Substance Abuse Disorders

A substance use disorder (SUD), also known as a drug use disorder, is a medical condition in which the use of one or more substances leads to a clinically significant impairment or distress. Substance use disorders are characterized by an array of mental, physical, and behavioral symptoms that may cause problems related to loss of control, strain to one’s interpersonal life, hazardous use, tolerance, and withdrawal.Drug classes that are involved in SUD include lcohol, phencyclidine, inhalants, stimulants, cannabis, “other hallucinogens”, opioids, tobacco, and sedatives, hypnotics, and anxiolytics

Substance use disorder occurs when a person’s use of alcohol or another substance (drug) leads to health issues or problems at work, school, or home.

This disorder is also called substance abuse.


The exact cause of substance use disorder is not known. A person’s genes, the action of the drug, peer pressure, emotional distress, anxietydepression, and environmental stress can all be factors.

Many who develop a substance use problem have depressionattention deficit disorderpost-traumatic stress disorder, or another mental problem. A stressful or chaotic lifestyle and low self-esteem are also common.

Children who grow up seeing their parents using drugs may have a high risk of developing substance use problem later in life for both environmental and genetic reasons.

Commonly used substances include:

  • Opiates and other narcotics are powerful painkillers that can cause drowsiness, and sometimes intense feelings of well-being, elation, happiness, excitement, and joy. These include heroin, opium, codeine, and narcotic pain medicines that may be prescribed by a doctor or bought illegally.
  • Stimulants are drugs that stimulate the brain and nervous system. They include cocaine and amphetamines, such as drugs used to treat ADHD (methylphenidate, or Ritalin). A person can start needing higher amounts of these drugs over time to feel the same effect.
  • Depressants cause drowsiness and reduce anxiety. They include alcohol, barbiturates, benzodiazepines (Valium, Ativan, Xanax), chloral hydrate, and paraldehyde. Using these substances can lead to addiction.
  • LSD, mescaline, psilocybin (“mushrooms”), and phencyclidine (PCP, or “angel dust”) can cause a person to see things that are not there (hallucinations) and can lead to psychological addiction.
  • Marijuana (cannabis, or hashish).

There are several stages of drug use that may lead to addiction. Young people seem to move more quickly through the stages than do adults. Stages are:

  • Experimental use — Typically involves peers, done for recreational use; the user may enjoy defying parents or other authority figures.
  • Regular use — The user misses more and more school or work; worries about losing drug source; uses drugs to “fix” negative feelings; begins to stay away from friends and family; may change friends to those who are regular users; shows increased tolerance and ability to “handle” the drug.
  • Problem or risky use — The user loses any motivation; does not care about school and work; has obvious behavior changes; thinking about drug use is more important than all other interests, including relationships; the user becomes secretive; may begin dealing drugs to help support habit; use of other, harder drugs may increase; legal problems may increase.
  • Addiction — Cannot face daily life without drugs; denies problem; physical condition gets worse; loss of “control” over use; may become suicidal; financial and legal problems get worse; may have broken ties with family members or friends.

What is a Substance

Substance use disorder occurs when a person’s use of alcohol or another substance (drug) leads to health issues or problems at work, school, or home.

This disorder is also called substance abuse.

In this paper a “substance” is defined as any psychoactive compound with the potential to cause health and social problems, including addiction. These substances may be legal (e.g., alcohol and tobacco); illegal (e.g., heroin and cocaine); or controlled for use by licensed prescribers for medical purposes such as hydrocodone or oxycodone (e.g., Oxycontin, Vicodin, and Lortab). These substances can be arrayed into seven classes based on their pharmacological and behavioral effects:

  • Nicotine — cigarettes, vapor-cigarettes, cigars, chewing tobacco, and snuff
  • Alcohol — including all forms of beer, wine, and distilled liquors
  • Cannabinoids — Marijuana, hashish, hash oil, and edible cannabinoids
  • Opioids — Heroin, methadone, buprenorphine, Oxycodone, Vicodin, and Lortab
  • Depressants — Benzodiazepines (e.g., Valium, Librium, and Xanax) and Barbiturates (e.g., Seconal)
  • Stimulants — Cocaine, amphetamine, methamphetamine, methylphenidate (e.g., Ritalin), and atomoxetine (e.g., Stratera)
  • Hallucinogens — LSD, mescaline, and MDMA (e.g., Ecstasy)

Please contact our office at (703) 542-3737 or if you would like to schedule an Online Video psych Consultation for medication management or therapy session.