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__NOTOC__
{{SI}}
'''For patient information click [[Substance abuse (patient information)|here]]'''
'''For patient information click [[Substance abuse (patient information)|here]]'''


{{CMG}}; {{AE}}
{{CMG}}; {{AE}} {{Uma}}
 


{{SK}}  
{{SK}}


==Overview==
==Overview==


==Historical Perspective==
==Historical Perspective==
[Disease name] was first discovered by [name of scientist], a [nationality + occupation], in [year]/during/following [event].
*Substance abuse has been around for centuries
 
*Dr. Benjamin Rush was one of the primary researchers in substance abuse
The association between [important risk factor/cause] and [disease name] was made in/during [year/event].
*The technology to tackle the "intricacies to tack the cellular response to the drugs"  were not present at the time.
 
In [year], [scientist] was the first to discover the association between [risk factor] and the development of [disease name].
 
In [year], [gene] mutations were first implicated in the pathogenesis of [disease name].
 
There have been several outbreaks of [disease name], including -----.
 
In [year], [diagnostic test/therapy] was developed by [scientist] to treat/diagnose [disease name].


==Classification==
==Classification==
There is no established system for the classification of [disease name].
OR
[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].
OR
[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3].
[Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].
OR
Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
OR
If the staging system involves specific and characteristic findings and features:
According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
OR
The staging of [malignancy name] is based on the [staging system].


OR
Alcoholism may be classified according to its symptomatic expression into three distinguished types:<ref name="RobinsonAdinoff2016">{{cite journal|last1=Robinson|first1=Sean|last2=Adinoff|first2=Bryon|title=The Classification of Substance Use Disorders: Historical, Contextual, and Conceptual Considerations|journal=Behavioral Sciences|volume=6|issue=3|year=2016|pages=18|issn=2076-328X|doi=10.3390/bs6030018}}</ref>
*episodic excessive drinking
*habitual excessive drinking
*dependency of alcohol.


There is no established system for the staging of [malignancy name].


==Pathophysiology==
==Pathophysiology==
The exact pathogenesis of [disease name] is not fully understood.
*The pathogenesis of substance abuse is not definitive.<ref name="RobinsonAdinoff2016">{{cite journal|last1=Robinson|first1=Sean|last2=Adinoff|first2=Bryon|title=The Classification of Substance Use Disorders: Historical, Contextual, and Conceptual Considerations|journal=Behavioral Sciences|volume=6|issue=3|year=2016|pages=18|issn=2076-328X|doi=10.3390/bs6030018}}</ref>
 
*Medical practitioners, instead, use symptoms to determine what the disease is
OR
*This arises problems because clinicians are not able to diagnose the disorder as effectively as systematic clinical visits
*First et al. [citation] and other analysis provides evidence that clinicians
**"were most likely making DSM diagnoses using a method other than by evaluating each of the diagnostic criteria in sequence." [citation]


It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
OR
[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
OR
Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
OR
[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
OR
The progression to [disease name] usually involves the [molecular pathway].
OR
The pathophysiology of [disease/malignancy] depends on the histological subtype.


==Causes==
==Causes==
Disease name] may be caused by [cause1], [cause2], or [cause3].


OR
*Substance abuse can emerge later on in life, but can still be influenced by factors from one's childhood.<ref name="Scheller-GilkeyThomas2002">{{cite journal|last1=Scheller-Gilkey|first1=G.|last2=Thomas|first2=S. M.|last3=Woolwine|first3=B. J.|last4=Miller|first4=A. H.|title=Increased Early Life Stress and Depressive Symptoms in Patients With Comorbid Substance Abuse and Schizophrenia|journal=Schizophrenia Bulletin|volume=28|issue=2|year=2002|pages=223–231|issn=0586-7614|doi=10.1093/oxfordjournals.schbul.a006933}}</ref>


Common causes of [disease] include [cause1], [cause2], and [cause3].
*Studies have found that early life stress and a tendency to have depression/ mental illnesses has proven to lead to substance abuse disorder later in life


OR
==Differentiating Substance Abuse from other Diseases==
 
The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].
 
