Substance Use Disorders
Explore 5-Minute Clinical Consult - view these FREE monographs:
-- The first section of this topic is shown below --
A substance use disorder manifests as any pattern of substance use causing significant physical, mental, or social dysfunction:
- Substances of abuse include:
- Cannabinoids (marijuana)
- Prescription medications:
- CNS depressants (barbiturates, benzodiazepines, hypnotics)
- Opioids and morphine derivatives (codeine, fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone)
- Stimulants (amphetamines, methylphenidate)
- Stimulants (cocaine, amphetamines, methamphetamines)
- Club drugs (MDMA, flunitrazepam, γ-hydroxybutyrate or GHB)
- Emerging drugs (K2/Spice, Salvia, bath salts)
- Opioids (heroin, opium)
- Dissociative drugs (ketamine, phencyclidine)
- Hallucinogens (lysergic acid diethylamide)
- Inhalants (glue, paint thinners, nitrous oxide)
- Anabolic steroids
- For street names see http://www.drugabuse.gov
- System(s) affected: Cardiovascular; Endocrine/Metabolic; CNS
- Synonym(s): Drug abuse; Drug dependence; Substance abuse
- Alcohol is the most commonly abused substance, and abuse often goes unrecognized.
- Higher potential for drug interactions
Substance abuse may cause fetal abnormalities, morbidity, and fetal or maternal death.
- Predominant age: 16–25 years
- Predominant sex: Male > Female
- 22.6 million (8.9%) Americans reported use of illicit substance in past month in 2010.
- 10.1% for age 12–17 years; 21.5% for age 18–25
- 1:6 males aged 18–25 years use marijuana.
- Male gender, young adult
- Depression, anxiety
- Other substance use disorders
- Family history
- Peer or family use or approval
- Low socioeconomic status
- Accessibility of substances of abuse
- Family dysfunction or trauma
- Antisocial personality disorder
- Academic problems, school dropout
- Criminal involvement
Substances of abuse affect dopamine, acetylcholine, γ-aminobutyric acid, norepinephrine, opioid, and serotonin receptors. Variant alleles may account for susceptibility to disorders.
Early identification and aggressive early intervention improve outcomes.
Multifactorial, including genetic, environmental
Commonly Associated Conditions
- Personality disorders
- Bipolar affective disorder
Prescription narcotic overdose is the leading cause of accidental death between the ages of 15 and 45 in the US; this correlates with increased prescribing of long-acting oxycodone http://www.cdc.gov/Injury/wisqars/pdf/10LCD-Age-Grp-US-2009-a.pdf).