Substance-related disorder

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 23, 2016
StartDiseasesSubstance-related disorder

Substance abuse is a common issue that plagues individuals from all walks of life. A wide range of difficulties are associated with substance-related disorder or substance use disorder, a type of mental disorder. Developing an understanding of substance abuse is key to finding solutions to the problems related to it and preventing further complications.


Definition & Facts

The Diagnostic and Statistical Manual of Mental Disorders includes a chapter on "substance-related and addictive disorders." Subcategories include substance use disorder and addictive disorders. Substance use disorder encompasses both substance abuse and substance dependence and is subsequently categorized by the specific type of substance being used (e.g. alcohol use disorder).

Substance abuse is the repeated use of high quantities of any substance that leads to physical and mental problems. Commonly abused substances include alcohol, nicotine, and illegal drugs. Legally obtained medication also makes up a large part of substance abuse. Anti-anxiety medication like Xanax®, for example, is popular among addicts while also being one of the easiest legal medications to receive.

In the United States alone over 27 million people have misused a substance at any given time in the past 30 days. It is most common in teenagers and adults in their twenties, with the majority of dependent users starting with marijuana as a teen or young adult.

Substance-related disorder is not exclusive to any one particular race, gender or culture. It is a leading cause of premature death among those under 50. Alcohol and prescription medication are the most common drugs abused by men and women aged 50 and up.

Symptoms & Complaints

Physical symptoms depend upon the substance being abused. New bruises are often visible if the user has been injecting drugs into his or her body. For those who abuse a drug like heroin, long sleeve clothing is used to cover up any needle marks. Scratching, weight loss, and complaints of bodily discomfort are common among those who abuse heroin.

Many complaints associated with the disorder are mental and emotional. Depending on the substance the individual might feel angry, anxious, depressed, or paranoia. Other symptoms of substance-related disorder include:


The causes for this disorder are oftentimes difficult to discover. There are social, psychological and biological factors that may contribute to a person abusing substances. Stress and the need for an escape are seen as causes with self-medication being a common factor. If one is suffering from another mental disorder like generalized anxiety or panic disorder the individual might be trying to cope with those feelings.

Other potential causes may include peer pressure, an addictive personality type, underlying mental illness and an unstable home life where drugs and alcohol are abused.

Environmental factors also play a large role in shaping a potential individual's choices in life. There is evidence that those with a family history of substance abuse will be at an increased risk for it themselves. Negative examples from singers, movie stars and others in the media that glorify drugs and alcohol have also been shown to influence substance abuse in some people.

Diagnosis & Tests

Diagnosing substance-related disorder is something that requires patience as the individual may not be ready to accept help and is in denial. To get an accurate diagnosis, all factors and symptoms must be considered. One must observe a pattern of behavior that is consistent with abuse. There are signs to look for, such as withdrawal symptoms that lead to the individual seeking medical help.

A psychiatric evaluation is necessary to rule out other disorders with similar symptoms, including major depression and bipolar disorder. It is easy to confuse the two if the entire picture is not taken into account. A history of substance abuse in the patients family, for example, can help determine if his or her symptoms are consistent with substance-related disorder.

Treatment & Therapy

There are treatment options available, each with their own benefits. Finding the right treatment is vital for preventing further abuse by the one suffering with the addiction. Family therapy can be used if the family is willing to lend their full support to the individual. The family can take part by assessing what their role in the substance abuse has been and can take steps to change their own behavior so that the individual can discontinue his or her habits.

Cognitive behavioral therapy has also been shown to be effective in eliminating substance-related disorder in individuals who are not in need of immediate medical attention and have the time and space to learn to cope with their inner feelings. Cognitive behavioral therapy teaches the person with the disorder to change his thinking patterns in order to stop his abusive behavior while also dealing with the underlying emotional causes.

Treatment centers are available for those who need medical care and cannot be left alone to their own devices. Treatment centers offer a plethora of options, including:

  • Group therapy
  • Individual therapy
  • Inpatient facilities
  • Intensive outpatient counseling
  • Medication

Prevention & Prophylaxis

Prevention of substance abuse is a major part of stopping the upward trend of drug and alcohol abuse. Because early use of drugs as teens and adolescents strongly correlates to later substance-related disorder or drug addiction among adults, it is important to prevent the use of alcohol and drugs among teens and adolescents.

A variety of initiatives may take place in the family, the school, or the community at large that can help discourage substance abuse. Seeking help for mental disorders like depression and anxiety disorders can help prevent substance-related disorder. Strong relationships with friends and can help prevent one from abusing substances.