OR
 
The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click [[Pericarditis causes#Overview|here]].
 
==Differentiating ((Page name)) from other Diseases==
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].


Line 100: Line 46:


==Epidemiology and Demographics==
==Epidemiology and Demographics==
The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
This table uses data from [citation]. When talking about any disease, there are many demographic characteristics that may affect the trends of the disorder.  
 
OR
 
In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
 
OR
 
In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate of [number range]%.
 
 
 
Patients of all age groups may develop [disease name].
 
OR
 
The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.
 
OR
 
[Disease name] commonly affects individuals younger than/older than [number of years] years of age.
 
OR
 
[Chronic disease name] is usually first diagnosed among [age group].
 
OR
 
[Acute disease name] commonly affects [age group].
 
 
 
There is no racial predilection to [disease name].
 
OR
 
[Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].
 
 
 
[Disease name] affects men and women equally.
 
OR


[Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.


 
{| border="3"
 
|+ Population Analysis of the Percentages of Unauthorized Drugs
The majority of [disease name] cases are reported in [geographical region].
! Population Composition !! Percent Total of Population
 
|-
OR
! Row heading 1
 
| Cell 2 || Cell 3
[Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].
|-
! Row heading A
|Cell B
|Cell C
|}


==Risk Factors==
==Risk Factors==
There are no established risk factors for [disease name].
OR
The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].
OR
Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
OR


Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.
*Alcohol is one of the oldest "psychoactive substances" that humankind has known.<ref name="RobinsonAdinoff2016">{{cite journal|last1=Robinson|first1=Sean|last2=Adinoff|first2=Bryon|title=The Classification of Substance Use Disorders: Historical, Contextual, and Conceptual Considerations|journal=Behavioral Sciences|volume=6|issue=3|year=2016|pages=18|issn=2076-328X|doi=10.3390/bs6030018}}</ref>
*Excessive drinking is a problem in the United States
*It can lead to intoxication
*Is the "third preventable leading cause of death in the United States."


==Screening==
==Screening==
There is insufficient evidence to recommend routine screening for [disease/malignancy].
OR


According to the [guideline name], screening for [disease name] is not recommended.
*It is essential that the screening process be structured an thorough, so the client is properly diagnosed
 
*Substance abuse cannot be detected with a simple X-ray machine
OR
*The Alcohol Use Disorder Identification Test [citation] is a screening test for General Alcohol and Drug Abuse
 
**It is a ten-question survey that takes about two minutes to answer
According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with [condition 1], [condition 2], and [condition 3].
*Substance abuse could be the result of/ can lead to mental disorders
*According to the U.S. Preventive Services Task Force 2002 [citation], screening for psychiatric diseases need to be thorough and follow these four steps:
**"comprehensive assessment, accurate diagnosis, effective treatment, and careful followup." [citation]


==Natural History, Complications, and Prognosis==
==Natural History, Complications, and Prognosis==
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
*Cannabis use disorder is a type of substance abuse disorder that about 42.4% of the US population has developed in the past 3 years.<ref name="SarvetHasin2016">{{cite journal|last1=Sarvet|first1=Aaron L.|last2=Hasin|first2=Deborah|title=The natural history of substance use disorders|journal=Current Opinion in Psychiatry|volume=29|issue=4|year=2016|pages=250–257|issn=0951-7367|doi=10.1097/YCO.0000000000000257}}</ref>
 
*Although not conventional, warning signs include:
OR
**Reduced frequency of use
 
**Abusing the substance when using it
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
**Developing other medical conditions
 
OR
 
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.


