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.

Substance use is any time someone consumes alcohol or drugs.

Substance abuse occurs when a person uses drugs or alcohol despite negative consequences in their lives. Substance dependency is when a person is dependent on drugs or alcohol.

Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsve drug seeking and use, despite harmful consequences.

It is considered a brain disease because drugs change the brain; they change its structure and how it works.

Substancerelated disorders are disorders of intoxication, dependence, abuse, and substance withdrawal caused by various substances, both legal and illegal.

Substance misuse is the harmful use of substances (like drugs and alcohol) for non-medical purposes. The term “substance misuse” often refers to illegal drugs. However, legal substances can also be misused, such as alcohol, prescription medications, caffeine, nicotine and volatile substances (e.g. petrol, glue, paint).

The diagnostic criteria for a substance use disorders apply to amphetamine use disorders. Amphetamines are stimulantdrugs. The most commonly known drug in this class is methamphetamine or “crystal meth” (also known as crank).

Substance Abuse

The following are some of the more common signs and symptoms of drug use.

  • It is important to keep in mind that if a person has any of these symptoms, it does not necessarily mean that he or she is using drugs. They could be due to a mental or physical health problem.
  • They might also be due to adolescent development (in the case of teens). Whatever the cause, they may warrant attention, especially if they persist or occur in a cluster.
  • The key is change – it is important to watch for any significant changes in the person’s physical appearance, personality, attitude or behavior.

(From the American Council for Drug Education, an affiliate of Phoenix House.)

Physical Signs

  • Inability to sleep, awake at unusual times, unusual laziness.
  • Loss of or increased in appetite, changes in eating habits
  • Cold, sweaty palms; shaking hands.
  • Red, watery eyes; pupils larger or smaller than usual
  • Unusual smells on breath, body or clothes.
  • Extreme hyperactivity; excessive talkativeness.
  • Slowed or staggering walk; poor physical coordination.
  • Needle marks on lower arm, leg or bottom of feet.
  • Nausea, vomiting or excessive sweating.
  • Tremors or shakes of hands, feet or head.
  • Irregular heartbeat.
  • Runny nose; hacking cough
  • Puffy face, blushing, or paleness
  • Frequent rubbing of the nose
  • Frequent twisting of the jaw, back and forth
  • Deterioration of hygiene or physical health

Behavioral Signs

  • Change in overall attitude/personality with no other identifiable cause.
  • Drop in grades at school or performance at work;
  • skips school or is late for school.
  • Change in activities or hobbies.
  • Chronic dishonesty.
  • Sudden oversensitivity, temper tantrums, or resentful behavior.
  • Difficulty in paying attention; forgetfulness.
  • General lack of motivation, energy, self-esteem, “I don’t care” attitude.
  • Change in habits at home; loss of interest in family and family activities.
  • Paranoia
  • Silliness or giddiness.
  • Moodiness, irritability, or nervousness.
  • Excessive need for privacy; unreachable.
  • Secretive or suspicious behavior.
  • Car accidents.
  • Change in personal grooming habits.
  • Possession of drug paraphernalia.
  • Changes in friends; friends are known drug users.
  • Unexplained need for money, stealing money or items
  • Possession of a false ID card
  • Missing prescription pills
  • Complaints of a sore jaw (from teeth grinding during an ecstasy high)
  • Presence of unusual number of spray cans in the trash

Signs of Intoxication, by Specific Drug

Marijuana

  • Glassy, red eyes; loud talking and inappropriate laughter followed by sleepiness;
  • a sweet burnt scent;
  • loss of interest, motivation; weight gain or loss.

Alcohol

  • Clumsiness
  • difficulty walking
  • slurred speech
  • sleepiness
  • poor judgment
  • dilated pupils.

Cocaine, Crack, Meth, and Other Stimulants

  • Hyperactivity
  • euphoria
  • irritability;
  • anxiety
  • excessive talking followed by depression or excessive sleeping at odd times
  • go long periods of time without eating or sleeping
  • dilated pupils
  • weight loss
  • dry mouth and nose.

Heroin

  • Needle marks
  • sleeping at unusual times
  • sweating
  • vomiting
  • coughing and sniffling
  • twitching
  • loss of appetite
  • contracted pupils
  • no response of pupils to light.

Depressants (including barbiturates and tranquilizers)

  • Seems drunk as if from alcohol but without the associated odor of alcohol
  • difficulty concentrating
  • clumsiness
  • poor judgment
  • slurred speech
  • sleepiness
  • contracted pupils.

Inhalants (Glues, aerosols, and vapors)

  • Watery eyes
  • impaired vision, memory and thoughts
  • secretions from the nose
  • rashes around the nose and mouth
  • headaches
  • nausea
  • appearance of intoxication
  • drowsiness
  • poor muscle control
  • anxiety
  • irritability

Hallucinogens

  • Dilated pupils
  • bizarre and irrational behavior including paranoia, aggression, hallucinations
  • mood swings
  • detachment from people
  • absorption with self or other objects
  • slurred speech
  • confusion.

