Substance-Related Disorders

Common substances linked to addiction include alcohol, tobacco, caffeine, opioids, cannabis, hallucinogens, stimulants, sedatives, sleeping aids, anxiolytics, and inhalants. Accordingly, the major types of substance abuse include:

• Alcohol use disorder
• Tobacco use disorder
• Cocaine/Heroin use disorder
• Methamphetamine use disorder
• Opioid use disorder, i.e., addiction to pain medications, such as morphine.
• Cannabis use disorder

The symptoms of substance abuse include:

• Euphoria
• Hallucinations
• Increased heart rate
• Anxiety
• Altered visual and auditory perceptions
• Withdrawal symptoms: Discontinuing the use of the substance being abused can cause short-term symptoms, such as nausea, sweating, diarrhoea, mood changes, and muscle aches/cramps.

While the exact cause of substance-related disorders remains unknown, the following causes/risk factors have been reported to be associated with these disorders:

• Family history of substance abuse or mental illness
• Genetics, i.e., Genetic susceptibility to substance abuse
• Mental/emotional stress
• Peer pressure
• Prescription use of a certain substance

Substance abuse is diagnosed via the following methods:

• Collection of medical history to check for medication use and history of mental illness.
• Blood tests to check for the presence of the substance being abused.
• Criteria checklist

Depending on the nature and severity of substance abuse, the following treatment approaches may be recommended:

• Medications: Specific medicines approved by the FDA may be used to modify brain chemistry for treating addiction and withdrawal symptoms:
  • Methadone and/or buprenorphine for opioid abuse.
  • Naltrexone and/or disulfiram for alcohol abuse.
  • Nicotine patches, nasal sprays, or chewing gums for tobacco addiction.
• Psychotherapies and mental health support: The psychologist and/or psychiatrist may recommend one or more therapies or treatment programs, which are quite effective in treating substance abuse and its associated mental health complications:
  • Cognitive behavioural therapy
  • Family/community therapy
  • Self-help/rehabilitation programs, such as “Alcoholics Anonymous”, at government-approved centres.

Patients are advised to consult their doctors if they notice that they are using a particular substance often and are worried that they might become addicted to it.

While not all cases of substance abuse can be prevented, the following steps can be taken to reduce the risk of developing substance-related disorders:

• Strictly following instructions for prescription medications and disposing leftover medicines safely.
• Not sharing prescription medications and storing them safely.
• Visiting a mental health professional if mental/emotional stress is difficult to manage. 

Patients suspected with or have substance abuse should consult a Psychiatrist (for diagnosis and medication) or a Psychologist/Therapist (for counselling and psychotherapy).