MAUNI

Do I have a substance use disorder?

—

by

David

The DSM 5 recognizes substance-related disorders resulting from the use of 10 separate classes of drugs:

  • alcohol
  • caffeine
  • cannabis
  • hallucinogens and other hallucinogens, such as LSD
  • inhalants
  • opioids
  • sedatives
  • hypnotics, or anxiolytics
  • stimulants (including amphetamine-type substances, cocaine, and other stimulants)
  • tobacco
  • and other or unknown substances.

Therefore, while some major groupings of psychoactive substances are specifically identified, the use of other or unknown substances, can also form the basis of a substance-related or addictive disorder.

The activation of the brain’s reward system is central to problems arising from drug use; the rewarding feeling that people experience as a result of taking drugs may be so profound that they neglect other normal activities in favour of taking the substance. 

While the pharmacological mechanisms for each class of drug are different, the activation of the reward system is similar across substances in producing feelings of pleasure or euphoria, which is often referred to as a “high.”

The DSM 5 recognizes that people are not all automatically or equally vulnerable to developing substance-related disorders and that some people have lower levels of self-control that predispose them to develop problems if they’re exposed to drugs.

What is the DSM-5?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by health care professionals in the United States and much of the world as the authoritative guide to the diagnosis of mental health disorders. The DSM contains descriptions, symptoms, and other criteria for diagnosing disorders.

The DSM-5 is the product of more than 10 years of effort by hundreds of international experts in all aspects of mental health. Their dedication and hard work have yielded an authoritative volume that defines and classifies mental disorders to improve diagnoses, treatment, and research.

Criteria for substance use disorders (SUDs):

Substance use disorders span a wide variety of problems arising from substance use, and cover 11 different criteria:

1.      Taking the substance in larger amounts or for longer than you’re meant to.

2.      Wanting to cut down or stop using the substance but not managing to.

3.      Spending a lot of time getting, using, or recovering from use of the substance.

4.      Cravings and urges to use the substance.

5.      Not managing to do what you should at work, home, or school because of substance use.

6.      Continuing to use, even when it causes problems in relationships.

7.      Giving up important social, occupational, or recreational activities because of substance use.

8.      Using substances again and again, even when it puts you in danger.

9.      Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.

10.  Needing more of the substance to get the effect you want (tolerance).

11.  Development of withdrawal symptoms, which can be relieved by taking more of the substance.

To determine the severity of the substance use disorder, the following guidelines are considered:

  • Two or three symptoms indicate a mild substance use disorder
  • Four or five symptoms indicate a moderate substance use disorder, and
  • Six or more symptoms indicate a severe substance use disorder.

Severity of substance use disorders:

The DSM 5 allows clinicians to specify how severe or how much of a problem the substance use disorder is, depending on how many symptoms are identified. Two or three symptoms indicate a mild substance use disorder; four or five symptoms indicate a moderate substance use disorder, and six or more symptoms indicate a severe substance use disorder.

Clinicians can also add “in early remission,” “in sustained remission,” “on maintenance therapy,” and “in a controlled environment.”

This information was sourced from the following websites:

Now that you have read through this section of the manual, what are your thoughts around your personal substance use and the severity of a substance use disorder in your life?

This is an opportunity to start practising the spiritual principles of:

  • honesty (to really look at your situation)
  • openness (to hear what others have to say and learn from them)
  • willingness (to get help and support so that you can move forward in your life).

The outpatient team are here to support you in developing tools, skills, and behaviours that are representative of recovery and wellness. We are focused on creating a space that is compassionate, loving, and non-judgemental, while at the same time challenging you around developing accountability and responsibility for, ownership of, your recovery and wellness.