Early and longer-lasting treatment reduces risk of substance use disorder most significantly.
Substance Abuse or Chemical Dependence
Substance abuse is a recognized medical brain disorder. It refers to the abuse of illegal or legal substances. Alcohol is the most common legal drug of abuse. Substance dependence describes abuse of drugs or alcohol that continues, even when serious problems related to their use have developed.
The Addiction Recovery Management Service (ARMS) specializes in supporting teenagers and young adults between the ages of 14 and 26 and their parents as they deal with their substance use and related problems.
The Center for Addiction Medicine at Mass General conducts cutting-edge research in addiction medicine, delivers clinical treatment for substance use disorders and provides advanced multidisciplinary training for addiction medicine.
The HOPE Clinic (Harnessing support for Opioid and substance use disorders in Pregnancy and Early childhood) provides care for pregnant women with substance use disorder and their infants from conception through early childhood.
The Inpatient Psychiatric Service located on Blake 11 at Massachusetts General Hospital cares for adults 18 years and older who need short-term, secure medical psychiatric treatment in an acute inpatient setting.
Substance Abuse or Chemical Dependence
What is substance abuse or dependence?
Substance abuse (alcohol or other drugs)
Substance abuse is a recognized health disorder. It refers to the abuse of illegal or legal substances. Alcohol is the most common legal drug of abuse. Substance abuse causes serious problems at work, school, in relationships, and with the law.
Substances that are often abused include:
Prescription drugs, such as pain pills, stimulants, or anxiety pills
Substance (drug) dependence
Substance dependence describes abuse of drugs or alcohol that continues even when serious problems related to their use have developed. Signs of dependence include:
You need more of the drug to get an effect.
You constantly think about getting or using the drug
You have withdrawal symptoms if you decrease or stop using the drug.
You spend a lot of time getting, using, and recovering from the effects of using drugs.
You withdraw from social and recreational activities.
You keep using the drug even though you are aware of the physical, psychological, economic, and family or social problems that are caused by your ongoing abuse.
What causes substance abuse or dependence?
The cause of substance abuse and dependence is unclear. It probably involves a mix of genetics, environment, and emotional factors. However, while the first use of drugs or alcohol is voluntary, continued use quickly changes how the brain feels pleasure. Using drugs repeatedly changes the structure of the brain so that a person no longer has control. Substance abuse is a disease that results in the compulsive need for the drug.
What are the symptoms of substance abuse or dependence?
The following are the most common behaviors that signal you have a problem with drug or alcohol abuse:
You get high on drugs or get drunk on a regular basis
You lie, especially about how much you are using or drinking
You avoid friends and family members
You have given up activities you used to enjoy, such as sports or spending time with non-using friends
You talk or think a lot about using drugs or alcohol
You believe you need to use or drink to have fun
You pressure others to use or drink
You get in trouble with the law
You take risks, such as sexual risks or driving under the influence of a substance
Your work performance suffers due to substance abuse before, after, or during working or business hours
You miss work due to substance use
You risk your financial security and that of your family to buy drugs or alcohol
You feel depressed, hopeless, or have suicidal feelings
The symptoms of drug or alcohol abuse may look like other medical problems or mental health conditions. Always consult your healthcare provider for a diagnosis.
How is substance abuse or dependence diagnosed?
A family doctor, healthcare provider, psychiatrist, or qualified mental health professional can diagnose substance abuse. Depending on the substance abused, the frequency of use, and the length of time since you last used, your doctor may note the following:
Little concern for hygiene
Unexpected problems in heart rate or blood pressure
Depression, anxiety, agitation, irritability, or sleep problems
Seizures and hallucinations seen in delirium tremens related to alcohol withdrawal
How is substance abuse or dependence treated?
Your healthcare provider will figure out the best treatment for you based on:
How old you are
Your overall health and medical history
How sick you are
How well you can handle specific medications, procedures, or therapies
How long the condition is expected to last
Your opinion or preference
Treatment for drug addiction is serious and complex. People who are addicted can’t simply stop using. Treatment programs involve many different components. You can take part in inpatient or outpatient treatment programs for substance abuse. Programs are usually based on the type of substance abused. Programs include:
Detoxification, if needed
Medicines for withdrawal, to lessen cravings, and to restore normal brain function
Long-term medical follow-up and support
Counseling for both you and any family affected
What are possible complications of substance abuse or dependence?
Complications of drug abuse or dependence vary depending of the drug or substance being used. They may include:
Increased risk for infections, such as HIV and other sexually transmitted infections
Injuries to yourself or others
Thoughts of suicide
Fatal accidental overdoses
Can substance abuse or dependence be prevented?
There are many things you can do to prevent substance abuse or dependence in your home and community, including:
Follow alcohol and drug control laws and policies. This includes maintaining the age 21 minimum legal drinking age and prohibiting the sale of alcohol to intoxicated persons.
Empower young people not to drink or use other drugs.
Store prescription medicine and alcohol safely.
Properly dispose of any medications. Do not share prescription drugs with others.
Key points about substance abuse or dependence
Substance abuse is a recognized health disorder that refers to the abuse of illegal or legal substances.
Substance abuse causes serious problems at work, school, in relationships, and with the law.
Substance dependence describes the abuse of drugs or alcohol that continues even when serious problems related to their use have developed.
There are many different treatment programs for substance abuse. You may need inpatient or outpatient help or a combination of both approaches.
Substance abuse is a lifelong condition that requires ongoing attention to manage.
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your provider if you have questions.
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