By Jay (John) Case, MD, Psychiatrist, Program Director at Virtua Behavioral Health
Chair of Psychiatry—Virtua Memorial Hospital

Substance use disorder, which is the medical diagnosis for what is commonly known as drug or alcohol addiction, is an incredibly complicated condition and very difficult to treat. It can have devastating effects on individuals, their families and, sometimes, entire communities. This is why it’s so important that we understand the condition and how to prevent it.

This complex condition includes biological and behavioral components and requires medical treatment. People who suffer from substance use disorder may not only develop other mental health and social problems, but the disease also can affect their physical health and safety—as well as the safety of others. Although it can be challenging to overcome, knowing the risk factors and warning signs can help prevent it.

What causes substance use disorder?

Years ago, there was a stigma surrounding addiction because it was viewed as something that was caused by a lack of willpower or morals. Although addiction still carries a stigma today, scientific research has shown that it’s a brain disease, which is why the diagnosis is substance use disorder.

Studies show that drug use triggers reward centers in the brain and causes the body to release chemicals that promote good feelings. Studies also show that tobacco, marijuana, stimulants, hallucinogens and opioids target different areas of the brain and, after continued use, biologically change the way the brain functions.

As the brain adapts to the drug and the increased “feel-good” chemicals, people with substance use disorder develop cravings for the drug—and symptoms of withdrawal when they don’t use it.

Although someone with substance use disorder initially may have chosen to use a drug, these biological changes promote dependence and ongoing drug use. After the brain adapts to the presence of the drug, people who suffer from this disorder will require increased amounts of the drug to achieve the same feelings.

What are the signs of substance use disorder?

A medical diagnosis of substance use disorder is based on four factors:

• Loss of control, including spending increased amounts of time using the drug or covering up its use, and wanting to stop, but being unable to do so.
• Social impairment, including absences from work or school, arguments with friends or family members and withdrawing from relationships.
• Risky use, including driving while under the influence or continuing to use the drug despite health problems.
• Biological criteria, including an increased tolerance for the drug, cravings and withdrawal symptoms.

Who is at risk for substance use disorder?

Anyone can develop substance use disorder, but not everyone is prone to it. Research shows that people who have a family or personal history of substance use disorder have a higher risk of developing the disease. That’s because these people often have genes that make them more likely to develop problems with it. People who begin using drugs at an early age also are at an increased risk.

Can you prevent substance use disorder?

Identifying the risks and symptoms of substance use disorder can stop it from progressing or prevent it altogether. Prevention typically follows a public health model, which involves restricting access to the drug and increasing education and awareness of its negative effects.

How is substance use disorder treated?

Because substance use disorder involves a complex interaction of biology and behavior, it requires personalized medical treatment. And because everyone with this disorder is different, treatment methods that work well for one person may not work for someone else. Treatment methods may include the following: 

• Inpatient treatment
• Outpatient treatment
• Support groups, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA)
• Peer counseling 

The Virtua Medication Assisted Treatment program, located in Voorhees, offers a combination of therapies on an outpatient basis to help individuals overcome opioid use disorders. We provide medical evaluation of patients with opioid use disorder, and prescribe FDA-approved medications such as Suboxone® and Vivitrol®, which are shown to be effective aiding people in recovery. In addition to medication management, our program provides:

• Psychotherapy, including substance abuse counseling and cognitive behavioral therapy
• Help with navigating to other needed services, including medical appointments and social service support

For more information, or to schedule an appointment, call 856-322-3110.