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What is substance use disorder?

Written by Drew Redd. Mina Draskovic, B.Psy., reviewed this content for accuracy.

Substance use disorder (SUD) is a mental health condition marked by the compulsive use of substances despite harmful consequences. It impacts the brain, behavior, and overall health, causing both physical and emotional dependence.

In 2022, SAMHSA reported that 48.7 million people aged 12 or older had a substance use disorder. Among them, 29.5 million struggled with alcohol use disorder (AUD), 27.2 million with drug use disorder, and 8 million had both.

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With proper treatment and support, you can overcome substance use disorder and regain control of your life. Our drug and alcohol rehab facility provides evidence-based therapies and a compassionate environment to support your journey to lasting sobriety.

Which substances are most commonly abused?

Substance use disorders can develop from the abuse of different types of substances, both legal and illegal. Here are the main types of substances that you can become addicted to:

  1. Alcohol is one of the most commonly abused substances. Alcohol is a legal depressant that may cause physical and psychological dependence.
  2. Opioids are a class of drugs that includes prescription painkillers (oxycodone, hydrocodone, and fentanyl), as well as illegal opioids such as heroin. Opioids are highly addictive and cause respiratory depression and overdose.
  3. Stimulants such as cocaine and methamphetamines produce a euphoric high but also lead to addiction, cardiovascular problems, and psychosis.
  4. Benzodiazepine drugs such as Xanax, Valium, and Klonopin are prescribed for anxiety and sleep disorders but can be habit-forming and lead to physical and emotional dependence.
  5. Marijuana is considered less harmful than other substances, but it can still lead to dependence.
  6. Hallucinogens such as LSD, psilocybin mushrooms, and PCP can cause profound distortions in perception and potentially trigger mental health issues in susceptible individuals.
  7. Inhalants such as aerosol sprays, paint thinners, and gasoline produce mind-altering effects and cause permanent brain damage and organ failure.
  8. Prescription drugs are often abused for their potent mind-altering effects and lead to addiction.

Regardless of the substance, all addictive drugs hijack the brain’s reward system and make it extremely difficult to quit.

What causes substance use disorder?

A combination of factors influences the development of SUD. 

…addiction is more than repeated exposure, it is the synchronicity between intrinsic factors (genotype, sex, age, preexisting addictive disorder, or other mental illness), extrinsic factors (childhood, level of education, socioeconomic status, social support, entourage, drug availability) and the nature of the addictive agent (pharmacokinetics, path of administration, psychoactive properties). (Popescu, et. al.)

The causes of substance use disorder include:

  1. Altered brain chemistry
  2. Genetic predisposition to substance use
  3. Environmental influences
  4. Accessibility and availability of substances
  5. Trauma and stress
  6. Co-occurring mental health disorders

Addiction alters brain chemistry

Drugs and alcohol affect the brain’s reward system and may cause long-term cognitive damage. Substances flood the brain with dopamine, a neurotransmitter that creates feelings of pleasure and reinforces substance use. Volkow, et. al. reveal that all addictive substances increase the levels of neurotransmitters such as endogenous opioids, endogenous cannabinoids, serotonin, glutamate, and neuropeptides. 

Over time, the brain adapts, requiring more of the substance to keep dopamine levels in balance and achieve the same pleasurable effect. This leads to tolerance, cravings, and withdrawal symptoms when attempting to quit, perpetuating the cycle of addiction.

The alterations in the brain’s chemistry and function caused by substance use are the hallmarks of the disease model of addiction. This model views addiction as a chronic brain disease, and not simply a behavioral issue.

Genetic predisposition

Genes play a significant role in the risk of developing an addiction. Research shows that genetics account for nearly half of the likelihood of someone struggling with substance abuse.

While genes don’t directly cause SUD, they can influence how the brain responds to substances and the likelihood of engaging in addictive behaviors.

A 2021 study suggests the existence of a unifying “Addiction-Risk-Factor” of genetic liability that increases vulnerability to SUDs. This common genetic factor is distinct from the genetics of normal substance use and other mental health issues, indicating that addiction has a unique genetic basis.

Environmental influences

The environment you live in can greatly impact your likelihood of developing SUD. Factors such as easy access to drugs, living in a disadvantaged neighborhood, and facing obstacles to getting treatment can contribute to problematic substance use and addiction. 

Researchers at Virginia Commonwealth University suggest that racial and socioeconomic inequalities often lead to disparities in these environmental risk factors and, consequently, in rates of substance use disorders and treatment outcomes.

