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Substance Use Disorder : What is it? What are the Symptoms? When to Seek Help?

Most of my patients who turn up at my door are not ready to believe that they have an ailment, a disorder that requires proper treatment. They are unable to find it in themselves to come to terms with it and I can understand how troublesome it is for them.

When they are sitting in my office, with troubled faces, they know in their hearts that something is wrong but are not able to put a finger to it. After having a thorough and detailed conversation, they are broken to the news of their brain disorder; substance use disorder. Sometimes, they go in shock, sometimes they surrender, you never know where it is going to go. But once, the truth is out, I can sense a weight lifting from their shoulders. They believe in the diagnosis or not, that’s a separate story, but they can see the elephant in the room and from there their long impending journey to sobriety begins.

What is Substance Use Disorder?

According to the National Institute of Mental Health, “Substance use disorder (SUD) is a treatable mental disorder that affects a person’s brain and behavior, leading to their inability to control their use of substances like legal or illegal drugs, alcohol, or medications. Symptoms can be moderate to severe, with addiction being the most severe form of SUD.”

In layman’s terms, it is a loss of control over any given substance/alcohol. Patients no matter how bad shape are unable to sway their use and end up succumbing to the hands of this deadly disease.

What are the symptoms of substance use disorder?

According to ICD, the following symptoms need to be kept in mind, while diagnosing SUD;

  1. A strong desire or sense of compulsion to take the substance;
  2. Difficulties in controlling substance-taking behavior in terms of its onset, termination, or levels of use;
  3. A physiological withdrawal state when substance use has ceased or been reduced, as evidenced by: the characteristic withdrawal syndrome for the substance; or use of the same (or a closely related) substance to relieve or avoid withdrawal symptoms;
  4. Evidence of tolerance, such that increased doses of the psychoactive substance are required to achieve effects originally produced by lower doses;
  5. Progressive neglect of alternative pleasures or interests because of psychoactive substance use, increased amount of time necessary to obtain or take the substance or to recover from its effects ;
  6. Persisting with substance use despite clear evidence of overtly harmful consequences, such as harm to the liver through excessive drinking, depressive mood states consequent to heavy substance use, or substance-related impairment of cognitive functioning. Efforts should be made to determine that the user was actually, or could be expected to be, aware of the nature and extent of the harm.

When to seek help?

The most frequently asked question in my career has been, “When to seek help from a doctor?” And sadly, in my years of service in this field, I have never seen anyone come in for treatment right when the problem starts.

Generally, on average 5-10 years are lost by patients and family, till they realize they need help. Often families would go on and on with trying to control the patient, they would also sometimes go as far as providing the patient with the substance themselves, thinking that they may be able to make him quit,                                                                                                                                                                                                                         by reducing the amount. However, though their hearts are in the right place, their actions on the other hand aggravate the situation.

Therefore, instead of trying to overpower the situation or the patient, families need to bring the patient in when they see even a glimpse of some odd behavior. While the patient may not have a full-blown disorder the symptoms can be targeted before they progress and the patient can be saved before he suffers from the disorder.

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