Substance Use Disorder
– by Timothy Lyons
A Definition, Signs and Symptoms of Substance Use Disorder
Substance use disorder is a complex behavioral disorder. Persons who do not understand this disorder often relegate its complexity to a lack of willpower or morals. The mistake that occurs with this thinking is the belief that someone can just stop using substances of abuse simply by choice (NIDA, 2016). The truth is that once a person has made the choice to engage in use of a substance with addiction potential, physiological changes in the brain can occur. Once this disorder has taken hold, those changes can make it difficult for the addicted person to maintain self-control or resist cravings for drugs. It will take more than willpower to overcome this problem.
The most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5), (American Psychiatric Association, 2013) defines substance use disorder. The main attributes of this disorder are complex interwoven symptoms of thoughts, behaviors and physiological changes that include use of the substance of abuse even though there are substantial problems created by its use. In many instances the understanding of this disorder is characterized and informed by the biopsychosocial model (Borrell-Carrió, Suchman, & Epstein, 2004). This would include biological social and psychological components that are the backbone of this DSM 5 definition.
A main attribute in this disease of substance use disorder is the physiological change that occurs in the systems of the brain that are directly affected by these substances. In a chapter from (Purves D, Augustine, & Fitzpatrick, 2001) these changes are considered long term potentiation which is a strengthening of synaptic transmissions in the storage of memory. These changes persist even after detoxification, the length of which is positively correlated with the severity of the disorder. The behavioral components of these changes are intense cravings for the substance when there are external stimuli presented that are in some way related to the drug, and repeated relapse into use once the person attempts use cessation (American Psychiatric Association, 2013). An overarching theme in the diagnosis is the pathological behavior patterns as a result of this disorder.