Addiction & Substance Use Disorders
Compassionate Support for Those Facing Addiction and Substance Use Disorders
Opioid Use Disorder (OUD)
Opioids produce high levels of positive reinforcement, increasing the odds that people will continue using them despite negative resulting consequences. Opioid use disorder is a chronic lifelong disorder, with serious potential consequences including disability, relapses, and death. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition describes opioid use disorder as a problematic pattern of opioid use leading to problems or distress, with at least two of the following occurring within a 12-month period:
- Taking larger amounts or taking drugs over a longer period than intended.
- Persistent desire or unsuccessful efforts to cut down or control opioid use.
- Spending a great deal of time obtaining or using the opioid or recovering from its effects.
- Craving, or a strong desire or urge to use opioids
- Problems fulfilling obligations at work, school, or home.
- Continued opioid use despite having recurring social or interpersonal problems.
- Giving up or reducing activities because of opioid use.
- Using opioids in physically hazardous situations.
- Continued opioid use despite ongoing physical or psychological problems likely to have been caused or worsened by opioids.
- Tolerance (i.e., need for increased amounts or diminished effect with continued use of the same amount)
- Experiencing withdrawal (opioid withdrawal syndrome) or taking opioids (or a closely related substance) to relieve or avoid withdrawal symptoms
Opioid use disorder has many similarities to other substance use conditions, but it also includes some distinct challenges. Physical dependence can occur quickly sometimes in as little as 4 to 8 weeks. For individuals who have used opioids for a long time, stopping suddenly can cause intense withdrawal symptoms such as body aches, chills, cramps, diarrhea, anxiety, restlessness, nausea, vomiting, trouble sleeping, and powerful cravings. These symptoms can make it extremely difficult to stop without support, as people often continue using opioids to avoid feeling so unwell.
Alcohol Use Disorder (AUD)
Alcohol use disorder (AUD) is a medical condition described as an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It includes the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and an informal term, alcoholism. It is considered a brain disorder, AUD can be mild, moderate, or severe. Lasting changes in the brain caused by alcohol misuse perpetuate AUD and make individuals vulnerable to relapse.
The good news is that no matter how severe the problem may seem, evidence-based treatment with behavioral therapies, mutual-support groups, and/or medications can help people with AUD achieve and maintain recovery. The national survey shows that about 14.1 million adults ages 18 and older had AUD in 2019. Among youth, approximately 414,000 adolescents ages 12–17 had AUD during this timeframe. (https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder).
Types of Treatment for AUD
Several evidence-based treatment approaches are available for AUD. One size does not fit all and a treatment approach that may work for one person may not work for another. Treatment can be outpatient and/or inpatient and be provided by specialty programs, therapists, and doctors.
Medications
Three medications are currently approved by the U.S. Food and Drug Administration to help people stop or reduce their drinking and prevent relapse: naltrexone (oral and long-acting injectable), acamprosate, and disulfiram. All these medications are non-addictive, and they may be used alone or combined with behavioral treatments or mutual-support groups.
Behavioral Therapies
Behavioral treatments—also called alcohol counseling or “talk therapy”—are provided by licensed clinicians and focus on helping individuals change their drinking behaviors. These treatments may include brief interventions, reinforcement-based approaches, therapies that strengthen motivation and teach coping and relapse-prevention skills, as well as mindfulness-based strategies.
Mutual-Support Groups
Mutual-support groups offer peer-based encouragement for reducing or stopping alcohol use. These meetings are widely available in most communities, often at little or no cost, and are offered at convenient times and locations—including growing options online. This accessibility makes them especially useful for individuals who may be at risk of relapse. When combined with medications and behavioral therapies provided by healthcare professionals, mutual-support groups can serve as a valuable additional layer of support.
