Substance-Related and Addictive Disorders

What are Substance-Related and Addictive Disorders?

Substance-related and addictive disorders are conditions where people develop problematic patterns of using substances (such as alcohol, drugs, or medications) or engage in addictive behaviors (such as gambling).

These disorders involve:

  • Loss of control over use or behavior

  • Cravings and strong urges

  • Continued use despite harm to health, relationships, or responsibilities

  • Physical and psychological dependence

They can affect anyone, regardless of age, background, or lifestyle, and often co-occur with other mental health conditions.

Common Symptoms

  • Behavioral

    • Using more of a substance than intended

    • Inability to cut down or stop despite wanting to

    • Spending large amounts of time obtaining, using, or recovering from substance use

    • Neglecting responsibilities at work, school, or home

    • Risky behaviors while under the influence (e.g., driving, unsafe sex)

  • Physical

    • Tolerance (needing more for the same effect)

    • Withdrawal symptoms when not using (shaking, sweating, nausea, irritability)

    • Health issues such as liver damage, lung problems, or heart disease (depending on substance)

  • Psychological

    • Cravings and preoccupation with substance or behavior

    • Mood swings, irritability, or anxiety

    • Depression or hopelessness linked to use

Types of Substance-Related Disorders

Substance Use Disorders (SUDs)

Involving misuse, dependence, or addiction to substances such as:

  • Alcohol – Alcohol Use Disorder (AUD)

  • Cannabis

  • Stimulants – e.g., cocaine, amphetamines

  • Opioids – e.g., heroin, prescription painkillers

  • Sedatives, Hypnotics, Anxiolytics – e.g., benzodiazepines

  • Tobacco/Nicotine

  • Hallucinogens – e.g., LSD, PCP

  • Inhalants – e.g., solvents, aerosols

Non-Substance Addictive Disorders

Currently recognized in the DSM-5:

  • Gambling Disorder – compulsive gambling despite harmful consequences.

(Other behavioral addictions, like internet, gaming, or shopping, are under research but not formally classified in DSM-5.)

Causes and Risk Factors

  • Biological: genetics, changes in brain chemistry (dopamine reward system).

  • Psychological: trauma, stress, co-occurring mental health conditions (depression, anxiety, PTSD).

  • Environmental: peer pressure, availability of substances, cultural attitudes.

  • Developmental: early use of substances increases risk of long-term addiction.

Diagnosis

  • Made by a mental health or medical professional.

  • Based on criteria such as loss of control, cravings, tolerance, withdrawal, and life impairment.

  • Severity is rated as mild, moderate, or severe depending on the number of symptoms.

Treatment Options

  • Detoxification (Detox)

    • Medically supervised withdrawal to manage symptoms safely.

  • Medication-Assisted Treatment (MAT)

    • For opioids: methadone, buprenorphine, or naltrexone.

    • For alcohol: disulfiram, acamprosate, or naltrexone.

    • Nicotine replacement therapies (patches, gums, medications).

  • Psychotherapy

    • Cognitive Behavioral Therapy (CBT) – changes unhelpful thoughts and behaviors.

    • Motivational Interviewing (MI) – strengthens motivation to change.

    • Contingency Management – rewards for positive behavior (e.g., drug-free tests).

    • Family Therapy – addresses relationship impacts.

  • Support Groups

    • 12-step programs (e.g., Alcoholics Anonymous, Narcotics Anonymous).

    • Peer support communities and recovery groups.

  • Lifestyle & Relapse Prevention

    • Stress management, mindfulness, exercise, and healthy routines.

    • Building sober social networks.

Living With a Substance-Related or Addictive Disorder

  • Recovery is possible, though relapse may be part of the journey.

  • Treatment often requires ongoing support and multiple approaches.

  • Many people achieve long-term recovery and rebuild healthy, fulfilling lives.

Supporting Someone With a Substance-Related Disorder

  • Show compassion – addiction is an illness, not a weakness.

  • Encourage treatment without forcing.

  • Avoid enabling – don’t provide money, substances, or cover up consequences.

  • Set boundaries to protect your own wellbeing.

  • Celebrate progress, even small steps toward recovery.

Getting Help

If you or someone you know may be struggling with substance use or addiction:

  • Contact a GP, counselor, or addiction specialist.

  • Seek local resources such as rehab centers or outpatient programs.

  • In emergencies (e.g., overdose, suicidal thoughts), call emergency services immediately.

  • National helplines (e.g., SAMHSA Helpline in the U.S., NHS services in the UK) can provide 24/7 confidential support.