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Updated: Aug 5 2021

Substance Dependence and Use Disorder

  • 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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