1. Define substance use disorder and describe the social, physical and
psychological signs and symptoms associated with substance-related and
addictive disorders. The drinking patterns that lead to Alcohol-Related and
addictive disorders, for instance, are diverse but all can be considered from
four interconnecting aspects: sociocultural, behavioral/psychological,
physical and spiritual.
NB. P.296-à Sue et al.
Substance use is the maladaptive patterns of an individual which continues for a period of 12
months or more. It is characterized by a compulsive use of a substance which is defined by the
individual taking the substance in larger amounts or over a longer period than was originally
intended. Attempts to discontinue is often unsuccessful and the use of the substance affects
various life domains such as impaired control within one’s life, social impairment and risky health
factors associated with it. Excessive time is spent upon acquiring, using and recovering from the
effects of the substance.
1. The social, physical and psychological signs and symptoms associated with substance-
related and addictive disorders:
• Social signs: Use results in inability in fulfilling obligations at school, work or home.
Continues use despite it causing interpersonal problems, or interpersonal problems are
worsened by use.Reduced, or withdrawal from, social, occupational or recreational
activities.
• Physical signs: Recurrent use in situations which are physically hazardous. Use despite of
knowledge of recurrent physical or physical or psychological problems caused or
worsened by the substance.
• psychological signs: Tolerance; Increased dosage to achieve effects that were previously
achieved by lower dosages. Withdrawal: adverse symptoms when substance is not
consumed. In alcohol withdrawal, delirium tremens may occur. The person is likely to
resume using the substance to relieve or reduce the symptoms. Refer further notes.
• Symptoms associated with substance-related and addictive disorders:
A definite diagnosis according to the ICD-10, of dependence should usually be made only if three
or more of the following have been present together at some time during the previous year:
• A strong desire or senses of compulsion to take the substance.
1
, • Difficulties in controlling substance-taking behavior in terms of its onset, termination, or
levels of use.
• A physiological withdrawal state when substance use has ceased or been reduced, as
evidenced by: the characteristic withdrawal syndrome for the substance or use of the
same (or closely related) substance with the intention of relieving or avoiding withdrawal
symptoms.
• Evidence of tolerance, such that increased doses of the psychoactive substances are
required in order to achieve effects originally produced (clear examples of this are found
in alcohol- and opiate-dependent individuals who may take daily doses sufficient to
incapacitate or kill intolerant users).
• Progressive neglect of alternative pleasures or interests because of psychoactive
substance use; increased amount of time necessary to recover from its effects.
• Persisting with substance use despite clear evidence of overtly harmful consequences,
such as harm to the liver through excessive drinking, depressive mood states consequent
to periods of heavy substance use, or drug-related impairment of cognitive functioning.
Efforts should be made to determine that the user was actually, or could be expected to
be, aware of the nature and extent of the harm
2. The drinking patterns that lead to Alcohol-Related and addictive disorders, for instance,
are diverse but all can be considered from four interconnecting aspects: sociocultural,
behavioral/psychological, physical and spiritual.
2.1. Sociocultural Perspectives:
Alcohol:
Alcohol use had a number of significant consequences:
• Alcohol continues to be a significant cause of death in SA.
• Levels of alcohol were high for transport- and violence-related injuries, with 73% of
patients with violence-related injuries in PE and 46% of patients with transport-related
injuries in CPT having levels above the legal limit for driving.
• Alcohol use is linked to high-risk behaviors, which often involves impaired judgement, and
can lead to exposure to life-threatening situations. Risky sex, for example, may lead to
exposure to HIV and unwanted pregnancy.
• There are correlations between alcohol use and family violence.
• Academic failure and absenteeism.
2
psychological signs and symptoms associated with substance-related and
addictive disorders. The drinking patterns that lead to Alcohol-Related and
addictive disorders, for instance, are diverse but all can be considered from
four interconnecting aspects: sociocultural, behavioral/psychological,
physical and spiritual.
NB. P.296-à Sue et al.
Substance use is the maladaptive patterns of an individual which continues for a period of 12
months or more. It is characterized by a compulsive use of a substance which is defined by the
individual taking the substance in larger amounts or over a longer period than was originally
intended. Attempts to discontinue is often unsuccessful and the use of the substance affects
various life domains such as impaired control within one’s life, social impairment and risky health
factors associated with it. Excessive time is spent upon acquiring, using and recovering from the
effects of the substance.
1. The social, physical and psychological signs and symptoms associated with substance-
related and addictive disorders:
• Social signs: Use results in inability in fulfilling obligations at school, work or home.
Continues use despite it causing interpersonal problems, or interpersonal problems are
worsened by use.Reduced, or withdrawal from, social, occupational or recreational
activities.
• Physical signs: Recurrent use in situations which are physically hazardous. Use despite of
knowledge of recurrent physical or physical or psychological problems caused or
worsened by the substance.
• psychological signs: Tolerance; Increased dosage to achieve effects that were previously
achieved by lower dosages. Withdrawal: adverse symptoms when substance is not
consumed. In alcohol withdrawal, delirium tremens may occur. The person is likely to
resume using the substance to relieve or reduce the symptoms. Refer further notes.
• Symptoms associated with substance-related and addictive disorders:
A definite diagnosis according to the ICD-10, of dependence should usually be made only if three
or more of the following have been present together at some time during the previous year:
• A strong desire or senses of compulsion to take the substance.
1
, • Difficulties in controlling substance-taking behavior in terms of its onset, termination, or
levels of use.
• A physiological withdrawal state when substance use has ceased or been reduced, as
evidenced by: the characteristic withdrawal syndrome for the substance or use of the
same (or closely related) substance with the intention of relieving or avoiding withdrawal
symptoms.
• Evidence of tolerance, such that increased doses of the psychoactive substances are
required in order to achieve effects originally produced (clear examples of this are found
in alcohol- and opiate-dependent individuals who may take daily doses sufficient to
incapacitate or kill intolerant users).
• Progressive neglect of alternative pleasures or interests because of psychoactive
substance use; increased amount of time necessary to recover from its effects.
• Persisting with substance use despite clear evidence of overtly harmful consequences,
such as harm to the liver through excessive drinking, depressive mood states consequent
to periods of heavy substance use, or drug-related impairment of cognitive functioning.
Efforts should be made to determine that the user was actually, or could be expected to
be, aware of the nature and extent of the harm
2. The drinking patterns that lead to Alcohol-Related and addictive disorders, for instance,
are diverse but all can be considered from four interconnecting aspects: sociocultural,
behavioral/psychological, physical and spiritual.
2.1. Sociocultural Perspectives:
Alcohol:
Alcohol use had a number of significant consequences:
• Alcohol continues to be a significant cause of death in SA.
• Levels of alcohol were high for transport- and violence-related injuries, with 73% of
patients with violence-related injuries in PE and 46% of patients with transport-related
injuries in CPT having levels above the legal limit for driving.
• Alcohol use is linked to high-risk behaviors, which often involves impaired judgement, and
can lead to exposure to life-threatening situations. Risky sex, for example, may lead to
exposure to HIV and unwanted pregnancy.
• There are correlations between alcohol use and family violence.
• Academic failure and absenteeism.
2
