Comprehensive Guide to Substance Use Disorders: Types, Effects, and Treatments

Substance Use Disorder

A condition characterized by an individual's inability to control their use of a substance, leading to significant impairment or distress.

Dextromethorphan

An OTC cough suppressant that, in large doses, produces a 'high' and may cause hallucinations.

Stimulants

A class of drugs including cocaine, methylphenidate, and methamphetamine that elevate mood, reduce fatigue, and increase alertness.

Cocaine

A highly addictive substance derived from the coca plant, available in powdered and crystallized forms.

Methamphetamine

A powerful stimulant with stronger effects than other amphetamines, available in pill, powder, and crystallized forms.

MDMA

Also known as 'Ecstasy' or 'E', it is usually prepared in secret laboratories and has calming effects compared to other amphetamines.

Withdrawal Symptoms

Physical and psychological symptoms that occur upon cessation of substance use, common in stimulant use.

Adverse Effects of Stimulants

Includes restlessness, dizziness, hyperactive reflexes, insomnia, and can lead to confusion and aggression.

CNS Stimulation

The result of stimulant drugs releasing norepinephrine, leading to increased heart rate and blood pressure.

Depressants

Drugs that relieve anxiety and tension, also used to treat seizure disorders and induce anesthesia.

Flunitrazepam

Also known as 'Roofies', it is illegal in the US and causes a relaxed, drunken feeling, often associated with disinhibition and amnesia.

Benzodiazepines

A class of depressants that work by increasing the action of GABA in the brain.

Barbiturates

Depressant drugs that also enhance the action of GABA, used for anxiety relief and anesthesia.

Cannabinoids (THC)

The active ingredient in marijuana that binds to cannabinoid receptors in the CNS.

Management of Overdose

Supportive treatment is required for overdose cases, which can lead to severe complications.

Stimulant Withdrawal Signs

Includes social withdrawal, psychomotor retardation, hypersomnia, and hyperphagia.

Duration of Stimulant Withdrawal

Peak period is 1 to 3 days, with a duration of 5 to 7 days.

Commonly Abused Substances

Includes stimulants, depressants, and other drugs that are frequently misused.

CNS Adverse Effects

Can include confusion, anxiety, delirium, and suicidal tendencies following stimulant use.

CV Adverse Effects

Includes headache, palpitations, tachycardia, and circulatory collapse as a result of stimulant use.

GI Adverse Effects

Can include dry mouth, anorexia, nausea, vomiting, and abdominal cramps associated with stimulant use.

Overexpression of their therapeutic effects

CNS: Drowsiness, sedation, lack of coordination, dizziness, blurred vision, headaches, paradoxical reactions

Depressants: Adverse Effects

Nausea, vomiting, constipation, dry mouth, abdominal cramping

Chronic respiratory symptoms

Chronic respiratory symptoms for marijuana smokers; memory and attention deficit problems; chronic depressive amotivational syndrome

Depressants Withdrawal: Peak period

2 to 4 days for short-acting drugs; 4 to 7 days for long-acting drugs

Depressants Withdrawal: Duration

4 to 7 days for short-acting drugs; 4 to 12 days for long-acting drugs

Depressants Withdrawal: Signs

Increased psychomotor activity; agitation; hyperthermia; diaphoresis; delirium; convulsions; elevated BP, pulse rate, and temperature; others

CBD

Cannabidiol: second most prevalent active ingredient of marijuana; Derived from the hemp plant; Does not cause a 'high'; To date, no evidence of abuse or dependence potential; Many CBD products, such as CBD oil, available without prescription; FDA has approved Epidiolex for seizure disorders

Alcohol (Ethanol)

More accurately known as ethanol (ETOH); Causes CNS depression by dissolving in lipid membranes in the CNS; Few legitimate uses of ethanol and alcoholic beverages; Used as a solvent for many drugs; Systemic uses of ethanol: treatment of methyl alcohol and ethylene glycol intoxication (e.g., from drinking automotive antifreeze solution)

CNS depression

Respiratory stimulation or depression; Ethanol: Vasodilation, producing warm, flushed skin

Alcohol Interactions

Interacts with medications that intensify sedative effects; Increases bioavailability of blood thinner warfarin with acetaminophen; Hepatotoxicity

Ethanol Withdrawal Treatment

Benzodiazepines are the treatment of choice; Dosage and frequency depend on severity; For severe withdrawal, monitoring in an intensive care unit is recommended.

Treatment for Alcoholism

Disulfiram (Antabuse); Acetaldehyde syndrome; Naltrexone; Acamprosate (Campral); Newest treatment; Counseling; Individual; Alcoholics anonymous

Nicotine

Many smoke to 'calm nerves'; Releases epinephrine, which creates physiologic stress rather than relaxation; Tolerance develops; Physical and psychologic dependency; Withdrawal symptoms occur if stopped; No therapeutic uses; 200 known poisons present in cigarette smoke.

Nicotine: Drug Effects

Transient stimulation of autonomic ganglia followed by more persistent depression of all autonomic ganglia; CNS and respiratory stimulation followed by CNS depression; Increased heart rate and BP; Increased bowel activity

Nicotine: Adverse Effects

Primarily affect the CNS; Large doses produce tremors and even convulsions; Respiratory stimulation commonly occurs; Increase heart rate and blood pressure; Increase tone and motor activity of bowel.

Nicotine: Withdrawal Treatment

Treatments provide nicotine without the carcinogens in tobacco; Nicotine transdermal system (patch); Nicotine polacrilex (gum); Inhalers; Nasal spray

Nicotine Withdrawal Treatment

Bupropion (Zyban): may be prescribed to aid in smoking cessation; Varenicline (Chantix): stimulates nicotine receptors; prescription medicine to treat nicotine dependence