Substance use disorder is the diagnostic term for the prolonged use & abuse of a substance. Behavioral, Physical & Psychological dependence are the hallmark of substance use disorder.
1. Behavioral Dependence:
Behavioral dependence refers to substance seeking activities.
2. Physical Dependence:
Physical dependence refers to the physical effects of multiple episodes of substance use.
3. Psychological Dependence:
Psychological dependence refers to intense desire for the substance to avoid a dysphoric state.
DSM-5 criteria for Substance Use Disorder
- Tolerance (Needing more substance to achieve effects equivalent to previous ones )
- Withdrawal (symptoms resulting from abrupt cessation of use of substance)
- Craving to use
- Using more than intended
- Difficulty stopping or reducing
- Spending a lot of time getting, using or recovering from substance use
- Continuing to use despite acknowledging health problems
- Continuing to use despite social, occupational or other adverse consequences
- Neglecting relationships because of substance use
- Neglecting work, home or school because of substance use
- Using substance even when it puts them in danger
Substance intoxication is characterized by specific signs & symptoms resulting from recent ingestion or exposure to the substance.
Factors determining 1st time use:
- Drug availability
- Social acceptability
- Family history of substance dependence
- Peer pressure
- About 50% of patients with substance abuse have a comorbid Psychiatric disorder.
- About 35-60% of patients with substance abuse have a comorbid antisocial personality disorder. These patients are less satisfied with their lives, are more impulsive, isolated & depressed than patients with antisocial personality disorder alone.