Psychology: Essential Thinkers, Classic Theories, and How They Inform Your World - Andrea Bonior 2016

Substance-Related Disorders
A Brief Survey of Abnormal Psychology
Definitions

ALCOHOL-USE DISORDER

US prevalence for alcohol-use disorder, the most common substance-related disorder: 8.5 percent among adults

Substance abuse and dependence are widespread problems, and it can sometimes be hard to know where the line is in terms of what is unhealthy. Substance-related disorders are characterized by their effects on the body, and the substances themselves fall into the categories of depressants, stimulants, opiates, and hallucinogens. Classic signs of substance abuse include letting a substance get in the way of relationships, work, school, or other responsibilities; using the substance when it’s physically dangerous to do so; trying to cut back and being unable to do so; using the substance in increasingly large amounts, or for longer than intended; strong cravings for the substance; and spending quite a lot of time getting or using the substance. Substance dependence, synonymous with addiction, has physiological as well as psychological components. The physiological components include tolerance (an inability, over time, to get the same effects from ingesting the same amount of the substance) and withdrawal symptoms (distressing and uncomfortable physical and psychological sensations that come on when the body has to go without the substance). Unfortunately, tolerance and withdrawal symptoms can combine to keep a person trapped in an addictive cycle. The person may no longer be using the substance to get high but may need it to keep from experiencing withdrawal symptoms. The psychological components of substance dependence include overwhelming cravings as well as substance-seeking behavior that impairs daily functioning. These components may be present even when the substance is not necessarily known for being physically addictive (for example, someone may not be physically addicted to marijuana but spends every moment wondering how to get it, no longer cares to see friends, and spends every last dime on marijuana while neglecting to buy basic necessities). As it happens, the DSM-5 no longer differentiates between substance abuse and substance dependence but now includes a model for diagnosing mild, moderate, or severe substance-related disorders. It is also worth noting that the DSM-5 includes in this category one disorder that is not technically related to a chemical compound—gambling disorder—because the symptoms of compulsive gambling closely mimic those of substance abuse and substance dependence and even include tolerance and withdrawal.