Frequently Asked Questions
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General Questions
What is Substance Use Disorder?
The American Society of Addiction Medicine (ASAM) recognizes and further defines that addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.
Further, ASAM states that prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases.
The most important point to make here is that having SUD is NOT YOUR FAULT. If you have it, you were born with it just like being male or female. Additionally, you had no clue that you had the illness or predisposition to it until some substance like nicotine, alcohol or some other substance “unlocked” the illness starting the process, often telling you it was the “best thing that ever happened to you.”
How do you know if someone has SUD?
According to multiple organizations like SAMHSA and ASAM, there are 11 criteria
11 Criteria for Substance Use Disorder:
1. Hazardous use: You have used the substance in ways that are dangerous to yourself and/or others, i.e., overdosed, driven while under the influence, or blacked out.
2. Social or interpersonal problems related to use: Substance use has caused relationship problems or conflicts with others.
3. Neglected major roles to use: You have failed to meet your responsibilities at work, school, or home because of substance use.
4. Withdrawal: When you stop using the substance, you experience withdrawal symptoms that resolve with use.
5. Tolerance: You have built up a tolerance to the substance so that you must use more to get the same effect.
6. Used larger amounts/longer: You have started to use larger amounts or use the substance for longer amounts of time.
7. Repeated attempts to control use or quit: You’ve tried to cut back or quit entirely but haven’t been successful.
8. Much time spent using: You spend a lot of your time using the substance.
9. Physical or psychological problems related to use: Your substance use has led to physical health problems, such as liver damage or lung cancer, or psychological issues, such as depression or anxiety.
10. Activities given up in order to use: You have skipped activities or stopped doing activities you once enjoyed in order to use the substance.
11. Craving: You have experienced cravings for the substance.
If you have experienced 2 or 3 of the above criteria in the past 12 months, you have a mild substance use disorder. Four to 5 criteria, moderate and 6 or more criteria a severe substance use disorder.
What causes substance use disorder?
Like other chronic illnesses, allergies, asthma, diabetes, high blood pressure, substance use disorder is something we are either predisposed to or not, and often, many factors are involved. The root cause is an inappropriate release of a nerve transmitter deep in the survival part of our brain known as the Ventral Tegmental Area or VTA, and we can visualize this happening on technology like functional MRI, PET and SPECT scans of the brain.
Like allergies, SUD is NOT your fault, it just happens. You are born with it and have no clue that you have it until some substance comes along and “unlocks” the process. Unfortunately, that process tells the rest of your brain that it’s the best thing that’s ever happened to you which begins the spiral of the disease process, which without treatment is almost universally fatal.
How is substance use disorder treated?
Like any other chronic illnesses, successful treatment is based on the individual and their needs.
1. Behavioral counseling
2. Medications for withdrawal and treatment
3. Evaluation and treatment of co-occurring mental health issues such as bipolar disorder, ADHD, depression and anxiety
4. Long-term follow-up and support to prevent relapse.
Why are people often resistant to treatment or “doing something about it?”
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