==Diagnosis==
==Diagnosis==
===Diagnostic Study of Choice===
===Diagnostic Study of Choice===
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
OR
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
OR


There are no established criteria for the diagnosis of [disease name].
*It is common that people with substance abuse disorder also have a severe mental illness.<ref name="Santucci2012">{{cite journal|last1=Santucci|first1=Karen|title=Psychiatric disease and drug abuse|journal=Current Opinion in Pediatrics|volume=24|issue=2|year=2012|pages=233–237|issn=1040-8703|doi=10.1097/MOP.0b013e3283504fbf}}</ref>
*Mental illness can lead to a substance abuse disorder
*It has been recorded that about 7-10 million people in America possess at least one mental illness along with their substance abuse disorder.


===History and Symptoms===
===History and Symptoms===
The majority of patients with [disease name] are asymptomatic.
*Since substance abuse disorder is the result of abusing virtually any drug, there are an array of symptoms depending on the substance
 
*This disorder can be common in people with other illnesses
OR
*Researchers have seen a spike in the number of substance abuse cases among schizophrenia patients
 
*Many hold it to the "self-medication theory."
The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
*Since schizophrenia can lead to "social withdrawal, apathy, dysphoria, and sleeping problems", many patients self-medicate to get rid of the negative feelings.  
** Alcohol abuse among schizophrenic patients may lead to over-the-top hallucinations and delusions
** Cannabis abuse can lead to outrageous psychotic symptoms
** Cocaine abuse among schizophrenic patients, on the other hand, leads to a depressed mood.


===Physical Examination===
===Physical Examination===
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
Some common symptoms that doctors look for are:
 
*poor personal hygiene
OR
*significantly fluctuating weight
 
*marks on the skin that indicate injections,
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
*signs of withdrawal:
 
**slurred speech
OR
**uneasy eyes
 
**euphoria
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
**sweating
 
**runny nose
OR
**agitation
 
**sedation
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].


===Laboratory Findings===
===Laboratory Findings===
An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
*Some lab tests that check for substance abuse include blood-alcohol content and urine Breathalyzers
 
**Although they are legal and effective, they only check for current use of the substance
OR
*Urine tests are used across the spectrum of substance abuse, not just alcohol.
 
Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
 
OR
 
[Test] is usually normal among patients with [disease name].
 
OR
 
Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
 
OR
 
There are no diagnostic laboratory findings associated with [disease name].


===Electrocardiogram===
===Electrocardiogram===
There are no ECG findings associated with [disease name].
There are no ECG findings associated with substance abuse.
 
OR
 
An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].


===X-ray===
===X-ray===
There are no x-ray findings associated with [disease name].
There are no x-ray findings associated with substance abuse.
 
OR
 
An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].


===Echocardiography or Ultrasound===
===Echocardiography or Ultrasound===
There are no echocardiography/ultrasound findings associated with [disease name].
There are no echocardiography/ultrasound findings associated with substance abuse.
 
OR
 
Echocardiography/ultrasound  may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
There are no echocardiography/ultrasound  findings associated with [disease name]. However, an echocardiography/ultrasound  may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].


===CT scan===
===CT scan===
There are no CT scan findings associated with [disease name].
There are no CT scan findings associated with substance abuse.
 
OR
 
[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].


===MRI===
===MRI===
There are no MRI findings associated with [disease name].
There are no MRI findings associated with substance abuse.
 
OR
 
[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].


===Other Imaging Findings===
===Other Imaging Findings===
There are no other imaging findings associated with [disease name].
There are no other imaging findings associated with [disease name].
OR
[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].


===Other Diagnostic Studies===
===Other Diagnostic Studies===
There are no other diagnostic studies associated with [disease name].
There are no other diagnostic studies associated with [disease name].
OR
[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].


==Treatment==
==Treatment==
===Medical Therapy===
===Medical Therapy===
There is no treatment for [disease name]; the mainstay of therapy is supportive care.
OR
Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].
OR
The majority of cases of [disease name] are self-limited and require only supportive care.
OR
[Disease name] is a medical emergency and requires prompt treatment.
OR
The mainstay of treatment for [disease name] is [therapy].
OR
 
The optimal therapy for [malignancy name] depends on the stage at diagnosis.
OR
[Therapy] is recommended among all patients who develop [disease name].


