alone realize they are not. People learn by listening to their peers. They connect and support one another in pursuing freedom from substance use disorder. Integro is a believer in Smart Recovery, and the 12-Step program as helpful options. Again, a customized plan for every individual is best

Call Integro today for a customized solution plan for substance use disorder. Call (602) 535-8200. Urgent help and added hope are here.

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