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Help With Addiction and Substance Use Disorders

Curated and updated for the community by APA

Substance use disorder (SUD) is complex a condition in which there is uncontrolled use of a substance despite harmful consequence. People with SUD have an intense focus on using a certain substance(s) such as alcohol, tobacco, or illicit drugs, to the point where the person’s ability to function in day to day life becomes impaired. People keep using the substance even when they know it is causing or will cause problems. The most severe SUDs are sometimes called addictions.

People with a substance use disorder may have distorted thinking and behaviors. Changes in the brain’s structure and function are what cause people to have intense cravings, changes in personality, abnormal movements, and other behaviors. Brain imaging studies show changes in the areas of the brain that relate to judgment, decision making, learning, memory, and behavioral control.

Repeated substance use can cause changes in how the brain functions. These changes can last long after the immediate effects of the substance wears off, or in other words, after the period of intoxication. Intoxication is the intense pleasure, euphoria, calm, increased perception and sense, and other feelings that are caused by the substance. Intoxication symptoms are different for each substance.

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  • Aug 31, 2021
Most Teens Who Use E-Cigarettes Have Tried to Quit

More than half of middle and high schoolers who use e-cigarettes said that they intend to quit and about two-thirds had tried to quit during the past year, according to a recent study in Pediatrics.

  • May 17, 2021
Cannabis: Understanding the Risks

At a recent session at the APA Annual Meeting, a panel of psychiatrists addressed many of the common misconceptions around cannabis. With more states legalizing cannabis and changing public perceptions, there is confusion around its safety and uses. At the APA session, Smita Das, M.D., Ph.D., M.P.H., provided an overview of cannabis and its current use. To date, 16 states and the District of Columbia have legalized cannabis for recreational use by adults, and 36 states legalized it for medical use. However, cannabis is still a federal schedule 1 substance (most restricted schedule) under the Controlled Substances Act.

  • Mar 26, 2021
Only One in 10 Youths in Community Justice Systems Who Need It Are Getting Behavioral Health Treatment

Youths entering the juvenile justice system are often identified as needing help for substance use and mental health concerns, yet very few—only one in ten—receive needed behavioral health services, according to a new study in Psychiatric Services, a journal of the American Psychiatric Association.  

What can you do to prevent relapse?

Preventing relapse to substance use is mainly a matter of becoming aware of the triggers to relapse and either finding ways to avoid or cope with them. Triggers can be external, for example being in places where substances are being used. Stress of any kind (job stress, financial stress, arguments with important people) can also be an external trigger. Triggers can also be internal such as craving, depressed mood, anxiety, hunger or fatigue. The key is to anticipate triggers ahead of time so they don’t come as a surprise and use a plan or coping strategy to deal with the triggers. Usually professional help is needed to gain awareness of and plans to deal with triggers to relapse. There are also very good medications for alcohol, opioid and tobacco use disorders that effectively reduce craving and can help prevent relapse. More

I live with pain and I want help, but I’m worried about becoming addicted to pain medication. What can I do?

Opioid type medications that have potential to lead to addiction are only one way, and probably not the best way, to help manage chronic pain. So the best plan is to try all the alternatives first.

Non-medication interventions such as graded exercise programs, physical therapy, mindfulness meditation, yoga, tai-chi and a form of psychotherapy called cognitive-behavioral therapy (CBT) all take some effort but often work very well. Acupuncture may benefit some people living with pain. Many medications that do not have addiction potential can also be helpful for chronic pain. These include anti-inflammatory medications like aspirin, ibuprofen or naproxen; antidepressants like nortriptyline or duoloxetine; or medications often used for seizures like gabapentin or pregabalin.

If you or someone you know does require opioid pain medications to help manage chronic pain, it is reassuring to know that the majority of people who take these medications for chronic pain do not become addicted to them, although anyone who takes these type of medications for more than a few weeks is likely to have some tolerance (less effect of the medication over time) and withdrawal symptoms if the medications are stopped abruptly. More

What resources are available for family members of an individual with addiction?

Al-Anon and Alateen are widely available and free resources for family members. These organizations offer mutual help groups. Members do not give direction or advice to other members. Instead, they share their personal experiences and stories, and invite other members to “take what they like and leave the rest” — that is, to determine for themselves what lesson they could apply to their own lives. The best place to learn how Al-Anon and Alateen work is at a meeting in your local community. Most professional treatment programs also offer family groups to help families support their loved ones struggling with addiction. More

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About the Expert:

Andrew Saxon, M.D.
Professor and Director, Addiction Psychiatry Residency Program
University of Washington
Director, Center of Excellence in Substance Abuse Treatment and Education (CESATE)
VA Puget Sound Health Care System
Seattle, Wash.

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Keith, a 45-year-old plumber, was referred for a psychiatric evaluation after his family met with him to express their concern about his heavy drinking. Since making the appointment three days earlier, Keith denied having a drink.

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Oct 14 2021

Many Addicts Turned to Telemedicine During Pandemic, But Does It Beat In-Person Care?


US News and World Report
The coronavirus pandemic forced a significant shift to telemedicine treatment for addiction, but it's not clear whether that approach is better than in-person care, a new study finds. Seven of the studies concluded that telehealth treatment was effective, but not more effective than in-person treatment in terms of retention, satisfaction with treatment, therapeutic alliance and substance use.

Oct 14 2021

Overdose Deaths Hit Record High of 96,000

Addiciton Center
The Centers for Disease Control and Prevention (CDC) data released on Wednesday reveals that over 96,000 Americans lost their lives to overdose-related deaths in the 12-month time span that concluded in March of this year. Deaths rose to new absolute heights, but at a relatively lower rate; fatalities saw a 29.7% increase from February 2020 to February 2021 and a 29.6% increase from March 2020 to March 2021. Although 96,000 seems a high number, it is actually lower than the CDC’s forecast for the time period. The agency had predicted over 99,000 deaths.

Oct 12 2021 

How one woman created a network to support the families of those struggling with addiction 
CNN

Peterson's mission is to help the families of people suffering from addiction. While so much attention is understandably focused on the individual with the substance use disorder, Peterson realized that suffering knows no bounds, because she was such a family member. She says her brother self-medicated with cocaine to deal with his depression and her niece died from a fentanyl overdose. Every time, Peterson felt the personal pain of seeing someone she loved suffer, and the silence that too often followed due to persistent stigma.