OR
*Substance abuse affects different circuits in the brain.<ref name="BariDiCesare2018">{{cite journal|last1=Bari|first1=Ausaf|last2=DiCesare|first2=Jasmine|last3=Babayan|first3=Diana|last4=Runcie|first4=Mariama|last5=Sparks|first5=Hiro|last6=Wilson|first6=Bayard|title=Neuromodulation for substance addiction in human subjects: A review|journal=Neuroscience & Biobehavioral Reviews|volume=95|year=2018|pages=33–43|issn=01497634|doi=10.1016/j.neubiorev.2018.09.013}}</ref>
**Standard medications and therapy, although helpful, cannot cure this disease
*People with this disorder have a tendency to relapse if treated with these types of medical therapies
*A field of medicine called neuromodulation has made advances in target and enhance treatment
**This method has proven effective for certain movement disorders such as epilepsy and OCD
**The data and interest in applying this to addiction is rapidly increasing


Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
OR
Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
OR
Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
OR
Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].


===Surgery===
===Surgery===
Surgical intervention is not recommended for the management of [disease name].
*Surgery is not recommended to prevent substance relapse
 
**this disorder can damage parts of the body that may require surgery to fix
OR
 
Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
 
OR
 
The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
 
OR
 
The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
 
OR
 
Surgery is the mainstay of treatment for [disease or malignancy].


===Primary Prevention===
===Primary Prevention===
There are no established measures for the primary prevention of [disease name].


OR
*The first step to preventing this disease is an intervention.<ref name="DasSalam2016">{{cite journal|last1=Das|first1=Jai K.|last2=Salam|first2=Rehana A.|last3=Arshad|first3=Ahmed|last4=Finkelstein|first4=Yaron|last5=Bhutta|first5=Zulfiqar A.|title=Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews|journal=Journal of Adolescent Health|volume=59|issue=4|year=2016|pages=S61–S75|issn=1054139X|doi=10.1016/j.jadohealth.2016.06.021}}</ref>
*Interventions are not easy to complete successfully
** However, intensive family interventions and mass media campaigns are some methods that have proven to be effective.


There are no available vaccines against [disease name].
OR
Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
OR
[Vaccine name] vaccine is recommended for [patient population] to prevent [disease name]. Other primary prevention strategies include [strategy 1], [strategy 2], and [strategy 3].


===Secondary Prevention===
===Secondary Prevention===
There are no established measures for the secondary prevention of [disease name].
*The next step after the intervention is providing intensive care:<ref name="FischerBlanken2015">{{cite journal|last1=Fischer|first1=Benedikt|last2=Blanken|first2=Peter|last3=Da Silveira|first3=Dartiu|last4=Gallassi|first4=Andrea|last5=Goldner|first5=Elliot M.|last6=Rehm|first6=Jürgen|last7=Tyndall|first7=Mark|last8=Wood|first8=Evan|title=Effectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: A comprehensive narrative overview of English-language studies|journal=International Journal of Drug Policy|volume=26|issue=4|year=2015|pages=352–363|issn=09553959|doi=10.1016/j.drugpo.2015.01.002}}</ref>
 
**Therapy and another psycho/socio care
OR
**Although these are valid tactics in the journey of recovery from substance abuse, they are understudied and require more research before they can be named "gold standard" treatment options
 
Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3].


==References==
==References==

Latest revision as of 14:59, 3 November 2020

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Ongoing Trials on Substance abuse at Clinical Trials.gov

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Guidelines / Policies / Govt

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For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Uma Maveli[2]


Synonyms and keywords:

Overview

Historical Perspective

  • Substance abuse has been around for centuries
  • Dr. Benjamin Rush was one of the primary researchers in substance abuse
  • The technology to tackle the "intricacies to tack the cellular response to the drugs" were not present at the time.

