Drug Use Disorder (DUD)
Drug Use Disorder (DUD) is no longer termed substance abuse or substance dependence. The current state of addiction science indicates that a Drug Use Disorder can be mild, moderate or severe. (See The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The diagnosis of DUD can only be made by a qualified professional. The level of severity is determined by the number of specific diagnostic criteria met by an individual. Drug Use Disorder generally occurs when the recurrent use of drugs causes clinically and functionally significant impairment, such as health problems, discord in personal and/or professional relationships, and failure to meet major responsibilities at home, work or school. The diagnostic criterial for DUD includes social impairment, risky use and other pharmacological criteria.
The following is a list of possible Drug Use Disorders:
- Alcohol Use Disorder
- More than half of Americans over the age of 12 report being users of alcohol. Most people drink in moderation, however of 176.6 million American users, an estimated 17 million have an AUD. (See Centers for Disease Control National Survey of Drug Use and Health, 2014)
- Cannabis Use Disorder
- Marijuana is the second most used drug after alcohol. 22.2 million Americans over the age of 12 reporting using marijuana in the last month. The average age of first use is 18.5 years. 4.2 million Americans have Cannabis Use Disorder. (See CDC Survey)
- Stimulant Use Disorder
- Stimulants increase alertness, attention and energy as well as elevate heart rate, blood pressure and respiration. Therapeutic prescription uses are for obesity, attention deficit disorder and depression in the form of Adderall, Vyvanse, or Ritalin, among others. However, increasingly these drugs are diverted for non-prescription use.
- Hallucinogen Use Disorder
- Hallucinogens can be chemical synthetics such as lysergic acid diethylamide (LSD) or be naturally occurring such as peyote or psilocybin mushrooms. Use of these drugs produce auditory and visual hallucinations, feelings detachment and distortions in time and perception. Approximately a quarter of a million Americans have a Hallucinogen Use Disorder.
- Opioid Use Disorder
- Opioid can be legally prescribed pain killers such as Fentanyl, Oxycontin, Vicodin, Codeine and Morphine or illegal drugs such as Heroin. Opioids reduce pain, produce drowsiness, mental confusion, euphoria, nausea and constipation. Opioids can be taken in pill form, snorted or taken intravenously.
- Americans are currently in grips of an opioid epidemic fueled by the over prescription of opioids for pain killers for a variety of pain including post-surgical (both inpatient and outpatient), post dental procedure and recurrent pain management. 2.1 million Americans have an Opioid Use Disorder. In 2016, 2 million Americans misused a prescription opioid on the first use. 886,000 Americans used heroin. 81,000 Americans used heroin for the first time. 130 Americans died every day from opioid related drug overdoses. 11.4 million Americans misused an opioid prescription. In 2017, The Department of Health and Humans Services declared a Public Health Emergency on the National Opioid Crisis and announced a 5-Point Strategy to Combat the Opioid Crisis. (See HHS.gov/opioids (2016-2017 By – The Numbers))
The current state of addiction science is clear that Drug Use Disorder is a disease with a clear path for recovery. Recovery can include:
- Community Based Programs:
- Participation in 12 step programs such as AA, or other programs such as Smart Recovery;
- Inpatient Rehabilitation:
- Round-the clock medical and psychological care to start recovery safely and effectively;
- Outpatient Treatment:
- Individual counseling with a licensed psychiatrist or licensed drug and alcohol counselor;
- Medically Assisted Treatment:
- Medication prescribed by a licensed physician to ease both cravings and withdrawal symptoms which is tapered off with progressive recovery;
- Sober Living:
- Group home setting which includes shared meetings, responsibilities and support to sustain recovery.
The misuse of drugs can be fatal. It is a progressive disease which always gets worse. Without recovery intervention, it never goes away and does not get better. There is no option to turn back the clock on alcohol misuse. There is no reset- once you start your body will always react as if you started right where you left off no matter how long it has been since the last use. There is no cure. It can only be treated and controlled. Relapse is common aspect of recovery, even after a long period of abstinence.