Substance Abuse and Related Disorders

views updated

Substance Abuse and Related Disorders





Substance-related disorders are disorders of intoxication, dependence, abuse, and substance withdrawal caused by various substances, both legal and illegal. These substances include: alcohol, amphetamines, caffeine, inhalants, nicotine, prescription medications that may be abused (such as sedatives ), opioids (morphine, heroin), marijuana (cannabis ), cocaine, hallucinogens, and phencyclidine (PCP).


According to the mental health clinician’s handbook, Diagnostic and Statistical Manual of Mental Disorders (the DSM), fourth edition text revised (DSM-IV-TR), all of the substances listed above, with the exceptions of nicotine and caffeine, have disorders of two types: substance use disorders and substance-induced disorders. Substance use disorders include abuse and dependence. Substance-induced disorders include intoxication, withdrawal, and various mental states (dementia, psychosis, anxiety, mood disorder, etc.) that the substance induces when it is used.

Substance dependence is characterized by continued use of a substance even after the user has experienced serious substance-related problems. The dependent user desires the substance (“craving”) and needs more of the substance to achieve the effect that a lesser amount of the substance induced in the past. This phenomenon is known as tolerance. The dependent user also experiences withdrawal symptoms when the substance is not used. Withdrawal symptoms vary with the substance, but some symptoms may include increased heart rate, shaking, insomnia, fatigue, and irritability.

Substance abuse is continued use of a substance in spite of school- or work-related or interpersonal problems, but the user has not gotten dependent on the substance. The individual who abuses asubstance may experience legal problems and may have problems fulfilling responsibilities, such as caring for a child.

Intoxication is the direct effect of the substance after an individual has used or has been exposed to the substance. Different substances affect individuals in various ways, but some of the effects seen in intoxication might include impaired judgment, emotional instability, increase or decrease in appetite, or changed sleep patterns.

The DSM-IV-TR does not recognize caffeine abuse or dependence, but does recognize the caffeine-induced


Amphetamines —A group of powerful and highly addictive substances that stimulate the central nervous system. May be prescribed for various medical conditions, but are often purchased illicitly and abused.

Anxiety —A feeling of apprehension and fear characterized by physical symptoms (heart palpitations, sweating, and feelings of stress, for example).

Anxiolytic —A preparation or substance given to relieve anxiety; a tranquilizer.

Dementia —A group of symptoms (syndrome) associated with a progressive loss of memory and other intellectual functions that is serious enough to interfere with a person’s ability to perform the tasks of daily life. Dementia impairs memory, alters personality, leads to deterioration in personal grooming, impairs reasoning ability, and causes disorientation.

Hallucinogens —Substances that cause hallucinations.

Hypnotic —A type of medication that induces sleep.

Inhalants —A class of drugs that are inhaled in order for the user to experience a temporary “high.” These chemicals include volatile solvents (liquids that vaporize at room temperature) and aerosols (sprays that contain solvents and propellants), and include glue, gasoline, paint thinner, hair spray, and others. They are dangerous because they can cause hallucinations, delusions, difficulty breathing, headache, nausea, vomiting, and even “sudden sniffing death.” Inhalants can also cause permanent damage to the brain, lung, kidney, muscle, and heart.

Opioids —Substances that reduce pain and may induce sleep. Some opioids are endogenous, which means that they are produced within the human body. Other opioids are produced by plants or formulated synthetically in the laboratory.

Phencyclidine —The full name of the drug commonly called PCP that is often abused to induce hallucinations.

Psychosis —Severe state that is characterized by loss of contact with reality and deterioration in normal social functioning; examples are schizophrenia and paranoia. Psychosis is usually one feature of an overarching disorder, not a disorder in itself. (Plural: psychoses)

Sedative —A medication that induces relaxation and sleep.

induced disorders caffeine intoxication (restlessness, nervousness, excitement, etc. after caffeine consumption), caffeine-induced anxiety disorder (feelings of anxiety or panic attacks after caffeine consumption), and caffeine-induced sleep disorder (usually insomnia, but some may experience excessive sleepiness when caffeine is not consumed). As for nicotine, the DSM-IV-TRrecognizes nicotine dependence and nicotine withdrawal.

The DSM-IV-TRlists disorders in the following categories:

  • alcohol-related disorders
  • amphetamine-related disorders
  • caffeine-related disorders
  • cannabis-related disorders
  • cocaine-related disorders
  • hallucinogen-related disorders
  • inhalant-related disorders
  • nicotine-related disorders
  • opioid-related disorders
  • phencyclidine-related disorders
  • sedative-, hypnotic-, or anxiolytic-related disorders
  • polysubstance dependence

See alsoAddiction; Alcohol and related disorders; Amnestic disorders; Amphetamines and related disorders; Antianxiety drugs and abuse-related disorders; Caffeine and related disorders; Cannabis and related disorders; Cocaine and related disorders; Denial; Disease concept of chemical dependency; Hallucinogens and related disorders; Inhalants and related disorders; Nicotine and related disorders; Opioids and related disorders; Phencyclidine and related disorders; Polysubstance dependence; Sedatives and related drugs; Substance Abuse Subtle Screening Inventory; Substance-induced anxiety disorder; Substance-induced psychotic disorder; Urine drug screening; Wernicke-Korsakoff syndrome.



American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders.Fourth edition, text revised. Washington DC: American Psychiatric Association, 2000.