Substance Use Disorder Basics

Substance use disorder includes a variety of unhealthy behaviors related to the use of alcohol or drugs. A teenager might have substance use disorder if he can't control his use, his use is interfering with his functioning, or if his use involves risky or hazardous behavior. In this guide you'll learn how to tell if an adolescent or young adult has a substance use disorder, how it's diagnosed and what the treatment options are.

Substance Use Disorder: What Is It?

Substance-use disorder comprises a wide variety of behaviors that include, but are not limited to, addiction, excessive usage, and dangerous substance-induced behavior. Diagnosis is based on a pattern of behaviors that include an inability to control substance use, impairment of functioning at school, home or work, interpersonal problems caused or exacerbated by the substance use, and risky or hazardous use of the substance. Tolerance to the substance, demonstrated by an increased dose needed to achieve the desired effect, is another criterion.

Substance Use Disorder: What to Look For

A young person who is frequently intoxicated, uses substances before or during school, sells drugs, or conceals alcohol or drugs in his room is displaying signs of a substance use disorder. But since many teenagers effectively hide their drug or alcohol consumption from their parents, other behaviors that result from substance abuse may be noticed first. These may include skipping school frequently, performing poorly in school, changing friends, and dropping activities or former interests. Other signs include dangerous behavior like getting in fights or driving while impaired. One does not need to be addicted to have a substance problem.

Parents of children with psychiatric disorders should know that their kids are particularly vulnerable to substance problems. Even normal teenage experimentation can become risky for someone with an anxiety or mood disorder. Use of alcohol or drugs, even when it’s limited, can worsen symptoms of panic attacks, trigger a manic or depressive episode, and induce psychosis. It is important to know that using substances will also interfere with the efficacy of prescribed medications.

Substance Use Disorder: Risk Factors

Factors that make a child more susceptible to substance abuse include a family history of addiction or another psychiatric disorder. Kids without strong family supports are also more vulnerable; parental supervision helps prevent kids who use substances from transitioning into chronic abusers. Boys are more likely than girls to be diagnosed with alcohol or drug-related problems.

Substance Use Disorder: Diagnosis

Substance use disorder takes many forms, depending on the substance and the intensity or frequency of use. Substance use merits intervention when use of the substance (or substances) results in poor academic performance or school attendance, dangerous behaviors, or social problems.  Other signs of substance abuse include physical or psychological tolerance to the drug so that increased consumption is necessary to attain the desired effect; withdrawal symptoms; taking a substance in larger amounts or for longer than intended; unsuccessful attempts to cut down or control substance use; abandoning or ignoring formerly significant activities and/or friends; and a strong craving for a specific substance.

Substance Use Disorder: Treatment

The first step of treatment is to stop using the substance. In severe cases of physical addiction, detoxification is necessary to help with symptoms of withdrawal. Creating a supportive environment and eliminating triggers for substance abuse are essential. Treatment may occur on an outpatient or inpatient basis depending on the severity of the problem. A doctor might recommend individual counseling with a psychologist, psychiatrist, or addiction counselor. Family counseling is often necessary. A doctor may reccomend special rehabilitation and/or treatment programs; self-help groups for kids and families with substance problems are often quite useful. Children with co-existing psychiatric disorders should be given a treatment plan that addresses those conditions as well.

Substance Use Disorder: Risk For Other Disorders

Many people who have substance use disorder also have another psychiatric disorder. Children are more likely to abuse drugs if they have anxiety disorders, bipolar disorder, disruptive behavior disorders, depression, or schizophrenia.  Kids who experience environmental stressors are also at increased risk for trying or excessive use of substances.