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Substance
Related Disorders
Substance-Related Disorders refer to not only the chemical upon
which abuse or dependence has occurred, but also the nature of the
impact of the substance use has had upon the individual. This can vary
from abuse to dependence and from hallucinations to
delusions to delirium. Substance abuse or dependence can result in
mood, anxiety, sleep and sexual disorders as well as problems arising
from withdrawal. Agents ranging from alcohol to cocaine to cannabis,
hallucinogens, inhalants, opioids, phencyclidine, inhalants and
sedatives can be of concern.
Alcohol:
When considering substance related disorders like alcohol abuse
or dependence, you need to think in terms of the moods and behaviors
that arise from intoxication as well as the physical problems which
arise from withdrawal from the substance. The morbidity and mortality
from alcohol, the most frequently used brain depressant, with 60% of
males and 30% of females having at least one alcohol related adverse
life event. There are psychological disorders that arise from the
dependence upon alcohol and its abuse. These include dementia,
amnesia, delusions, hallucinations, mood disorder, sleep disorder,
anxiety disorder and sexual disorder. Not surprisingly, alcohol,
the most commonly abused substance, is often an attempt at
self-medicating the very problems that it creates.
Opioid-Related Disorder (including
syntheric opiates) can be associated with abuse and dependence. The
discontinuation of the medication can be related to withdrawal and
overuse can be associated with intoxication, and dependent upon
patient and dosage, psychotic symptoms with hallucinations and/or
delusions. The medications themselves can create their own clinical
manifestation of mood disorder. Sleep disorder due to changes in sleep
architecture and sexual dysfunction may occur.
Sedative-, Hypnotic-, or Anxiolytic-Related
Disorders: There are
several sedative, hypnotic and anxiolytic disorders. Hypnotics are
used for treatment of sleep disorders, anxiolytics are used for the
treatment of a range of anxiety disorders. All three groups of agents,
if not properly regulated can result in dependence, and all three are
open to abuse. In some cases intoxication, withdrawal, delirium,
amnesia, mood, sleep, sexual and other symptom patterns may arise. In
some cases hallucinations may occur even though the individual is
aware that the hallucinations are caused by the medication (does not
believe the hallucinations to be real). However, these medications,
when dispensed and used appropriately, can be quite effective as an
adjunct to the treatment of a range of disorders and should be taken
according to guidelines and not avoided due to fear.
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