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This topic is about substance use disorder in adults. For information about drug use in teens or children, see the topic Teen Alcohol and Drug Use.
What is substance use disorder?
Substance use disorder is using drugs in a way that harms you or that leads you to harm others. It can range from mild to severe. Moderate to severe substance use disorder is sometimes called addiction.
This disorder can develop from the use of almost any type of substance. This includes alcohol, illegal drugs, prescription drugs, or over-the-counter drugs.
When you have substance use disorder, you are not always able to meet work, home, or school duties. You may be late to work. You may use drugs in dangerous situations, such as when driving or operating machines. Or drugs may cause problems in your relationships.
People who have it find it hard to control substance use. Any of the following can happen:
- You take more of the drug over longer periods of time and need more of the drug to feel "high."
- You try to quit using the drug, but you are not able to.
- You continue to use the drug even though it harms your relationships and causes you to develop physical problems.
- If you stop using the drug, you feel sick. This is known as withdrawal.
Substance use disorder is a disease. It's not a weakness or a lack of willpower. It's your choice to begin using a drug. But as you use it more, your brain begins to change. This change can lead to a craving to use the drug, and this can influence how you act.
Which drugs might be a problem?
Drugs that may lead to substance use disorder include:
- Marijuana, cocaine, and hallucinogens, such as LSD (lysergic acid diethylamide), mescaline, psilocybin, PCP (phencyclidine), and ketamine.
- Inhalants, such as glues, aerosol sprays, gasoline, paints, and paint thinners.
- Club drugs, such as ecstasy (MDMA).
- Methamphetamine, which is called meth, crank, or speed.
- Opioids, such as heroin, morphine, and codeine.
- Prescription drugs, such as diazepam (Valium), hydrocodone and acetaminophen (Norco), methylphenidate (Ritalin), and oxycodone (OxyContin).
- Over-the-counter medicines, such as cough syrups and cold pills.
What are the signs of substance use?
Behaviors that may be signs of substance use include:
- Changes in sleeping or eating habits, less attention to dressing and grooming, or less interest in sex.
- Up-and-down moods, a mood or attitude that is getting worse, or not caring about the future.
- Sneaky behavior, lying, or stealing.
- Poor family relationships, or relationships that are getting worse.
- New problems at work or school, or problems with the law.
Having these signs doesn't always mean a person is using drugs. The behavior could be because of work or school stress, or it could be a sign of depression or another medical problem. But behavior changes like these are common in people who use drugs.
Physical signs of drug use include:
- Red eyes, a sore throat, a dry cough, and feeling tired.
- Needle marks on the arm or other area of the body.
- Small, "pinpoint" pupils in the eyes.
- Losing weight without trying to, or not feeling like eating.
- Changes in sleep behavior, such as not sleeping as well.
- Seeing things that don't exist (hallucinations).
How is substance use disorder diagnosed?
Substance use disorder may be diagnosed at a routine doctor visit or when you see your doctor for a health or social problem linked to drug use, such as anxiety, depression, or family conflict. If a partner or friend thinks you have substance use disorder, he or she may urge you to see your doctor.
Your doctor will ask questions about your symptoms and past health. He or she will do a physical exam and sometimes a mental health assessment.
How is substance use disorder treated?
Treatment includes medicine, therapy, and support groups.
The first step in treatment is to quit using drugs. You may need medical care to manage withdrawal symptoms when you first quit. Some people call this detoxification, or detox.
After you stop using drugs, you focus on staying drug-free. Most people receive some type of therapy, such as group counseling. You also may need medicine to help you stay drug-free.
When you have stopped using drugs, you have taken the first step toward recovery. To gain full recovery, you need to take steps to improve other areas of your life, such as learning to deal with your work, family, and living situation in healthy ways. This makes it easier to stay drug-free.
What can you do if you or another person has a problem with drugs?
If you are worried about your substance use, get help. You can visit a doctor or go to a self-help group. The earlier you get help, the easier your recovery will be for you and your family.
Helping someone who has substance use disorder is hard. If you are "covering" for the person, you need to stop. For example, don't make excuses for the person when he or she misses work.
You may be able to help by talking to the person about what his or her drug use does to you and others. Talk to the person in private, when he or she isn't using drugs or alcohol and when you are both calm. If the person agrees to get help, call for an appointment right away. Don't wait.