Psychiatry for Physicians - Substance Use Disorders

Substance use disorders are now a source of huge medical involvement with significant impact on all levels of economy. The main substances of abuse are always psychoactive. For centuries alcohol, coca leaves, opium, and cannabis are being used for the purpose of abuse. But most widely used substance is always tobacco. The term substance abuse is usually used to address a pattern of pathological use of a psychoactive substance for a significant duration of time that leads to impairment in social or occupational functioning, while substance dependence represents additional features like tolerance, dependence etc. In DSM-IV, the following disorders are enlisted as substance related

1. Alcohol use disorders
\r 2. Amphetamine use disorders
\r 3. Caffeine use disorders
\r 4. Cocaine use disorders
\r 5. Hallucinogen use disorders
\r 6. Inhalant use disorders
\r 7. Nicotine use disorders
\r 8. Opioid use disorders
\r 9. Phencyclidine use disorders
\r 10. Sedative, hypnotic, or anxiolytic substance use disorders
\r 11. Polysubstance use disorders
\r 12. Other substance use disorders

In DSM the criteria for substance dependence are described as below

1. Tolerance
\r 2. Withdrawal
\r 3. Unintentional overdose or longer period of use
\r 4. Persistent desire or unsuccessful efforts to substance use
\r 5. Spending a great deal of time in relation to substance use
\r 6. Activities are disturbed
\r 7. Continuation of abuse with the knowledge of its harmful effects

The DSM also has established some course specifiers for substance dependence. Also effort for distinguishing dependence and abuse is also there for clarifying similar issues. The criteria for substance abuse, excluding or differentiating from dependence, are

1. Recurrent substance use with interruption of major functions in daily life
\r 2. Recurrent substance use in physically hazardous situation
\r 3. Recurrent substance related legal problems
\r 4. Continuation of substance use despite many abrupt and severe problems occurring in relation to abuse

This article is constructed mainly to introduce the main scientific presentation overall. Description of specific substance related disorders will be presented in the following articles separately.

About the Author:

Dr. Mohammad Samir Hossain PhD is a researcher teacher of Psychiatry and a Psychotherapist in Bangladesh. He is renouned for his educational and research activity in mental health sector nationally and internationally. The Dictionary of International Biography cites his brief biography starting from its 33rd edition. One of the best educational institutions involved with his educational activity is the Harvard Medical School of USA. Visit his personal page at http://www.samirhossain.org

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