Accessibility and availability

Easy access to drugs or alcohol increases the likelihood of developing SUD. Many factors contribute to the risk of developing substance use disorder, including: 

  • Living in an area with high drug availability
  • Having a prescription for opioids
  • Working in an environment where alcohol is readily available

Frone, et. al. show that “physical access to substances and ease of use may promote higher levels of substance use and misuse, which can increase the likelihood of SUDs and act as a trigger for craving and use among those with an active SUD or in recovery.”

Trauma and stress

Many people turn to substances to relieve emotional pain, stress, and trauma temporarily, but drugs and alcohol often worsen mental health issues and can lead to addiction. Early childhood trauma and complex mental health issues often lead to high-risk behaviors, including hazardous substance use. A 2010 study found “a strong relationship between adverse childhood experience and subsequent substance use and poor mental health outcomes, particularly PTSD.” 

Co-occurring mental health disorders

Many people use alcohol or drugs to self-medicate mental health symptoms and provide temporary relief. These substances ultimately worsen the symptoms and interfere with the effectiveness of medications used to manage mental health conditions, delaying recovery.

For example, those with posttraumatic stress disorder (PTSD) use substances to self-medicate their symptoms, which may explain the high rates of co-occurring substance use disorders in people with PTSD.

Co-occurring mental health disorders, also known as dual diagnosis, require integrated treatment that addresses both the substance use disorder and the mental health condition at the same time. Ardu provides personalized dual diagnosis treatment to help you overcome addiction and manage your mental health symptoms. 

Stages of substance use disorder

Substance use disorder is a progressive condition. It develops through several stages. 

First stage: experimentation 

This is the initial stage where a person tries a substance out of curiosity, peer pressure, or to experience its effects. The use is occasional and the person may not perceive any significant consequences or develop a strong desire for the substance.

Second stage: regular use 

After experimenting, people progress to using the substance more regularly, often to experience the pleasurable effects or to cope with stress, anxiety, or other negative emotions. During this stage, some people develop tolerance to the substance, requiring higher doses to achieve the desired effects.

Third stage: risky use

Substance use becomes more frequent and starts to interfere with daily life, causing problems in relationships, work, or school. People may engage in risky behaviors while under the influence, such as driving or engaging in unprotected sex. Negative consequences accumulate, but the person continues the use despite them.

Fourth stage: dependence

In this stage, the person has developed a physical and psychological dependence. They experience strong cravings and withdrawal symptoms when they stop using the substance, which makes it extremely difficult to quit even if they want to. Their life revolves around obtaining and using the substance, often at the expense of other important aspects of their life.

Sixth stage: addiction

Addiction is the most severe stage of SUD. At this stage, the person has lost control over their use. They may experience severe physical, psychological, and social consequences, but they can’t stop using despite the negative consequences. Addiction requires comprehensive treatment to achieve and maintain recovery.

Not everyone progresses through all stages, and many factors influence the severity and the symptoms experienced. 

What are the symptoms of substance use disorder?

Symptoms of SUD can range from mild to severe and differ from person to person. The signs can be divided into physical and behavioral. Let’s take a closer look at both.

Physical symptoms of SUD

Substance use disorder takes a heavy toll on the body. The physical manifestations of SUD may include:

  1. Bloodshot eyes
  2. Dilated or constricted pupils
  3. Impaired coordination
  4. Shakes, tremors, or muscle twitches
  5. Excessive sweating
  6. Runny nose or persistent sniffling
  7. Needle track marks on arms (from injecting drugs)
  8. Disrupted sleep patterns
  9. Nausea and vomiting
  10. Rapid or irregular heartbeat
  11. Respiratory issues
  12. Deterioration of physical appearance
  13. Dramatic weight loss or gain
  14. Seizures

Behavioral symptoms of SUD

Substance use disorder also shows itself through a person’s behaviors and psychological state. Addiction also drastically impacts how someone thinks, feels, and acts. The behavioral symptoms of SUD include:

  1. Intense cravings
  2. Failing to meet responsibilities
  3. Changes in attitude, personality, or behaviors due to substance use
  4. Inability to control or cut back on use despite negative consequences
  5. Inability to feel pleasure from other things besides the substance
  6. Using more of the substance or for longer than intended
  7. Spending excessive time obtaining, using, and recovering
  8. Developing tolerance and withdrawal symptoms
  9. Engaging in deception or illegal activities to obtain the substance

These symptoms can manifest from the short-term effects of substance use or prolonged, heavy use over time depending on the substance involved.

The symptoms of alcohol and drug addiction can overlap, but certain telltale signs indicate that someone is struggling with alcohol addiction. If you or someone you know is showing signs of drug or alcohol use disorder, seek professional help.

