Substance use disorder

Definition of Disorder: For a condition to qualify as a disorder, it must involve dysfunction in some sort of occupation and lead to negative consequences affecting day-to-day functioning.
  - Considerations include:
    - Activities of Daily Living (ADLs)
    - Leisure activities
    - Familial relationships (friends and family)
    - Work performance
Consequences of Substance Use: Examples illustrating dysfunction from substance use:
  - Being reprimanded at work
  - Difficulties with attendance (e.g., falling asleep at work or not showing up)
  - Severe impairment (e.g., high on methamphetamine, hallucinating)
  - Inability to manage basic tasks (e.g., handling kitchen equipment safely)
Assessment of Baseline Functioning:
- The challenge in assessing a person’s baseline functioning due to ongoing substance use.
- Questioning whether true capability can be evaluated if the individual never stops using.

Personal Connections to Addiction: Reflection on how addiction has pervaded family experiences.
- Examples of personal connections include family members with visible ailments induced by substance use.
Prevalence of Addictions: It is noted that most people have encountered addiction in some form:
- Friends, family members, acquaintances may have struggled with addiction.
Genetic Component of Addiction:
- Addiction is often influenced by genetic predisposition, recognized within families over generations.
- Environmental influences shape whether genetic predisposition leads to actual addiction.

Connection to Trauma: Many individuals struggling with addiction find that substance use is a coping mechanism for trauma, including physical, emotional, or cognitive distress.
Functionality and Performance: Clients might initially use substances like methamphetamine to increase productivity but may then become dependent beyond work-related needs.

Compulsive Behavior: The compulsion to use substances often develops as users find temporary relief from their issues (pain, emotional dysregulation).
Intensiveness of Use: Dependence creeps into all aspects of their lives, not just work.

Engaging with Individuals: Importance of educational conversations with clients dealing with substance use—especially around their medications like lithium, impacting relationships and responsibilities.
Consequences of Treatment Decisions: Discussion surrounding how recovery choices and lifestyle habits affect personal relationships, especially familial ties.

Impact Beyond The User: The consequences of addiction ripple through families, friends, and communities, impacting every layer of support around the individual.
Social Circles: Those deep in addiction may gravitate towards others with similar issues, reinforcing their behaviors.

Classification of Disorders: Substance use disorders are identified in the DSM-5 as clusters of cognitive, behavioral, and physiological symptoms leading to ongoing substance use despite adverse consequences.
Types of Substances: Includes but is not limited to:
  - Alcohol
  - Cannabis
  - Stimulants (e.g., methamphetamine)
  - Hallucinogens (e.g., acid, mushrooms)
  - Tobacco and others

Eleven Criteria for Diagnosis: Criteria for a substance use disorder includes:
  - Social impairments (relationships, work)
  - Lack of control over substance use
  - Risky behavior usage
  - Preoccupation with acquisition or recovery from use
  - Lack of use stemming from legitimate medical treatments
  - Experiences of cravings or withdrawal symptoms
Cravings and Withdrawal:
- Cravings manifest as intense, insatiable urges to use substances, leading to irritability when not fulfilled.

Legal Issues: Substance use often leads to legal problems, especially when engaging in illegal activities to support addiction. Notable points include:
- Consequences of decriminalization in certain states (e.g., Oregon) leading to treatment dilemmas.
Physiological and Psychological Impact: Discussion around how addiction affects brain structure and function:
- Impacts on reward systems, reducing overall pleasure without the substance, leading to a cycle of dependence and harm.
- Neuroplasticity reinforces behaviors related to addiction while weakening self-control.

Chronic Health Implications: Long-term use can result in:
- Grey and white matter changes in the brain,
- Increased risk of secondary health issues due to addiction (like respiratory diseases and early dementia).

Prevalence Among Youth: 4.6% of 12 to 17-year-olds have an alcohol use disorder, with the risk increasing significantly in older populations.
Consequences of Use: Increased incidents of accidents associated with alcohol use, leading to significant medical or legal repercussions.

Criteria for Gambling Disorders: Defined by the DSM-5, similar to substance use disorders, highlighting problematic behavior related to gambling that leads to distress and impairment. Specific signs include:
  - Increased use to achieve excitement (tolerance)
  - Irritability and restlessness when trying to reduce or stop
  - Deception regarding involvement with gambling
  - Impact on significant life aspects (relationships, jobs)

Reflection on Understanding Addiction: Discussion on how family experiences inform understanding and empathy towards individuals suffering from addiction—an emphasis on growth in perspective rather than a complete overhaul of beliefs.