Substance Use and Addiction
Substance Use Disorder (SUD) is a chronic condition characterized by the compulsive use of a substance despite continued negative consequences, including negative impacts on health, relationships, and responsibilities. SUD is often characterized by physical dependence, psychological distress, and social impairment. SUD can range from mild to severe and impacts people from all walks of life at all stages of the life cycle.
Symptoms of SUD may include:
Behavioral symptoms: inability to control substance consumption, neglecting obligations at work, school, or home, or risky behaviors (such as driving under the influence or using dangerous methods to obtain substances).
Physical symptoms: tolerance (needing larger amounts of the substance to achieve the same effect), withdrawal symptoms when not using, and health problems like organ damage or infections.
Psychological symptoms: powerful cravings, mood swings, anxiety, depression, and a sense of isolation or guilt related to their substance use.
Common substances for which people seek addiction treatment include:
Alcohol
Opioids (e.g., prescription painkillers like oxycodone and oxycontin or illicit drugs like heroin)
Stimulants (e.g., cocaine, methamphetamine, or prescription medications like Adderall)
Cannabis
Sedatives and tranquilizers (e.g., benzodiazepines like Xanax)
Inhalants (e.g., glue, paint thinner)
Phencyclidine (PCP)
Treatment for SUD often involves a combination of therapies, medications, and support systems tailored to individual needs.
The first step is often detoxification, which safely manages withdrawal symptoms under medical supervision. This process is crucial for substances like alcohol or benzodiazepines, where withdrawal can be life-threatening.
Evidence-based psychotherapeutic approaches include:
Cognitive-behavioral therapy (CBT), which helps examine cognitive distortions and maladaptive thinking around the causes and impacts of substance use.
Motivational Interviewing (MI) helps clients more fully gauge and grapple with both the negative and positive aspects of their substance use, and better understand their internal and external barriers to change.
Eye Movement Desensitization and Reprocessing (EMDR) helps those with SUD reduce the emotional impact of use triggers, including both internal states of discomfort and external cues.
Contingency management helps individuals identify triggers, develop coping strategies, and build motivation for sustained recovery.
Internal Family Systems (IFS) helps clients recognize parts of themselves that want to drink and why, and allows clients to engage with other internal parts to see if those needs can be met through approaches other than substance use.
Contingency management helps individuals identify triggers, develop coping strategies, and build motivation for sustained recovery.
Additionally, many of those recovering from addiction use Medication-Assisted Treatment (MAT) to support their recovery, especially in the case of opioid or alcohol addiction. The most well known mediation used in the support of substance use recovery is probably methadone, but other widely used medications include buprenorphine, naltrexone, disulfiram, and acamprosate for alcohol. These medications prevent relapse in a number of ways, including reducing cravings, eliminating euphoria associated with use, and making use physically uncomfortable.
Peer support groups may also comprise an important part of recovery from substance use disorder. In the United States, 12-step groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) are probably the best known, but a number of other support groups, including SMART Recovery (which is CBT-based in it’s approach) and Recovery Dharma (which focuses on trauma-informed Buddhist and mindfulness elements).
With a comprehensive treatment plan and ongoing support, many individuals achieve lasting recovery from SUD. Early intervention and addressing co-occurring mental health conditions are essential for successful outcomes.