Updated: 8/5/2021

Substance Dependence and Use Disorder

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Substance dependence
  • Definition
    • physiologic addiction behaviors that include:
      • tolerance 
        • need to take larger amounts for the same desired effect
      • withdrawal
      • persistent desire or unsuccessful attempts to cut down
    • disturbance of life function
      • significant energy spent obtaining, using, or recovering from substance
      • impaired control over substance use (work, school, relationships suffer and time spent doing these activities is reduced)
      • continued use in light of the problems caused by the drug
Substance use disorder
  • Definition
    • less emphasis on biochemical addiction; one or more of the following:
      • impaired control over substance use (work, school, relationships suffer and there is failure to fulfill major obligations in these areas)
      • compulsive use (use in physically hazardous situations)
      • continued use despite harm
      • recurrent substance-related legal problems
Stages in overcoming substance addiction
  • Pre-contemplation - no acknowledgement of the problem
  • Contemplation - acknowledgement of the problem, but not ready to make a change  
  • Preparation/Determination - getting ready to change behavior 
  • Action/Willpower - process of changing behavior
  • Maintenance - maintaining the behavioral change
  • Relapse - returning back to old behavior

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