Contact Ardu Recovery Center and let us help you take your first step on the road to recovery.

Health consequences of substance use disorder

Substance use disorder devastates physical and mental health. Long-term addiction to drugs and alcohol causes:

  1. Liver damage and disease: chronic alcohol and drug use inflame the liver, leading to scarring (cirrhosis) and liver failure. The liver is essential for filtering toxins, so any damage can be life-threatening.
  2. Cardiovascular problems: substance abuse can raise blood pressure, cause irregular heartbeat, and increase the risk of heart attack or stroke. 
  3. Respiratory issues: inhaling drugs damages the lungs, leading to chronic coughing, bronchitis, and a higher risk of lung infections.
  4. Increased risk of certain cancers: alcohol and drug use is linked to higher rates of liver, lung, throat, and mouth cancers. 
  5. Neurological problems: drugs and alcohol cause memory loss, confusion, seizures, and permanent brain damage. Long-term use can even physically shrink the brain.
  6. Gastrointestinal issues: substance use causes stomach ulcers, pancreatitis, and severe nausea and vomiting. 
  7. Weakened immune system and increased susceptibility to infections: drugs and alcohol wear down your body’s natural defenses, making it easier to get sick. Users are more prone to diseases such as HIV, hepatitis, and tuberculosis.
  8. Mental health disorders: substance abuse can trigger or worsen depression, anxiety, and psychosis. It’s a vicious cycle because many people use drugs to self-medicate mental health symptoms.
  9. Hormonal imbalances and reproductive health issues: chronic drug and alcohol use disrupts normal hormone production, causing problems with fertility, menstrual cycles, and sexual function in men and women.
  10. Malnutrition and vitamin deficiencies: people with addiction often have poor diets. They struggle with malnutrition and deficiencies in essential vitamins and minerals. 

Many people underestimate the negative health impacts of alcohol, but both alcohol and drug use disorders can have detrimental effects on health. Don’t wait until substance use disorder takes a heavy toll on your health. Contact us today to start your journey to a healthier, substance-free life.

How common is substance use disorder?

Research shows that around 15–17% of Americans aged 12 and older had a substance use disorder involving alcohol or drugs in 2022. This makes SUDs highly prevalent across the U.S. 

The prevalence of SUDs among young adults (aged 18-25) has also increased in recent years—from 5.4% in 2011 to 6.2% in 2019 (Lu, et. al.). Cannabis use was the most common SUD in young adults, with 3.6% of them abusing cannabis in 2011 to 4.2% in 2019. 

The overall trend indicates a growing problem that requires attention and effective interventions to prevent and treat substance use disorders in the United States.

How is substance use disorder diagnosed?

SUD is diagnosed through a clinical assessment using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. The DSM-5 evaluates the presence and severity of problematic substance use patterns and their impacts on a person’s life. 

Patients with a substance use disorder are diagnosed when they exhibit at least 2 of the 11 symptoms within 12 months:

  1. Use of the substance in larger amounts or for longer periods than intended
  2. Desire to cut down or stop use, but inability to do so
  3. Excessive time spent obtaining, using, or recovering from effects
  4. Persistent cravings or urges to use
  5. Failure to meet obligations at work, home, or school due to use
  6. Continued use despite recurrent interpersonal and social problems caused by it
  7. Abandonment of important recreational, occupational, or social activities
  8. Repeated substance use in physically dangerous situations
  9. Continued use despite physical or psychological issues caused or worsened
  10. Need for increased amounts to achieve the desired effect (tolerance)
  11. Experience withdrawal symptoms when not using, relieved by taking more

Based on the number of criteria met, SUD can be classified as mild (2-3 criteria), moderate (4-5 criteria), or severe (6 or more criteria). If someone you care about is showing symptoms of SUD, reach out for help as soon as possible. 

Every person’s path to recovery is unique. Our programs address your specific needs, drawing from a wealth of proven therapeutic approaches. More than just treating the symptoms, Ardu understands the root causes fueling the addiction, providing you with the tools to rebuild a life of purpose and fulfillment. 

What are the treatment options for substance use disorder?

The treatment of substance use disorder involves a combination of approaches tailored to the person’s needs, the severity of the disorder, and personal circumstances. Ardu’s expert team will guide and support you through the key components of treatment for substance use disorders.

Detox program

The first step in treating SUD is detoxification. Drug and alcohol detox programs help your body safely adjust to the absence of the substance while managing potentially uncomfortable or dangerous withdrawal symptoms. 