Substance Use Disorder (SUD)
Substance use disorder (SUD) is a complex condition in which there is uncontrolled use of a substance despite harmful consequences. Individuals with SUD have an intense focus on using a certain substance(s) such as alcohol, tobacco, or illicit drugs, to the point where the person’s ability to function in day-to-day life becomes impaired. People keep using the substance even when they know it is causing or will cause problems. The most severe SUDs are sometimes called addictions.
People with a substance use disorder may have distorted thinking and behaviors. Changes in the brain’s structure and function are what cause people to have intense cravings, changes in personality, abnormal movements, and other behaviors. Brain imaging studies show changes in the areas of the brain that relate to judgment, decision making, learning, memory, and behavioral control.
Repeated substance use can cause changes in how the brain functions. These changes can last long after the immediate effect of the substance wears off, or in other words, after the period of intoxication. Intoxication is the intense pleasure, euphoria, calm, increased perception and sense, and other feelings that are caused by the substance. Intoxication symptoms are different for each substance.
When someone has a substance use disorder, they usually build up a tolerance to the substance, meaning they need larger amounts to feel the effects.
According to the National Institute on Drug Abuse, people begin taking drugs for a variety of reasons, including:
- To feel good — feeling of pleasure, “high” or “intoxication.”
- To feel better — relieve stress, forget problems, or feel numb.
- To do better — improve performance or thinking.
- Curiosity and peer pressure or experimenting.
People with substance use and behavioral addictions may be aware of their problem but not be able to stop even if they want and try to. The addiction may cause physical and psychological problems as well as interpersonal problems such as with family members and friends or at work. Alcohol and drug use is one of the leading causes of preventable illnesses and premature death nationwide.
Symptoms of substance use disorder are grouped into four categories:
- Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use.
- Social problems: substance use causes failure to complete major tasks at work, school, or home; social, work or leisure activities are given up or cut back because of substance use.
- Risky use: substance is used in risky settings; continued use despite known problems.
- Drug effects: tolerance (need for larger amounts to get the same effect); withdrawal symptoms (different for each substance).
It’s common for people to face a substance use disorder together with another mental health concern. Sometimes the mental health condition appears first, and in other cases, substance use can bring on or intensify psychiatric symptoms.
Treatment
Effective treatments for opioid use disorder are available, yet only about one in four individuals receive specialized care. At LANA Health Services, we offer Medication-Assisted Treatment (MAT), an evidence-based approach that combines FDA-approved medications with counseling and behavioral therapies.
Because brain chemistry plays a role in both mental health and substance use, medications may be prescribed to help stabilize chemical imbalances, reduce cravings, ease withdrawal symptoms, and block the euphoric effects of opioids.
Treatment often includes cognitive-behavioral strategies that build motivation, support lifestyle changes, and provide education on relapse prevention. Many individuals also benefit from participation in self-help groups such as Narcotics Anonymous.
MAT has been proven to help people remain engaged in treatment, reduce opioid use, lower the risk of overdose, and improve overall outcomes for those living with opioid use disorder.
Three FDA-approved medications are commonly used in the treatment of opioid use disorder:
Methadone – Helps prevent withdrawal symptoms and significantly reduces cravings. Once patients develop tolerance, it does not produce a euphoric effect. Methadone is available only through specially regulated treatment clinics.
Buprenorphine – Blocks the effects of other opioids and reduces or eliminates withdrawal symptoms and cravings. Buprenorphine can be prescribed for detoxification or long-term maintenance by specially trained and DEA-waivered physicians, nurse practitioners, and physician assistants in office-based settings.
Naltrexone – Prevents the euphoric effects of opioids by blocking opioid receptors. It is available in pill form or as a monthly injection and can be prescribed by office-based providers.
The National Institute on Drug Abuse (NIDA) makes it clear that these medications do not replace one addiction with another. When used as prescribed, they do not produce a “high.” Instead, they help reduce cravings and ease withdrawal, supporting the restoration of healthy brain function disrupted by opioid use disorder.
If you or someone you love is struggling, there’s no reason to wait. Contact Lana Health Services today to begin compassionate, evidence-based treatment for addiction and substance use disorders.
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