Jeus Harvey C.

Agadulin Psychiatry PT-3A

Substance Abuse
-Substance abuse, also known as drug abuse, is a patterned use of a substance (drug) in which the user consumes the
substance in amounts or with methods neither approved nor supervised by medical professionals. Substance abuse/drug abuse is not limited to mood-altering or psycho-active drugs. If an activity is performed using the objects against the rules and policies of the matter (as in steroids for performance enhancement in sports), it is also called substance abuse.

Types of Substance abuse

Substance dependence is defined as physical or psychological dependence. For example, if a person has a physical dependence, s/he may experience tolerance or withdrawal. Substance abuse is a pattern of compulsive use. Generally, when teenagers are diagnosed with a substance disorder, they have a pattern of "binge" use. Not all "recreational" use is a disorder, but excessive use is Substance Abuse. Binging may occur during weekends, parties, or other social occasions. To be considered an "abuser," a person's drug use must cause significant problems and have a negative impact on his/her life. The effects of abuse may affect school, work, legal, family, and social relationships. Substance-induced disorder is diagnosed when someone experiences psychiatric symptoms that are solely related to substance use or withdrawal. For example, depression, anxiety, sleep problems, and hallucinations may occur. But it's important to distinguish these substance-induced symptoms from a preexisting condition. Further, any symptoms should disappear within a month or so after substance use has stopped. can determine the nature, extent, and pattern of substance use

Criterias:
Tolerance Defined by either of the following: - A need for markedly increased amounts of the substance to achieve intoxication or desired effect - Markedly diminished effect with continued use of the same amount of the substance Withdrawal Manifests by either of the following: - The characteristic withdrawal syndrome for the specific substance - The same substance, or one closely related, is taken to relieve or avoid withdrawal symptoms The substance is often taken in larger amounts or over longer periods of time than was intended There is a persistent desire or unsuccessful efforts to cut down or control the substance use Loss of control Important social, occupational, or recreational activities are given up or reduced because of the substance use The substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance.

Epidemiology
The initiation of drug and alcohol use is most likely to occur during adolescence, and some experimentation with substances by older adolescents is common. For example, results from 2010 Monitoring the Future survey, a nationwide study on rates of substance use in the United States, show that 48.2% of 12th graders report having used an illicit drug at some point in their lives. In the 30 days prior to the survey, 41.2% of 12th graders had consumed alcohol and 19.2% of 12th graders had smoked tobacco cigarettes. In 2009 in the United States about 21% of high school students have taken prescription drugs without a prescription. And earlier in 2002, the World Health Organization estimated that around 140 million people were alcohol dependent and another 400 million suffered alcohol-related problems. Studies have shown that the large majority of adolescents will phase out of drug use before it becomes problematic. Thus, although rates of overall use are high, the percentage of adolescents who meet criteria for substance abuse is significantly lower (close to

5%). According to BBC, "Worldwide, the UN estimates there are more than 50 million regular users of morphine diacetate (heroin), cocaine and synthetic drugs."

Diagnosis
DSM-IV-TR defines substance abuse as:

A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:

1.

Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household)

2.

Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)

3. 4.

Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct) Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)