Classification

Alcoholism may be classified according to its symptomatic expression into three distinguished types:[1]

  • episodic excessive drinking
  • habitual excessive drinking
  • dependency of alcohol.


Pathophysiology

  • The pathogenesis of substance abuse is not definitive.[1]
  • Medical practitioners, instead, use symptoms to determine what the disease is
  • This arises problems because clinicians are not able to diagnose the disorder as effectively as systematic clinical visits
  • First et al. [citation] and other analysis provides evidence that clinicians
    • "were most likely making DSM diagnoses using a method other than by evaluating each of the diagnostic criteria in sequence." [citation]


Causes

  • Substance abuse can emerge later on in life, but can still be influenced by factors from one's childhood.[2]
  • Studies have found that early life stress and a tendency to have depression/ mental illnesses has proven to lead to substance abuse disorder later in life

Differentiating Substance Abuse from other Diseases

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].

Epidemiology and Demographics

This table uses data from [citation]. When talking about any disease, there are many demographic characteristics that may affect the trends of the disorder.


Population Analysis of the Percentages of Unauthorized Drugs
Population Composition Percent Total of Population
Row heading 1 Cell 2 Cell 3
Row heading A Cell B Cell C

Risk Factors

  • Alcohol is one of the oldest "psychoactive substances" that humankind has known.[1]
  • Excessive drinking is a problem in the United States
  • It can lead to intoxication
  • Is the "third preventable leading cause of death in the United States."

Screening

  • It is essential that the screening process be structured an thorough, so the client is properly diagnosed
  • Substance abuse cannot be detected with a simple X-ray machine
  • The Alcohol Use Disorder Identification Test [citation] is a screening test for General Alcohol and Drug Abuse
    • It is a ten-question survey that takes about two minutes to answer
  • Substance abuse could be the result of/ can lead to mental disorders
  • According to the U.S. Preventive Services Task Force 2002 [citation], screening for psychiatric diseases need to be thorough and follow these four steps:
    • "comprehensive assessment, accurate diagnosis, effective treatment, and careful followup." [citation]

Natural History, Complications, and Prognosis

  • Cannabis use disorder is a type of substance abuse disorder that about 42.4% of the US population has developed in the past 3 years.[3]
  • Although not conventional, warning signs include:
    • Reduced frequency of use
    • Abusing the substance when using it
    • Developing other medical conditions

Diagnosis

Diagnostic Study of Choice

  • It is common that people with substance abuse disorder also have a severe mental illness.[4]
  • Mental illness can lead to a substance abuse disorder
  • It has been recorded that about 7-10 million people in America possess at least one mental illness along with their substance abuse disorder.

History and Symptoms

  • Since substance abuse disorder is the result of abusing virtually any drug, there are an array of symptoms depending on the substance
  • This disorder can be common in people with other illnesses
  • Researchers have seen a spike in the number of substance abuse cases among schizophrenia patients
  • Many hold it to the "self-medication theory."
  • Since schizophrenia can lead to "social withdrawal, apathy, dysphoria, and sleeping problems", many patients self-medicate to get rid of the negative feelings.
    • Alcohol abuse among schizophrenic patients may lead to over-the-top hallucinations and delusions
    • Cannabis abuse can lead to outrageous psychotic symptoms
    • Cocaine abuse among schizophrenic patients, on the other hand, leads to a depressed mood.

Physical Examination

Some common symptoms that doctors look for are:

  • poor personal hygiene
  • significantly fluctuating weight
  • marks on the skin that indicate injections,
  • signs of withdrawal:
    • slurred speech
    • uneasy eyes
    • euphoria
    • sweating
    • runny nose
    • agitation
    • sedation

Laboratory Findings

  • Some lab tests that check for substance abuse include blood-alcohol content and urine Breathalyzers
    • Although they are legal and effective, they only check for current use of the substance
  • Urine tests are used across the spectrum of substance abuse, not just alcohol.

