Substance abuse problem
| Substance use disorder | |
|---|---|
| Classification and external resources | |
| Specialty | psychiatry |
| ICD-10 | F10-F19 |
| ICD-9-CM | 303-305 |
| MeSH | D019966 |
Substance use disorder (SUD), also known as drug use disorder, is a condition in which 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, 'substance' in this context is limited to psychoactive drugs.
SUD refers to the overuse of, or dependence on, a drug leading to effects that are detrimental to the individual's physical and mental health, or the welfare of others. SUD is characterized by a pattern of continued pathological use of a medication, non-medically indicated drug or toxin, which results in repeated adverse social consequences related to drug use, such as failure to meet work, family, or school obligations, interpersonal conflicts, or legal problems.
There are on-going debates as to the exact distinctions between substance abuse and substance dependence, but current practice standard distinguishes between the two by defining substance dependence in terms of physiological and behavioral symptoms of substance use, and substance abuse in terms of the social consequences of substance use. In the DSM-5 substance use disorder replaced substance abuse and substance dependence.
In 2013 drug use disorders resulted in 127,000 deaths; up from 53,000 in 1990. The highest number of deaths are from opioid use disorders at 51,000. Cocaine use disorder resulted in 4,300 deaths and amphetamine use disorder resulted in 3,800 deaths. Alcohol use disorders resulted in an additional 139,000 deaths.
Substance abuse may lead to addiction or substance dependence. Medically, physiologic dependence requires the development of tolerance leading to withdrawal symptoms. Both abuse and dependence are distinct from addiction which involves a compulsion to continue using the substance despite the negative consequences, and may or may not involve chemical dependency. Dependence almost always implies abuse, but abuse frequently occurs without dependence, particularly when an individual first begins to abuse a substance. Dependence involves physiological processes while substance abuse reflects a complex interaction between the individual, the abused substance and society.
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