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Overview of Substance-Related Disorders

By

Mashal Khan

, MD, Weill Cornell Medicine

Last full review/revision Dec 2020| Content last modified Dec 2020
CLICK HERE FOR THE PROFESSONAL VERSION
Topic Resources

Substance-related disorders can arise when drugs that directly activate the brain's reward system are taken for the feelings of pleasure they induce. The pleasurable sensations vary with the drug. The drugs are divided into 10 different classes based on the different effects they produce in the body:

Substance-related disorders can develop whether or not a drug is legal, is socially acceptable, or has an accepted medical use (with or without a prescription). Details about specific drugs and their effects are discussed elsewhere in THE MANUAL.

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Types of Substance-Related Disorders

Substance-related disorders are usually broken down into two groups:

Substance-induced disorders are problems caused by the direct effects of a drug and include

  • Intoxication

  • Withdrawal

  • Substance-induced mental disorders

Substance use disorders generally involve behavior patterns in which people continue to use a substance despite having problems caused by its use.

Drugs in the 10 classes vary in how likely they are to cause a substance use disorder. The likelihood is termed addiction liability and depends upon a combination of factors including

Definitions

The terms "addiction," "abuse," and "dependence" have traditionally been used in regard to people with substance use disorders. However, those terms are all too loosely and variably defined to be very useful and also are often used judgmentally. Thus, doctors now prefer to use the more comprehensive and less negative term "substance use disorder."

In discussions about controlled substances and drug use, the term "narcotics" is often used. This term refers to drugs that cause loss of feeling, a sense of numbness, and drowsiness, specifically opioids Opioids Opioids are a class of drugs derived from the opium poppy (including synthetic variations) that are pain relievers with a high potential for misuse. Opioids are used to relieve pain, but they... read more (drugs that bind to opiate receptors on cells). However, the term "narcotics" is also used in a broader (and inaccurate) sense to include any drug that is illegal or used illegitimately.

Scheduled Drugs

The Comprehensive Drug Abuse Prevention and Control Act (Controlled Substances Act) was implemented in the United States in 1970 and modified over the years to regulate the manufacture and distribution of certain classes of drugs, or controlled substances (see table Some Examples of Controlled Substances Some Examples of Controlled Substances* Drugs are an integral part of everyday life for many people, whether the drugs are used for legitimate medical purposes or recreationally (see table Drugs with Medical and Recreational Uses)... read more ).

Controlled substances are divided into 5 schedules (or classes) based on their potential for abuse, how accepted they are for medical use, and how safe they are when used under medical supervision. Schedule I drugs are considered the most harmful and therefore have the tightest controls. Schedule V drugs are considered the least harmful and are widely available. State and federal schedules may differ (see also US Drug Enforcement Administration Drug Schedules).

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More Information

The following are some English-language resources that may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

NOTE: This is the Consumer Version. DOCTORS: CLICK HERE FOR THE PROFESSONAL VERSION
CLICK HERE FOR THE PROFESSONAL VERSION
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Test your knowledge
Avoidant/Restrictive Food Intake Disorder
Avoidant/restrictive food intake disorder is an eating disorder characterized by eating very little food and/or avoiding eating certain foods. Which of the following symptoms is most characteristic of a person with this disorder?
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