Addictive disorders, such as substance abuse and dependence, are common disorders that involve the overuse of alcohol or drugs. Addiction develops over time and is a chronic and relapsing illness.
There are three different terms used to define substance-related addictive disorders:
Substance abuse is an addictive disorder that describes a pattern of substance (usually drug or alcohol) use leading to significant problems or distress, such as failure to attend school, substance use in dangerous situations (eg, driving a car), substance-related legal problems or continued substance use that interferes with friendships and/or family relationships. Substance abuse, as a disorder, refers to the abuse of illegal substances or the abusive use of legal substances. Alcohol is the most common legal drug to be abused.
Substance dependence is an addictive disorder that describes continued use of drugs or alcohol, even when significant problems related to their use have developed. Signs include an increased tolerance — that is, the need for increased amounts of the substance to attain the desired effect; withdrawal symptoms with decreased use; unsuccessful efforts to decrease use; increased time spent in activities to obtain the substance; withdrawal from social and recreational activities; and continued use of the substance even with awareness of the physical or psychological problems encountered by the extent of substance use.
Chemical dependence is also an addictive disorder that describes the compulsive use of chemicals (usually drugs or alcohol) and the inability to stop using them despite all the problems caused by their use.
The substances frequently abused, particularly by adolescents with addictive disorders, include, but are not limited to, the following:
- Anabolic steroids
People with addictive disorders may experience symptoms differently. Some typical symptoms of addictive disorders may include:
- Getting high on drugs or getting intoxicated (drunk) on a regular basis
- Lying, especially about how much they are using or drinking
- Avoiding friends and family members
- Giving up activities they used to enjoy, such as sports or spending time with non-using friends
- Talking a lot about using drugs or alcohol
- Believing they need to use or drink in order to have fun
- Pressuring others to use or drink
- Getting in trouble with the law
- Taking risks, such as sexual risks or driving under the influence of a substance
- Suspension/expulsion from school or being fired from work for a substance-related incident
- Missing school or work due to substance use
- Depressed, hopeless or suicidal feelings
Addictive disorders are caused by multiple factors, including genetic vulnerability, environmental stressors, social pressures, individual personality characteristics and psychiatric problems.
From a neurological standpoint, addictive disorders arise when a substance changes the way the user’s brain feels pleasure. Addictive substances alter the brain’s ability to send and receive chemicals called neurotransmitters, which cause pleasure. The addictive substances can prevent nerves in the brain called neurons from receiving these pleasure chemicals, meaning the drug user relies on the drug, rather than his or her natural brain chemicals, for feelings of pleasure.
Most of the knowledge available regarding substance use and abuse comes from studying adult populations. A lack of research studying young adult substance use and abuse leaves questions concerning how it differs from substance abuse in other age groups unanswered.
Some adolescents are more at risk of developing addictive disorders, including adolescents with one or more of the following conditions present:
- Children of substance abusers
- Adolescents who are victims of physical, sexual or psychological abuse
- Adolescents with mental health problems, especially depressed and suicidal teens
- Physically disabled adolescents