Substance Use Disorders

You can find heaps of information online about Substance Use Disorders – a broad term referring to the Category of Mental Disorder where misuse, overuse, illegal use, abuse, addiction and dependency on substances occurs. Most of this online information is a regurgitation of symptoms from the classification ‘bible’ DSM-5, which lists the features of different diagnoses like the ingredients of a cookbook! Despite these ‘descriptions’ being easily available, all the publicity about more common disorders has meant that education about ‘drug and alcohol abuse’ has has been somewhat neglected so the stereotypes and misunderstandings abound.  Another reason for dissatisfaction about the quality of information available about ‘drug and alcohol abuse’ disorders is that the DSM-5 classification system does not provide any ‘explanations’ or ‘causes’ and hence there is a lack of education about causes to the general public. Even we psychiatrists have not categorised causes in a way that is easily understood by the public, beyond using the term ‘biopsychosocial’ amongst ourselves, which refers to the biological, psychological and social factors contributing to any individual case of disorder. Because we have failed to adequately educate the public about these causes, I have ‘given a go’ to fill this gap in my eLearning education program! 
 

In fact, there are 3 different ‘types’ of ‘drug and alcohol abuse’ disorders  that we psychiatrists diagnose to help treat our patients. And an individual with ‘Psychosis’ might have a mixture of more than one cause. Hence, those with ‘drug and alcohol abuse’ disorders  often get the best outcomes from combinations of approaches – a management package – sometimes by more than one type of Help-Provider. Despite this, the treatment approach many people receive is too often dictated by the setting where the person goes for help or the type of Help-Provider a person seeks help from: some Help-Providers only offer medication, others only psychotherapy, some only life coaching, some only positive lifestyle factors. Whilst in many cases that may be adequate, what if it doesn’t adequately facilitate  recovery? 

Because each type of ‘drug and alcohol abuse’ disorder  tends to have a dominant cause, I’ve gone ‘Beyond DSM-5’ to divide all the common 6 Categories of Disorder (Mood, Anxiety, Personality, Psychotic, Substance Use and Eating Disorders) into 3 Explanatory SubTypes that reflects how most psychiatrists conceptualise mental health problems. 

For Psychotic Disorders, I have placed each of the 16 different types of ‘drug and alcohol abuse’ disorder  into 1 of their 3 causative subtypes: 
1.     The Mind subtype due to an underdeveloped or immature capacity for decision-making and coping skills and unhelpful scripts. This tends to explain 1 ‘drug and alcohol abuse’ diagnosis: (1) Substance Use Disorder-Mind Subtype (preoccupation with acquiring a substance without psychological or physical dependence)
2.     The Body subtype is due to ‘runaway feedback loops’ causing physical distress due to anxiety, pain, fatigue or nausea. This covers 1 diagnosis: (2) Substance Use Disorder-Body Subtype (preoccupation with acquiring a substance with psychological dependence)
3.     The Brain subtype is due to malfunctions, injuries & glitches. This explains 1 diagnosis: (3) Substance Use Disorder-Brain Subtype  (reward pathway brain networks taken over by mind-altering addictive substances)
 
Ok, but what is the common mechanism that leads to Substance Use Disorders? Well, when there is overuse or misuse of a substance, abuse of a high risk substance or physiological dependency on a substance develops, you have a problem.  I have depicted all of this information  pictorially, conversationally and pragmatically in eLearning...

 

Register