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SUBSTANCE USE 101

Learn what substance use disorder is, how it affects the brain and behavior, and why treatment, compassion, and continued recovery support matter.

The Disease Model of Substance Use Disorder

Substance use disorder is recognized as a disease by leading medical organizations, including the American Medical Association and the American Society of Addiction Medicine.

Like diabetes, cancer, and heart disease, substance use disorder can develop because of a combination of behavioral, psychological, environmental, and biological factors. Genetics account for about half of a person’s risk of developing a substance use disorder.

Ongoing use of nicotine, alcohol, or other substances can change how the brain and body function.

Without treatment and support, substance use disorder can contribute to other physical and mental health conditions that require medical care. Over time, the condition can become more serious, more disabling, and potentially life threatening.

Source: Partnership to End Addiction, drugfree.org

Is Substance Use Disorder a Disease?

Yes. Substance use disorder is a complex disease that affects the brain and body. It can cause a person to feel a powerful need to use one or more substances, even when doing so leads to serious health or social consequences.

Substance use disorder affects the areas of the brain responsible for reward, motivation, learning, judgment, and memory.

Source: Partnership to End Addiction, drugfree.org

How substance use changes the brain

People experience pleasure when basic needs such as hunger, thirst, and physical connection are met. These feelings come from chemicals released by the brain. They teach the brain to repeat behaviors that help us survive, such as eating, drinking, and forming relationships.

Many substances cause the brain to release unusually high levels of these same chemicals.

Over time, repeated exposure can change the areas of the brain responsible for reward, motivation, and memory. The brain tries to restore balance by becoming less responsive to these chemicals or by releasing stress hormones.

As a result, a person may need more of the substance to achieve the same effect or simply to feel closer to normal. The person may experience powerful cravings and continue using the substance despite harmful consequences.

Substance use may begin to replace healthy sources of pleasure, causing the person to lose interest in everyday activities. In its most severe form, substance use disorder can significantly affect a person’s ability to care for themselves and maintain relationships with others.

 

Changes in the brain can continue long after a person stops using substances. These changes may make the person more sensitive to people, places, feelings, or situations associated with previous substance use. These reminders are often called triggers and can increase the risk of a return to use.

 

Source: Partnership to End Addiction, drugfree.orga

Why is willpower not enough?

A person’s initial decisions about substance use may involve personal choice, but those decisions are also influenced by culture, environment, and life experiences.

Certain factors can increase a person’s vulnerability to developing a substance use disorder. These may include a family history of substance use disorder, trauma, or mental health conditions such as depression or anxiety that have not been adequately treated.

 

Once substance use begins changing the brain, a person’s ability to control their behavior and rely on willpower may become significantly impaired. One of the primary symptoms of substance use disorder is the loss of control over substance use.

 

Source: Partnership to End Addiction, drugfree.org

Are people with addiction responsible for their actions?

People do not choose how their brains and bodies respond to substances. This helps explain why one person may develop a substance use disorder while another person does not.

A person with substance use disorder can stop using substances, but doing so may be far more difficult than it is for someone who has not developed the condition. People should not be blamed or shamed for having a disease.

Every person should have access to compassionate, evidence based care. Support from family members, friends, peers, and treatment professionals can strengthen a person’s chances of recovery and survival.

Source: Partnership to End Addiction, drugfree.org

Is Substance Use Disorder a Chronic Disease?

A chronic disease is a long lasting condition that can be treated and managed but may not be permanently cured.

Most people who use substances do not develop a substance use disorder. Many young people who use substances during high school or college reduce their use as they take on adult responsibilities.

However, an estimated twenty five to fifty percent of people with substance use challenges develop a severe and long lasting disorder. For these individuals, substance use disorder may involve a recurrence of symptoms and require effective treatment, continued care, monitoring, and support from family members or peers.

The good news is that even severe and long lasting substance use disorder can be managed with appropriate treatment, continued monitoring, and consistent recovery support.

Source: Partnership to End Addiction, drugfree.org

Why Do Some People Say Substance Use Disorder Is Not a Disease?

Some people believe substance use disorder cannot be a disease because substance use often begins with a personal choice.

Although the initial or early use of a substance may involve choice, experts recognize that repeated substance use can change the brain and reduce a person’s ability to control their behavior.

Personal choice does not determine whether a condition is a disease. Heart disease, diabetes, and certain cancers may also involve choices related to diet, exercise, or sun exposure. The disease is defined by the changes that occur inside the body, regardless of what may have contributed to those changes.

Others argue that substance use disorder is not a disease because some people recover without professional treatment. A person with a mild substance use disorder may recover with little or no formal care. Someone with a severe substance use disorder is more likely to need comprehensive treatment and continued support.

Some people recover after experiencing a serious family, social, professional, physical, or spiritual crisis. Others find recovery through peer support groups, twelve step programs, or Alcoholics Anonymous without receiving extensive professional treatment.

 

Every recovery journey is different. Evidence based treatment and recovery support should be available to every person with substance use disorder who needs or wants them.

Substance use disorder is treatable, and recovery is possible.

Source: Partnership to End Addiction, drugfree.org

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