The criteria for a substance abuse disorder as set forth by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR) includes the repeated use of a substance for 12 straight months or longer despite adverse consequences. Substances can be legal, such as alcohol or medications, or illegal.
Social
Alcohol and other drugs can impair brain functioning. The severity of the impairment correlates with the amount of substance consumed. Changes in behavior that result from intoxication vary but in general the abuse of a substance results in a lack of control over one's behavior. Substance abusers might say inappropriate or hurtful comments while they are intoxicated, causing problems in relationships. They might also fail to keep plans with others and use the time to get high or recuperate from a night of drinking.
Lack of Control
Because control over behavior is diminished by substance use, individuals tend to take more risks while intoxicated. Drunken driving is a common risk-taking behavior. Driving while intoxicated increases the risk of a car accident because of a decrease in reflexes, coordination and concentration. According to Mother's Against Drunk Driving, three out of every 10 people in the United States will be involved in an alcohol-related car crash during their lives.
Neglect
The temporary high experienced while intoxicated can lead to the neglect of responsibilities. Substance abusers can become so preoccupied with using that it becomes their first priority. As more importance is placed on getting high, family, work and school obligations fall away. Household chores such as cooking, cleaning and throwing out the garbage might be avoided or foisted on another family member. According to the U.S. Department of Health and Human Services-- Substance Abuse and Mental Health Services Administration (SAMHSA), substance abusers are more likely to be late or absent from work, less productive and more injury prone on the job than non-substance abusers.
Dependence
Continued substance abuse can lead to the development of a dependence. Frequent drug use eventually leads to a need to increase the amount taken to obtain the desired effect because the body comes to tolerate lower doses. When drug use becomes heavy and prolonged, the body begins to crave the substance and suffer consequences of withdrawal when the amount of a substance in the body falls below a certain level. Common withdrawal symptoms are nausea, vomiting, nervousness, fatigue and sleep disturbances.
References
- "Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR); American Psychiatric Association"; 2000
- Mother's Against Drunk Driving
- Substance Abuse and Mental Health Services Administration: Why You Should Care About Having a Drug-free Workplace
