Substance Related Disorders 1

Substance Related Disorders Substance Abuse: viewed as less severe, continued use, knowing it is causing harm, does not apply to caffeine and nicotine Substance Dependence: taking larger amounts with unsuccessful attempts to quit Substance Intoxication: the development of a substance specific (reversible) syndrome, condition related to recent ingestion of psychoactive substance Substance Withdrawal: follows termination of a psychoactive substance (Abstinence Syndrome)

Types of Substances Include: alcohol, amphetamines, cocaine, caffeine, hallucinogens, inhalants, nicotine, opioids, phencyclidine (PCP), cannabis, and sedatives-hypnotics- anxiolytics Polysubstance Dependence: the criteria for abuse or dependence for any one substance is not met, the client abuses more than one substance and groups them together 3

DSM-5: Substance Related Disorders Will eliminate substance abuse and dependence and replace it with a new category “addiction and the related disorders.” Will include substance use disorders with each drug identified in its own category. Eliminate the category of dependence, will help to differentiate between those that are drug seeking and those that have developed tolerance (from withdrawal).

DSM-5: Substance Disorders Each drug will have its own category A new category of behavioral addictions will be added (behavioral addictions, only one so far and internet addiction is mentioned in the appendix) Discontinuation syndromes: related to TCA’s and the SSRI’s

Substance Related Disorders When NOT working in the area of substance use/abuse a social worker should never counsel a client actively using and influenced by a substance. The client needs to be referred for detoxification, or rescheduled when not under the influence. Twelve months is required for a client to achieve sustained remission. 6

Substance Related Disorders In the DSM-IV-TR all substance related conditions are now grouped in one category and in DSM-IV-TR much clarification was used to outline the different areas and substances.

Substance Related Disorders Be sure the relationship between dependence and withdrawal is noted Almost always when dependence is an issue treat the substance first