What is Substance Use Disorder?

Substance Use Disorder (SUD), also referred to addiction or substance abuse, is a complex and chronic, but treatable, brain disease.

It is not a moral failing, a choice, or a character flaw. Research proves it is a chronic disease involving “complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences”.

Substance use disorder is not something that is planned. It is characterized by the inability to manage the use of substances, whether illicit or legal. It results in changes in brain function and behavior, and the use persists despite harmful consequences.

Substance use usually starts as experimentation or in social situations, but it often progresses to more frequent use and dependency. In certain cases, individuals may develop an addiction to opioids or prescription drugs after being legitimately prescribed these medications for pain or health reasons.

It is chronic, meaning it lasts forever, progressive, and fatal if left untreated. But with proper evidence-based treatment individuals can live in long-term recovery.

Successful treatment for SUD’s requires an individualized approach that addresses the unique and multiple needs of each person, such as addressing co-occurring disorders.

To learn more about what a personalized recovery plan entails, or help finding treatment, check out the following organizations:

What Does Substance Use Disorder do to the brain?

The human brain is designed to reward pleasurable activities by releasing dopamine, a neurotransmitter linked to our survival. When we engage in activities like exercising and eating, the brain releases dopamine, making us feel good and motivating us to continue those behaviors.

Drugs target the same reward system in the brain. Whether it's alcohol, marijuana, opioids, amphetamines, or other substances, they cause a surge of dopamine release. As a result, the brain learns to associate this behavior with pleasure and reinforces the urge to repeat it.

According to the National Institutes on Drug Abuse (NIDA), “Drugs over-activate [the reward] circuit, producing the euphoria of the drug high. But with repeated exposure, the circuit adapts to the presence of the drug, diminishing its sensitivity and making it hard to feel pleasure from anything besides the drug.”

These circuit changes cause individuals to crave their substance of choice unconsciously rather than making a conscious choice. The body then adapts to maintain balance, leading to tolerance. This means higher doses are needed to achieve the same effects, further reinforcing the brain's desire for more.

This progression results in addiction, where the body can't function normally without the substance. Stopping substance use leads to painful withdrawal effects, pushing many to continue using to avoid this agony, perpetuating a cycle of SUD.

Who Can Develop a Substance Use Disorder?

ADDICTION CAN HAPPEN TO ANYONE.

Addiction can affect anyone. A SUD does not stem from a single driving factor alone. Instead, a complex interplay of various factors influences the risk. The presence of multiple risk factors increases the vulnerability of some individuals more than others.

Biological factors: Scientific research shows that 40–60% of the predisposition towards developing addiction is attributed to genetics. This includes a family history of the condition and the influence of epigenetics, which pertains to how “environmental factors impact a person's gene expression”.

Individuals with behavioral health disorders such as depression, anxiety or ptsd are at a higher risk of sud.

Environmental factors: Include family, friends, and community. Factors such as peer pressure, early exposure to substances or if other family members misuse substances, and stress can greatly affect a person’s likelihood of developing a SUD. Trauma and exposure to traumatic experiences, especially in childhood, also put individuals at a greater risk.

Using drugs for the first time at a young age can also increase addiction risk. Also, the risk of addiction is heightened when substances are snorted or injected because of the rapid and intense delivery of the substance into the body.

Risk factors are unique to each person, and ultimately it depends on a person’s brain chemistry and life experiences. Understanding the individual's distinct factors and experiences is essential in treating SUD. Addressing these aspects as part of a person's treatment plan and recovery journey is crucial.

An enormous amount of stigma, shame and misunderstanding surrounds this disease.

Punitive measures, social stigma, and severe punishments prove ineffective in addressing an individual's addiction. The impact of substances on a person's body chemistry cannot be reversed solely through willpower. Like chronic illnesses, such as asthma or diabetes, lifelong management is essential for achieving long-term recovery from addiction. Thankfully, numerous evidence-based solutions exist to assist individuals with substance use disorders on their path to recovery.

Yet, fewer than 11 percent of the nearly 22 million Americans who meet the criteria for SUD receive the specialized treatment they need to live in recovery.

Largely, this is due to the widespread misunderstanding, misdiagnosis, and inadequate treatment of addiction. Also, the enormous stigma attached to this disease compounds the problem.

Today, more and more of our society, doctors, and policy makers are embracing the science of SUD, which is great news. But it is important to understand that addiction has always been a disease, and up until recently, society and our healthcare system has been resistant to accept it as such.

While a cancer patient's need for chemotherapy or a diabetic's requirement for insulin is met with understanding and compassion, individuals with SUD’s often face judgment, leading many to refrain from seeking treatment.

We aim to shift the conversation around addiction to eradicate the stigma, promote evidence-based treatment programs, and empower individuals and families seeking assistance, providing them with hope and the support they need.