mental health disorders
Substance Use Disorders
Causes of Substance Use Disorders
People usually progress from experimentation to occasional use and then to heavy use and sometimes to a substance use disorder. This progression is complex and only partially understood. The process depends on interactions between the drug, user, and setting. Drugs in the 10 classes vary in how likely they are to cause a substance use disorder. The likelihood is termedaddiction liability.Addiction liability depends upon a combination of factors including How the drug is used How strongly the drug stimulates the brain's reward pathway How quickly the drug works The drug's ability to induce Intoxication and/or symptoms of In addition, substances that are legally and/or readily available, such as Alcohol Use and During treatment of medical illness or following surgical or dental procedures, people are routinely prescribed opioids. If people do not take the whole amount prescribed, the drugs sometimes end up in the hands of people who wish to use them recreationally. Because the use of these drugs for nonmedical purposes has become such a large problem, many health care providers have responded by Prescribing lower amounts of opioid drugs Encouraging people to safely store or dispose of any leftover drugs Expanding prescription take-back programs Factors in users that may predispose to a substance use disorder include Psychologic characteristics Circumstances and disorders Psychologic characteristicsare not clearly a strong factor, although people with low levels of self-control (impulsivity) or high levels of risk-taking and novelty-seeking behaviors may have an increased risk of developing a substance use disorder. However, there is little scientific evidence to support the concept of the "addictive personality" that has been described by some behavioral scientists. A number ofcircumstances and coexisting disordersappear to increase the risk of a substance use disorder. For example, People who are sad, emotionally distressed, or socially alienated may find temporary relief from drug use, which can lead to increased use and sometimes to a substance use disorder. People with other, unrelated mental health disorders such as or People with Chronic Pain often require However, in many of these people, Nonopioid Pain Relievers and other treatments do not adequately relieve pain and suffering. Addiction likely has many causes, some of which are genetic and other of which are epigenetic (effects of behaviors and the environment carried with the genes). Research into specific genetic abnormalities varies by the specific substance. Researchers have found few biochemical or metabolic differences between people who do and do not develop substance use disorder. Cultural and social factors are very important in initiating and maintaining (or relapsing to) substance use. Watching family members (eg, parents, older siblings) and peers using substances increases the risk that people will begin using substances. Peers are a particularly powerful influence among adolescents (see Substance Use in Adolescents ). People who are trying to stop using a substance find it much more difficult if they are around others who also use that substance. Doctors may inadvertently contribute to harmful use of psychoactive drugs by overzealously prescribing them to relieve stress. Many social factors, including mass media, contribute to the expectation that drugs should be used to relieve all distress. 