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Substance Abuse or Chemical Dependence

What is substance abuse or dependence?

Substance abuse (alcohol or other drugs)

Substance abuse is a recognized health disorder. It refers to the abuse of illegal or legal substances. Alcohol is the most common legal drug of abuse. Substance abuse causes serious problems at work, school, in relationships, and with the law.

Substances that are often abused include:

  • Alcohol

  • Marijuana

  • Tobacco

  • Prescription medicines, such as pain pills, stimulants, or anxiety pills 

  • Methamphetamine  

  • Cocaine

  • Opiates

  • Anabolic steroids

  • Hallucinogens 

  • Inhalants

Substance (drug) dependence

Substance dependence describes abuse of drugs or alcohol that continues even when someone has serious problems linked to their use. Signs of dependence include:

  • You need more of the drug to get an effect.

  • You constantly think about getting or using the drug

  • You have withdrawal symptoms if you decrease or stop using the drug.

  • You spend a lot of time getting, using, and recovering from the effects of using drugs.

  • You withdraw from social and recreational activities.

  • You keep using the drug. You do this even when you know that your ongoing abuse is causing many problems. These include physical, psychological, economic, and family or social problems.

About Xylazine

Xylazine is a sedative and pain reliever approved for animals only. It is not approved or safe for humans. Xylazine has recently been linked to drug overdoses. It has been found in illegal drugs such as heroin and fentanyl. It has been linked to overdose and severe side effects such as:

  • Slow heart rate and breathing

  • Low blood pressure

  • Coma

  • Skin sores


Care for xylazine overdose or exposure is supportive. It's aimed at helping the body recover.

What causes substance abuse or dependence?

The cause of substance abuse and dependence is unclear. It likely includes a mix of genetics, environmental, and emotional factors. The first use of drugs or alcohol is voluntary. But continued use quickly changes how the brain feels pleasure. Using drugs often changes the structure of the brain. Over time a person no longer has control. Substance abuse is a disease that results in the compulsive need for the drug.

What are the symptoms of substance abuse or dependence?

These are the most common behaviors that signal you have a problem with drug or alcohol abuse:

  • You get high on drugs or get drunk on a regular basis

  • You lie, especially about how much you are using or drinking

  • You stay away from friends and family members

  • You have given up activities you used to enjoy, such as sports or spending time with nonusing friends

  • You talk or think a lot about using drugs or alcohol

  • You believe you need to use or drink to have fun

  • You pressure others to use or drink

  • You get in trouble with the law

  • You take risks, such as sexual risks or driving under the influence of a substance

  • Your work suffers due to substance abuse before, after, or during working or business hours

  • You miss work due to substance use

  • You risk your financial security and that of your family to buy drugs or alcohol

  • You feel depressed, hopeless, or have suicidal feelings

Many of these symptoms may be caused by other medical problems or mental health conditions. Always see your healthcare provider for a diagnosis.

How is substance abuse or dependence diagnosed?

A family healthcare provider, psychiatrist, or qualified mental health provider can diagnose substance abuse. Depending on the substance abused, the frequency of use, and the length of time since you last used, your provider may note the following:

  • Weight loss

  • Memory and thinking problems

  • Constant fatigue

  • Red eyes

  • Little concern for hygiene

  • Unexpected problems in heart rate or blood pressure

  • Depression, anxiety, agitation, irritability, or sleep problems 

  • Seizures and hallucinations seen in delirium tremens related to alcohol withdrawal

How is substance abuse or dependence treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment for drug addiction is serious and complex. People who are addicted can’t simply stop using. Treatment programs have many different components. You can take part in inpatient or outpatient treatment programs for substance abuse. Programs are often based on the type of substance abused. Programs include:

  • Detoxification, if needed

  • Medicines for withdrawal, to lessen cravings, and to restore normal brain function

  • Behavioral therapy

  • Long-term medical follow-up and support

  • Counseling for both you and any family affected

What are possible complications of substance abuse or dependence?

Complications of drug abuse or dependence vary depending on the drug or substance being used. They may include:

  • Liver damage

  • Heart damage

  • Memory and thinking problems

  • Increased risk for infections, such as HIV and other sexually transmitted infections

  • Pneumonia

  • Tuberculosis

  • Injuries to yourself or others

  • Weight loss

  • Sleep disturbances

  • Sexual dysfunction

  • Depression

  • Thoughts of suicide

  • Suicide attempts

  • Anxiety

  • Psychosis

  • Fatal accidental overdoses

Can substance abuse or dependence be prevented?

There are many things you can do to prevent substance abuse or dependence in your home and community, including: 

  1. Follow alcohol and drug control laws and policies. This includes maintaining the age 21 minimum legal drinking age. And prohibiting the sale of alcohol to intoxicated people.

  2. Be a positive role mode. Don't drink. Or if you do, drink responsibly and don't use drugs. Never drive after using substances.

  3. Empower young people not to drink or use other drugs.

  4. Store prescription medicine and alcohol safely.

  5. Correctly dispose of any medicines. Do not share prescription drugs with others.

Key points about substance abuse or dependence

  • Substance abuse is a recognized health disorder that refers to the abuse of illegal or legal substances.

  • Substance abuse causes serious problems at work, school, in relationships, and with the law.

  • Substance dependence describes the abuse of drugs or alcohol that continues even when serious problems l to their use have developed.

  • There are many different treatment programs for substance abuse. You may need inpatient or outpatient help or a combination of both approaches.

  • Substance abuse is a lifelong condition. It needs ongoing care to manage correctly.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • Bring someone with you to help you ask questions and remember what your provider tells you.

  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.

  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

  • Ask if your condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if you do not take the medicine or have the test or procedure.

  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your healthcare provider if you have questions, especially after office hours and on weekends.

Online Medical Reviewer: L Renee Watson MSN RN
Online Medical Reviewer: Marianne Fraser MSN RN
Online Medical Reviewer: Paul Ballas MD
Date Last Reviewed: 3/1/2023
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