Ten Popular Myths About Drugs, Addiction, and Recovery

  1. If it’s a prescription, it must be safe; you can’t get addicted to something your doctor prescribes. Although many medications are perfectly safe if taken in the prescribed dosage for a short period of time, prolonged use can be dangerous—and, yes, addictive. Some prescription drugs are especially hazardous if the user exceeds the prescribed dosage or takes a combination of drugs.
  2. “Natural” drugs are safer than synthetic ones. Marijuana, mushrooms and other “natural” highs still alter brain chemistry and produce dangerous side effects. They aren’t harmless just because they grow in the ground.
  3. The heroin era (or the crack crisis, the age of ecstasy, etc.) is over. Drugs don’t just go away. Although certain drug trends become more popular and available and then seem to diminish in popularity over time, a drug doesn’t pose a lesser threat to you – or your kids – simply because it is associated with the culture of a previous decade.
  4. If you have a high alcohol tolerance, you don’t have a drinking problem. If you feel nothing after several drinks, you DO have a problem. A casual drinker wouldn’t be able to finish a couple of six-packs—and if they did, they’d feel very sick. If you’re drinking this much and feeling fine, you need help.
  5. If you have a stable job and family life, you’re not addicted. You may still have a job or career, a loving spouse and kids, and still have a drug or alcohol problem. Just ask any physician in recovery—many of them practiced for years without anyone recognizing their drug addiction. Holding down a job doesn’t mean you’re not addicted—it could mean that you have a tolerant spouse or boss, or you are in a career that puts up with excessive drug or alcohol use. Although you may still be treading water, you are risking everything, and rock bottom may not be far away.
  6. Drug addiction is a choice. Drug use is a choice, and prolonged use changes your body and brain chemistry. When that happens, the user no longer appears to have a choice—this is when use and misuse become addiction.
  7. Detox is all you need. You aren’t addicted after you finish detox. They can just knock you out so you can detox while you sleep. Detox is difficult and it’s just the beginning. The new “ultra rapid detox” programs can be dangerous and even deadly. Finally, detox is the first step towards recovery, but addiction is a chronic illness—like diabetes, asthma or hypertension, it needs to be managed throughout the lifespan. There is no cure.
  8. If someone in recovery uses drugs or alcohol again, they’ll be right back where they were when they first quit. This can be a self-fulfilling prophecy. If you believe that one drink will throw you back to “square one,” then it will. However, it is entirely possible to relapse, realize your mistake, and get right back in recovery.
  9. You need to be religious in order to get sober. Sobriety doesn’t require you to believe in God or subscribe to any organized religion. It helps, however, if you believe in humanity, family, community, and the good aspects of yourself—beliefs that are greater and stronger than your own daily life with drugs.
  10. Addicts are bad people. Addicts aren’t “bad” people trying to get “good,” they’re sick people trying to get well. They don’t belong to a particular race or exist only in certain parts of the country. They are lawyers, farmers, soldiers, mothers and grandfathers who struggle with drug dependence on a daily basis. They are proof that addiction doesn’t discriminate—but, thankfully, neither does recovery.

Deni Carise, Ph.D. – Chief Clinical Officer, Phoenix House

What to do if someone in your family has a problem

  • Try to be calm and factually honest in speaking about their behavior and its day-to-day consequences.
  • If you are reading and learning about substance abuse, or attending support groups, let your loved one know.
  • Discuss the situation with someone you trust – a friend, colleague, someone from the clergy, a social worker, a counselor, or someone you know who has experienced drug and alcohol abuse personally.
  • Establish and maintain a healthy atmosphere in the home and include the substance abuser in family life.
  • Explain the nature of alcoholism and drug abuse as an illness to the children in the family.
  • Encourage new interests and participate in leisure time activities that the person enjoys.
  • Encourage them to see old friends.
  • Be patient and live one day at a time. Recovery does not occur overnight.
  • Try to accept setbacks and relapses with calmness and understanding.
  • Refuse to ride with anyone who’s been drinking or using and don’t let your children ride with them.

What Not To Do

  • Don’t attempt to punish, threaten, bribe, or preach.
  • Avoid emotional appeals that may only increase feelings of guilt and the compulsion to drink/use.
  • Do not cover up or make excuses for the person or shield them from the consequences of their behavior.
  • Don’t take over their responsibilities.
  • Don’t argue with the person when they have been drinking/using.
  • Don’t drink/use in front of the person, even if you don’t have a problem.
  • Above all, don’t feel guilty or responsible for their behavior.

(Adapted from : Substance Abuse and Mental Health Services Administration; U.S. Department of Health and Human Services)


I will be posting something important about mental illness every day throughout the month of May on my blog in honor of Mental Health Awareness Month.

Please keep visiting my blog My Loud Bipolar Whispers and look for statistics or other beneficial information related to mental illness to increase awareness, educate, reduce mental illness stigma and reduce suicides.

It is crucial and imperative for all of us to get involved and save lives.

So, please visit my blog every day, but especially every day throughout the month of May.

Thank you. Hugs and blessings to all of you always and forever.