Substance use disorder: dependence is not addiction
Defines substance use disorder (SUD), its severity levels and hallmarks, and separates physical dependence (tolerance and withdrawal) from the disorder itself.
Where this fitsConnects to 2 · Unlocks 1
- Connects to
- Acute and chronic effects: up- and down-regulation — Physical dependence is receptor up- and down-regulation.
- The course lens: biopsychosocial, and no 'chemical imbalance' — Comorbidity and the biopsychosocial lens shape how SUD is diagnosed and treated.
- Unlocks
- The reward circuit: reinforcement and dopamine — Next: what happens in the brain to produce loss of control.
Orient
DSM-5 substance use disorder – a category that lets experts diagnose people by looking at a continuum of severity: mild, moderate, severe. Chronic drug use leads to tolerance and withdrawal, i.e., dependency on the drug. But “addiction” (substance use disorder) is more than dependency – it is a disorder, which also needs compulsive use, adverse consequences of use, and preoccupation/obsession with obtaining, using, and recovering from substance.
Course terms
Your professor's wording, word for word from the slides. Learn the term and this definition — the explanation underneath is only there to help it make sense.
- Substance use disorder (SUD)
“New category allows experts to diagnose people with an alcohol and/or drug problem more easily by looking at a continuum of severity”Slides 06, p. 1
Mild, moderate, severe; specific forms such as opioid use disorder, alcohol use disorder.
- Physical dependence
“Physical dependence – down/upregulation”Slides 06, p. 1
Tolerance and withdrawal — not the same as a disorder.
- Compulsive use
“Compulsive use (using when not intending to, trying and failing to stop, inability to control use)”Slides 06, p. 2
Hallmark 1.
- Adverse consequences
“Adverse consequences of use (while continuing to use)”Slides 06, p. 2
Hallmark 2.
- Preoccupation
“Preoccupation/obsession with obtaining, using, and recovering from substance”Slides 06, p. 2
Hallmark 3.
- Dual diagnosis
“Often a dual diagnosis (major depressive disorder most common)”Slides 06, p. 2
Assume comorbidities when diagnosing and treating.
From your course: Course slides 06, pp. 1–5
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