Substance-Related and Addictive Disorders: A Special Case

Substance-Related and Addictive Disorders: A Special Case

Addiction is often viewed as a chronic disease (Figure). The choice to use a substance is initially voluntary; however, because chronic substance use can permanently alter the neural structure in the prefrontal cortex, an area of the brain associated with decision-making and judgment, a person becomes driven to use drugs and/or alcohol (Muñoz-Cuevas, Athilingam, Piscopo, & Wilbrecht, 2013). This helps explain why relapse rates tend to be high. About 40%–60% of individuals relapse, which means they return to abusing drugs and/or alcohol after a period of improvement (National Institute on Drug Abuse [NIDA], 2008).

A chart labeled “Prevalence of Drug Use by Age Group” graphs “Age (years)” on the x axis and “Percentage of use” on the y axis. Note that the following percentages are estimates. According to this chart, 10 percent of people in the age range of 12–17 use illicit drugs, compared to 22 percent usage in the age range of 18–25, and 7 percent usage in the age range of 26 and older. 7.5 percent of people in the age range of 12–17 use marijuana, compared to 18 percent usage in the age range of 18–25, and 5 percent usage in the age range of 26 and older. 3 percent of people in the age range of 12–17 use psychotherapeutics, compared to 6 percent usage in the age range of 18–25, and 2.5 percent usage in the age range of 26 and older. 1 percent of people in the age range of 12–17 use inhalants. This number steadily drops off to 0 percent in the 26 and older age group. 1 percent of people in the age range of 12–17 use hallucinogens, compared to 2.5 percent usage in the age range of 18–25, and almost 0 percent usage in the age range of 26 and older. Cocaine use in the age range of 18–25 is around 2 percent, and it drops off to nearly 0 percent by the age range of 26 and older.
The National Survey on Drug Use and Health shows trends in prevalence of various drugs for ages 12–17, 18–25, and 26 or older.

The goal of substance-related treatment is to help an addicted person stop compulsive drug-seeking behaviors (NIDA, 2012). This means an addicted person will need long-term treatment, similar to a person battling a chronic physical disease such as hypertension or diabetes. Treatment usually includes behavioral therapy and/or medication, depending on the individual (NIDA, 2012). Specialized therapies have also been developed for specific types of substance-related disorders, including alcohol, cocaine, and opioids (McGovern & Carroll, 2003). Substance-related treatment is considered much more cost-effective than incarceration or not treating those with addictions (NIDA, 2012) (Figure).

A photograph shows a person injecting heroin intravenously with a hypodermic needle into her ankle.
Substance use and abuse costs the United States over $600 billion a year (NIDA, 2012). This addict is using heroin. (credit: "jellymc - urbansnaps"/Flickr)
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