At our evidence-based drug detox center and alcohol detox facility, you receive round-the-clock care and monitoring by our experienced professionals. In certain cases, they integrate FDA-approved medications into your treatment plan to manage cravings, ease withdrawal, and support recovery. Our medical detox facility employs the use of medications such as buprenorphine, naltrexone, and acamprosate.

After you complete detox, you enter our rehab facility where you choose one of the following treatment modalities.

Inpatient and outpatient treatment programs

Our inpatient and outpatient programs cater to the diverse needs of those seeking help for substance abuse and addiction.

  • Inpatient or residential treatment provides a structured, immersive environment with 24/7 medical and emotional support, daily therapy sessions, and a distraction-free setting. For those with severe SUD, co-occurring disorders, or a history of relapse, an inpatient program is the most effective.
  • Outpatient treatment allows you to live at home while receiving regular care at our center. Suitable for mild to moderate SUD with a strong support system, it includes individual and group therapy, workshops, and skill-building to manage triggers and cravings.

Evidence-based therapies we use

We employ evidence-based therapies to change unhealthy patterns and behaviors contributing to SUD. These include:

  1. Cognitive-behavioral therapy (CBT)
  2. Dialectical behavior therapy (DBT)
  3. Family therapy
  4. Motivational interviewing
  5. Contingency management
  6. Trauma-informed care
  7. Mindfulness and meditation

Ongoing aftercare and relapse prevention planning are crucial for sustaining long-term sobriety. Our aftercare provides continued support through sober living, alumni programs, therapy, support groups, and lifestyle coaching to help you build a strong recovery network.

No matter your substance of abuse, Ardu Recovery Center provides comprehensive, evidence-based care to treat substance use disorders of all severities. We tailor our programs to meet your unique needs and circumstances, so you can build a foundation for lasting sobriety.

Get help with Ardu Recovery Center

Our addiction treatment facility is located in Provo, Utah. Comprehensive programs, expert staff, and a serene natural setting provide the ideal environment for your recovery journey. Whether you’re struggling with alcoholism or drug substance use disorders, Ardu provides specialized programs and employs diverse therapeutic approaches to treat:

We also offer cutting-edge therapies to address drug and alcohol addiction holistically such as:

Successful recovery is possible—we’re here to guide you. Contact us to get informed and start your sobriety journey today. 

Read our admissions process page for more information.

Drew Redd

Drew Redd is the executive director of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.

Substance use disorder FAQ

What are examples of substance use disorders?

Examples of substance use disorders include:

  • Opioid use disorders involving both prescription painkillers and illicit opioids
  • Illegal drug use disorders with substances such as cocaine and methamphetamine
  • Alcohol use disorder involving heavy drinking and leading to physical dependence
  • Prescription medication abuse, which includes the misuse of benzodiazepines and stimulants.

What is the difference between substance use and misuse?

Substance use refers to the consumption of any mind or body-altering substance, whether legal, such as alcohol and prescription medications, or illegal, like heroin and cocaine. Substance misuse occurs when these substances are used in a harmful or illegal manner. This includes taking medication not prescribed by a healthcare provider or engaging in binge drinking.

How does addiction affect the brain?

Addiction affects the brain by altering dopamine levels. This reinforces the desire to continue using the substance to experience pleasure despite the negative consequences. Chronic use changes the brain’s structure and function, particularly in areas responsible for decision-making and impulse control. As a result, the person becomes physically dependent and experiences withdrawal symptoms when the substance is unavailable.

Is substance use disorder a family disease?

Substance use disorder is often considered a family disease because it’s heavily influenced by genetic and environmental factors. Family dynamics and home environments play a crucial role in the development and continuation of SUD. These include communication patterns, stress levels, and exposure to substance use within the family. 

There is a hereditary component to addiction. Research shows that those with a family history of addiction are more likely to develop SUD themselves. This shows that addiction can be passed down through generations.

How can I reset dopamine levels?

You can reset dopamine levels in many ways. Here are a few of them:

  1. Engage in healthy behaviors. Exercise regularly to naturally boost dopamine production. A balanced diet rich in proteins and antioxidants supports brain health. Sufficient sleep is important for dopamine receptor sensitivity and overall brain function.
  2. Avoid substances. It may be difficult, but when you abstain from drugs and alcohol, you’re giving your brain a chance to recover its natural dopamine production.
  3. Seek help from health care providers. They can prescribe medications to manage withdrawal symptoms and support the recovery process, so you can receive a safer and more effective treatment of dopamine deficiency.
  4. Adopt healthy behaviors and coping mechanisms. Try mindfulness practices, meditation, and hobbies to manage stress and promote dopamine balance.
  5. Create a supportive environment, free from triggers that might lead you back to substance use. This way, you maintain stable dopamine levels and prevent relapse. 

