Substance addiction is classified under the name of substance use disorders in the International Classification of Diseases Handbook (ICD-11) published by the World Health Organization in its 11th revision. Chemical substances that can cause changes in behavior, mental state, and body when entering the body and can be addictive are called addictive substances. These substances are referred to as psychoactive substances in medical sources.
Psychoactive substances are chemical substances that affect the central nervous system, causing changes in perception, senses, behavior, consciousness, and mood by altering brain functions. Various disorders related to use can occur even with a single use of psychoactive substances, including certain medications. Addictive substances should not be limited only to psychoactive substances. Disorders arising from the harmful use of non-chemical but addiction-risk substances and non-medical drugs are also included in this classification. Substance use disorders include various disorders arising from the single or repeated use of psychoactive substances, including certain medications. Additionally, disorders arising from the harmful, non-medical use of non-psychoactive substances are also included in this classification. Substance use stimulates reward pathways in the brain. The pleasurable and attractive effects associated with substance use disrupt the dopamine hormone in the brain, reinforcing repeated use with the disruption. When substance use turns into repeated use, it can become addictive. At the same time, it can lead to many damages that threaten mental and physical health.
According to the DSM-5 Diagnostic Criteria Reference Handbook determined by the American Psychiatric Association, substance use disorder is defined as follows:
A problematic pattern of substance use leading to clinically significant distress or impairment, manifested by at least two of the following within a 12-month period:
- The substance is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control substance use.
- A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
- Craving, or a strong desire or urge to use the substance.
- Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home.
- Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance.
- Important social, occupational, or recreational activities are given up or reduced because of substance use.
- Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
- Tolerance, as defined by either of the following:
A. A need for markedly increased amounts of the substance to achieve intoxication or desired effect
B. A markedly diminished effect with continued use of the same amount of the substance.
10. Withdrawal, as manifested by either of the following:
A. The characteristic withdrawal syndrome for the substance
B. The same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms.
What is Substance Withdrawal?
According to the DSM-5 Diagnostic Criteria Reference Handbook, substance withdrawal is defined as follows:
A. Cessation of (or reduction in) substance use that has been heavy and prolonged (typically, several months or longer).
B. After the cessation of substance use as described in criterion A, the development of three (or more) of the following signs and symptoms within approximately one week:
Increased irritability, anger, or aggression
Nervousness or anxiety
Sleep disturbance (e.g., insomnia, disturbing dreams)
Decreased appetite or weight loss
Restlessness
Depressed mood
At least one of the following physical symptoms causing significant discomfort: abdominal pain, tremors/shaking, sweating, fever, chills, or headache.
C. The signs and symptoms in criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
D. The symptoms and signs are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.
What Health Problems Does Substance Addiction Cause?
Substance-related disorders are divided into two categories: substance use disorders and substance-induced disorders. Conditions caused by substances include intoxication, withdrawal, and substance/medication-induced mental disorders (psychotic disorders, bipolar and related disorders, depressive disorders, anxiety disorders, obsessive-compulsive and related disorders, sleep disorders, sexual dysfunctions, delirium, and neurocognitive disorders).
Individuals with substance use disorders may experience various problems in their thoughts and behaviors. Changes in the structure and function of the brain lead to intense cravings, personality changes, unusual movements, and other behaviors in people. Brain imaging studies show changes in areas related to judgment, decision-making, learning, memory, and behavioral control due to substance use. Additionally, newborn withdrawal syndrome can be seen in babies of addicted women.
Individuals with substance use disorders often have lung or heart disease, stroke, cancer, or various mental health problems. These individuals are also likely to experience infectious diseases such as HIV, Hepatitis C, and early deaths.
The frequency of substance use, the amount of substance taken at one time, risky behaviors arising from substance use or the context in which it is used, the method of substance intake, or a combination of all these increase the physical and mental health problems arising from substance use.
Did you know?
According to the 2021 World Drug Report;
In 2019, approximately 275 million people aged 15-64, or 1 in every 18 people, used drugs at least once. This finding constitutes 5.5% of the total world population aged 15-64.
Drug use is observed to be lower in women compared to men.
Over the past 10 years, deaths related to drug use have doubled. In 2019, approximately 500,000 people died due to substance use. More than half of these deaths were due to liver cancer, cirrhosis, and other chronic liver diseases related to Hepatitis C.
According to the 2021 European Drug Report;
Cannabis is the most commonly used drug.
Cannabis is used approximately five times more than other substances.
It is estimated that approximately 83 million adults (15-64 years) (or 28.9% of the adult population) in the European Union have used illegal drugs at least once in their lifetime.
What to Do?
Drug addiction is a treatable health problem, but it is not easy to treat. Since addiction is a chronic disease, people cannot recover by just stopping drug use for a few days. Most patients need long-term and repeated support to completely stop using and save their lives.