Electrocardiogram

There are no ECG findings associated with substance abuse.

X-ray

There are no x-ray findings associated with substance abuse.

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with substance abuse.

CT scan

There are no CT scan findings associated with substance abuse.

MRI

There are no MRI findings associated with substance abuse.

Other Imaging Findings

There are no other imaging findings associated with [disease name].

Other Diagnostic Studies

There are no other diagnostic studies associated with [disease name].

Treatment

Medical Therapy

  • Substance abuse affects different circuits in the brain.[5]
    • Standard medications and therapy, although helpful, cannot cure this disease
  • People with this disorder have a tendency to relapse if treated with these types of medical therapies
  • A field of medicine called neuromodulation has made advances in target and enhance treatment
    • This method has proven effective for certain movement disorders such as epilepsy and OCD
    • The data and interest in applying this to addiction is rapidly increasing


Surgery

  • Surgery is not recommended to prevent substance relapse
    • this disorder can damage parts of the body that may require surgery to fix

Primary Prevention

  • The first step to preventing this disease is an intervention.[6]
  • Interventions are not easy to complete successfully
    • However, intensive family interventions and mass media campaigns are some methods that have proven to be effective.


Secondary Prevention

  • The next step after the intervention is providing intensive care:[7]
    • Therapy and another psycho/socio care
    • Although these are valid tactics in the journey of recovery from substance abuse, they are understudied and require more research before they can be named "gold standard" treatment options

References

  1. ↑ 1.0 1.1 1.2 Robinson, Sean; Adinoff, Bryon (2016). "The Classification of Substance Use Disorders: Historical, Contextual, and Conceptual Considerations". Behavioral Sciences. 6 (3): 18. doi:10.3390/bs6030018. ISSN 2076-328X.
  2. ↑ Scheller-Gilkey, G.; Thomas, S. M.; Woolwine, B. J.; Miller, A. H. (2002). "Increased Early Life Stress and Depressive Symptoms in Patients With Comorbid Substance Abuse and Schizophrenia". Schizophrenia Bulletin. 28 (2): 223–231. doi:10.1093/oxfordjournals.schbul.a006933. ISSN 0586-7614.
  3. ↑ Sarvet, Aaron L.; Hasin, Deborah (2016). "The natural history of substance use disorders". Current Opinion in Psychiatry. 29 (4): 250–257. doi:10.1097/YCO.0000000000000257. ISSN 0951-7367.
  4. ↑ Santucci, Karen (2012). "Psychiatric disease and drug abuse". Current Opinion in Pediatrics. 24 (2): 233–237. doi:10.1097/MOP.0b013e3283504fbf. ISSN 1040-8703.
  5. ↑ Bari, Ausaf; DiCesare, Jasmine; Babayan, Diana; Runcie, Mariama; Sparks, Hiro; Wilson, Bayard (2018). "Neuromodulation for substance addiction in human subjects: A review". Neuroscience & Biobehavioral Reviews. 95: 33–43. doi:10.1016/j.neubiorev.2018.09.013. ISSN 0149-7634.
  6. ↑ Das, Jai K.; Salam, Rehana A.; Arshad, Ahmed; Finkelstein, Yaron; Bhutta, Zulfiqar A. (2016). "Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews". Journal of Adolescent Health. 59 (4): S61–S75. doi:10.1016/j.jadohealth.2016.06.021. ISSN 1054-139X.
  7. ↑ Fischer, Benedikt; Blanken, Peter; Da Silveira, Dartiu; Gallassi, Andrea; Goldner, Elliot M.; Rehm, Jürgen; Tyndall, Mark; Wood, Evan (2015). "Effectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: A comprehensive narrative overview of English-language studies". International Journal of Drug Policy. 26 (4): 352–363. doi:10.1016/j.drugpo.2015.01.002. ISSN 0955-3959.


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