How does addiction affect the quality of life?

Addiction significantly deteriorates a person’s quality of life, touching nearly every aspect of their daily existence. Its effects lead to a cycle of negative consequences, including:

  1. Deteriorated physical health. Addiction increases the risk of infectious diseases, such as HIV and hepatitis. It contributes to chronic conditions such as heart disease, liver damage, and respiratory problems. Long-term substance use weakens the immune system, so you become more susceptible to medical conditions and complications.
  2. Deteriorated mental health. Addiction often co-occurs with psychiatric disorders such as depression, anxiety, and bipolar disorder. Substance use can exacerbate these conditions, making them more difficult to treat. The cycle of addiction leads to increased feelings of hopelessness, low self-esteem, and other mental health challenges.
  3. Strained social relationships. Addiction strains relationships with family and friends. Trust issues, frequent conflicts, and unpredictable behavior leave people struggling with addiction feeling isolated and lacking supportive networks. 
  4. Economic instability. Addiction causes financial problems because many people face job loss, decreased productivity, and the high cost of sustaining the addiction. Legal issues, such as arrests and fines related to substance use, add to the financial burden. 

Addiction reduces overall life satisfaction by diminishing the ability to enjoy daily activities and maintain a balanced lifestyle. It often leads to engaging in risky behaviors, neglecting personal responsibilities, and losing interest in hobbies and passions. 

How are drugs used as a coping mechanism?

Many people use drugs as a coping mechanism to manage life stressors and challenges. Emotional stress, dealing with trauma, and significant life pressures can drive people to seek temporary relief through substances. Those with psychiatric disorders, such as depression and anxiety, often self-medicate with prescription medicine or some types of illicit drugs to alleviate their symptoms. The risk of substance use increases in stressful living conditions, poverty, or abusive relationships, where people use drugs as an escape. 

Resources

HHS, SAMHSA Release 2022 National Survey on Drug Use and Health Data. (2023, November 13). SAMHSA. https://www.samhsa.gov/newsroom/press-announcements/20231113/hhs-samhsa-release-2022-nsduh-data

Popescu, A., Marian, M., Drăgoi, A. M., & Costea, V. (2021). Understanding the genetics and neurobiological pathways behind addiction (Review). Experimental and Therapeutic Medicine, 21(5). https://doi.org/10.3892/etm.2021.9976

Volkow, N. D., Michaelides, M., & Baler, R. (2019). The Neuroscience of Drug Reward and Addiction. Physiological Reviews, 99(4), 2115-2140. https://doi.org/10.1152/physrev.00014.2018

Volkow, N. D., Michaelides, M., & Baler, R. (2019). The Neuroscience of Drug Reward and Addiction. Physiological Reviews, 99(4), 2115-2140. https://doi.org/10.1152/physrev.00014.2018

Hatoum, A. S., Johnson, E. C., Colbert, S. M., Polimanti, R., Zhou, H., Walters, R. K., Gelernter, J., Edenberg, H. J., Bogdan, R., & Agrawal, A. (2022). The addiction risk factor: A unitary genetic vulnerability characterizes substance use disorders and their associations with common correlates. Neuropsychopharmacology, 47(10), 1739-1745. https://doi.org/10.1038/s41386-021-01209-w

Mennis, J., Stahler, G. J., & Mason, M. J. (2016). Risky Substance Use Environments and Addiction: A New Frontier for Environmental Justice Research. International Journal of Environmental Research and Public Health, 13(6). https://doi.org/10.3390/ijerph13060607

Frone, M. R., Chosewood, L. C., Osborne, J. C., & Howard, J. J. (2022). Workplace Supported Recovery from Substance Use Disorders: Defining the Construct, Developing a Model, and Proposing an Agenda for Future Research. Occupational Health Science, 6(4), 475–511. https://doi.org/10.1007/s41542-022-00123-x

Khoury, L., Tang, Y. L., Bradley, B., Cubells, J. F., & Ressler, K. J. (2010). Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population. Depression and Anxiety, 27(12), 1077-1086. https://doi.org/10.1002/da.20751

2022 NSDUH Detailed Tables. (n.d.). CBHSQ Data. https://www.samhsa.gov/data/report/2022-nsduh-detailed-tables

Lu, W., Lopez-Castro, T., & Vu, T. (2023). Population-based examination of substance use disorders and treatment use among US young adults in the National Survey on Drug Use and Health, 2011–2019. Drug and Alcohol Dependence Reports, 8. https://doi.org/10.1016/j.dadr.2023.100181

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