Introduction
Substance-related disorders present a significant challenge for both individuals and society, with alcohol-related issues being particularly widespread and impactful. While many people enjoy alcohol as a social beverage, for others, it can lead to serious problems, including addiction and health risks. This article focuses primarily on alcohol use disorders, examining their causes, symptoms, and effects. Additionally, other substance use disorders as defined by the DSM-5-TR are explored, offering a broader perspective on the various forms of substance abuse that affect many lives.
Key Terms
Before diving into substance-related disorders, it is essential to understand the relevant terms associated with them:
Psychoactive Substances
Psychoactive substances are those that affect an individual’s thoughts, emotions, and behaviors. They typically lead to a generalized reduction in goal-directed behavior along with cognitive deficits.
Addiction
Addiction describes the harmful effects of excessive reliance on drugs for pleasure and relief of tension. It indicates that the individual uses the substance at all costs.
Substance Abuse
Substance abuse includes psychological problems and maladaptive behaviors, such as failing to fulfill social or work responsibilities.
Substance Dependence
Substance dependence often involves tolerance, withdrawal, and compulsive use of substances.
Tolerance
Tolerance means that a person needs to use larger amounts of a substance to get the same effect because the same dose becomes less effective over time.
Withdrawal
Withdrawal includes the physical and mental symptoms that occur when someone suddenly stops using an addictive substance.
What is Substance Use Disorder?
Substance use disorders encompass problems associated with the use and abuse of various drugs, including alcohol, cocaine, heroin, and others. These substances can alter how an individual thinks, feels, and behaves. According to the DSM-5-TR, substance-related disorders encompass 10 distinct categories of drugs, including alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, stimulants, tobacco, and other or unknown substances.
Alcohol Use Disorder
Ethanol, commonly referred to as ethyl alcohol, is the chemical substance present in beverages like beer, wine, and spirits. Alcohol use disorder or alcoholism is a clinical condition characterized by excessive or frequent consumption of alcohol that persists even when it causes problems, emotional turmoil, or bodily harm.
This condition is characterized by a range of signs and symptoms, including powerful urges to drink, increased sensitivity to alcohol, and withdrawal effects. When a person who has been drinking excessively for an extended period reduces their alcohol consumption or stops entirely, they may start to encounter withdrawal symptoms that can be quite challenging. As a result, many individuals may resume drinking to ease the discomfort of withdrawal or to avoid the adverse effects of their alcohol use.
Factors Contributing to Alcohol Use Disorder
- Poverty, discrimination, and structural inequities
- Unemployment and low education
- Alcohol availability and pricing
- Cultural attitudes and social norms
- Stress, trauma, and family history
- Genetic predisposition (40-60% of risk)
How Alcohol Works
| Effect | Impact |
|---|---|
| Influences the frontal lobe of the brain | Reduces clear thinking, decision-making abilities, memory, and judgment |
| Impacts the cerebellum | Hinders muscle coordination, balance, and the use of senses such as sight, hearing, and touch |
| Very high blood alcohol levels (0.5% or more) | Disrupts the spinal cord and medulla, which manage automatic functions like breathing and heart rate, potentially leading to death |
Effects on Organs
| Organ | Effect |
|---|---|
| Brain | Brain cells die, memory formation is blocked, senses are dulled, and physical condition is impaired |
| Heart | Deterioration of heart muscles |
| Immune System | The risk of bacterial diseases increases |
| Stomach and Intestines | It can trigger bleeding and cause cancer |
Caffeine Use Disorder
Caffeine use disorder involves a collection of behavioral, mental, and physical signs that emerge due to repeated use of caffeine. These include a powerful craving for caffeine, an inability to limit caffeine intake, persisting in using it even when it causes problems, needing more caffeine to get the same effect, and experiencing unpleasant withdrawal symptoms when stopping or cutting back on caffeine use.
Symptoms include
- Unease
- Anxiety
- Agitation
- Sleeplessness
- Gastrointestinal problems
- Muscle twitches
- Episodes of hyperactivity
Caffeine can be found in coffee, tea, soft drinks, energy drinks, certain medications, supplements, and chocolate. Regular consumption in large amounts can cause dependence, and people may experience withdrawal symptoms if they cut back.
Cannabis Use Disorder
Cannabis is a plant rich in cannabinoids. People use it in various ways, such as smoking, vaping, or consuming it in foods like tea, baked goods, and candies. Some cannabinoids can be psychoactive and affect people’s moods, altering their state of mind.
Risks of Use
Frequent or heavy cannabis use can create tolerance, meaning people need to consume more to achieve the same effects. This is especially concerning for teenagers, as cannabis use during critical growth periods is associated with a higher risk of developing schizophrenia. Long-term cannabis use can also damage the lungs and impair memory and attention.
Withdrawal and Medical Use
People trying to stop using cannabis may experience withdrawal symptoms, such as irritability, restlessness, and trouble sleeping. Although cannabis is used to manage chronic pain, the rules for its medical use differ from state to state. Regular users often cite mood swings, insomnia, anger, and pain as reasons for using cannabis.
Hallucinogens
Hallucinogens are drugs that significantly alter how a person perceives reality. Users may experience vivid hallucinations, seeing, hearing, or feeling things that aren’t there. Repeated use of hallucinogens can lead to hallucinogen use disorder, where individuals continue taking these drugs despite facing problems in their relationships, work, and overall health.
Short-term effects may include changes in mood, hallucinations, and a sense of disconnection from oneself or the environment.
Long-term effects may include mood swings, anxiety, and panic attacks.
Sedatives
Sedatives, or central nervous system (CNS) depressants, are drugs that create calming and tranquilizing effects by slowing down the CNS. They can help lower anxiety, encourage relaxation, and make it easier to sleep.
Common Types of Sedatives
- Alcohol
- Barbiturates
- Anti-Anxiety Medications
Mechanism of Action
Sedatives increase the effects of Gamma-aminobutyric acid (GABA), a neurotransmitter responsible for calming brain activity, resulting in greater relaxation and drowsiness.
Stimulants
Stimulants are drugs that make people feel more awake and alert by speeding up communication between the brain and body. They boost energy, confidence, and mood.
Effects on the Central Nervous System (CNS)
Stimulants increase CNS activity, leading to physiological responses like:
- Increased heart rate
- Elevated respiration rate
- Heightened alertness and energy levels
Common Examples of Stimulants
- Amphetamines: Often prescribed to treat ADHD and narcolepsy.
- Cocaine: A powerful illegal stimulant with a high risk of addiction.
- Nicotine: Found in tobacco, it stimulates the CNS and can lead to dependence.
Conclusion
In summary, substance-related disorders pose a considerable challenge, impacting individuals, families, and communities. The biological, psychological, and social elements of these disorders highlight the need for comprehensive approaches to treatment. Early identification of the signs of substance use disorders is essential for effective intervention and recovery.
Author
