Understanding a Complex Disease

Substance use disorder

Substance use disorder (SUD), also known as drug use disorder, is a condition where the use of one or more substances leads to a clinically significant impairment or distress. Although the term substance can refer to any physical matter, or substance in this context, is limited to psychoactive drugsAddiction and dependence are components of a substance use disorder and addiction represents the most severe form of the disorder. Addiction is defined as a disease by most medical associations.

Abuse versus Dependence

There’s an on-going debates about the exact distinctions between substance abuse and substance dependence. You can distinguish between the two by defining substance dependence in terms of physiological and behavioral symptoms of substance use. Substance abuse is defined in terms of the social consequences of substance use.

It’s easier to understand substance use, and how it can become a problem, if you think of it as occurring on a spectrum - from beneficial to problematic use. Having an occasional alcoholic drink might help us be more comfortable in social situations. Taking a pain relieving medicine after surgery helps us recover and heal.

It’s the compulsive use of a substance (or engagement in an activity) despite ongoing negative consequences that we classify as addiction - You’re no longer taking the medicine for pain but because you feel ill when you stop or you simply like the way you feel when you take it.

Physical dependency

When you think about it we’re all physically dependent upon oxygen, food and water. Some prescription medicines can cause physical dependence. For example, some blood pressure medications, which can produce fatal withdrawal symptoms if you stop them without tapering off on their use. Some medicines can cause psychological dependence. For instance the withdrawal symptoms associated with cocaine are all psychological. Some cause both: Opiate withdrawal causes both a psychological dependence and physical symptoms, such as vomiting or diarrhea.

Defining dependence

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV TR) describes dependence, abuse, and withdrawal from drugs and other substances. It does not use the word 'addiction' at all. It has instead a section about substance dependence. The DSM definition of addiction can be boiled down to compulsive use of a substance - or engagement in an activity - despite ongoing negative consequences.

The medical community makes a distinction between physical dependence (characterized by symptoms of physical withdrawal symptoms, like tremors and sweating) and psychological dependence (emotional-motivational withdrawal symptoms). Physical dependence is simply needing a substance to function. 

How Four Rivers Can help

Four Rivers Behavioral Health (FRBH) offers a variety of substance abuse programs for both adults and adolescents. Their Specialized Addiction Services offers additional substance abuse treatment programs.

An Intensive Substance Abuse Program is available for those involved in the court system, have a history of legal problems related to substance abuse or have failed at other treatment efforts. Specifically, they offer Hazelden Betty Ford’s COR-12 Program as part of the many substance abuse treatment options available to our clients.

COR is the acronym used for Comprehensive Opioid Response and the 12 signifies the importance of including a Twelve Step component with treatment. The program has an option for medically assisted treatment in conjunction with substance abuse counseling.

“The program is unique as it wraps the participant with a support system that gives them hope, strength and accountability to overcome their battle with addiction,” explained Elizabeth Fleming, LCSW, LCADC, SAP director for the COR-12 Treatment Program at Four Rivers Behavioral Health.

Visit http://4rbhaddictiontreatment.org to learn how to get help.