Overview of Substance Use and Addiction

Question 1

What are the reasons for substances

Answer 1

To feel good
To feel better
To do better
Curiosity or new experiences 
Tradition

Question 2

What are the different ways/relationships people use/have with substances

Answer 2

Abstinence
Beneficial (positive health, spiritual and/or social impacts)
Non-problematic (recreational, casual)
Problematic (use at early age, negative health impacts for individual/family/friends/society)
Substance use disorder/addiction

Question 3

What is addiction?

Answer 3

A primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction of these circuits leads to characteristic biological, psychological, social and spiritual manifestatsions. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviours

Question 4

Characteristics of addiction (ABCDE)

Answer 4

Inability to consistently abstain
Impairment in behavioural control
Craving
Diminished recognition of significant problems with one's behaviours and interpersonal relationships
A dysfunctional emotional response

Question 5

What is substance use disorder

Answer 5

A cluster of cognitive, behavioural, and psychological symptoms indicating that an individual continues using despite significant substance related problems

Question 6

What is criteria for substance use

Answer 6

Recurrent use of alcohol and/or other drugs which cause significant clinical and functional impairment, exacerbated health conditions, decreased functioning and quality o of life

Question 7

What are the four C’s

Answer 7

Loss of control
Consequences
Compulsions
Cravings

Question 8

What is the DSM criteria for substance use disorder

Answer 8

At least 2 of the following within a 12-month period:

1. The substance is often taken in larger amounts or over a longer period than was intended
2. There is a persistent desire or unsuccessful efforts to cut down or control sustance use
3. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects
4. Craving or a strong desire to use the substance
5. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school or home
6. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance
7. Important social, occupational, or recreational activities are given up or reduced because of substance use
8. Recurrent substance use in situations in which it is physically hazardous
9. Continued use despite knowledge of having persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance
10. Tolerance
11. Withdrawal

Question 9

How is substance use disorder severity determined by DSM?

Answer 9

Mild: 2-3 symptoms
Moderate: 4-5 symptoms
Severe: 6+