Substance use is studied in psychology from personality, social, and biological perspectives. Social and personality studies of individuals with substance use disorders have produced a variety of theories. These theories have focused on issues such as difficulties people might have with tolerating stress, being unable to delay gratification, developing social skills, being socially isolated or marginalized, being attracted to taking risks, and having difficulties regulating one's own behavior. Additionally, environmental issues, such as poverty or high levels of stress, have been linked to substance use problems. Biological theories of these disorders suggest that genetic and conditioned sensitivities to substances of abuse and their effects may predispose individuals to acquire these disorders. For instance, people who have increased needs to seek relief from pain or have an increased need to seek pleasure or euphoria might be at greater risk for developing such problems. Pain is broadly defined as any feeling of dysphoria. Because both pain and euphoria can be produced by psychosomatic or somatopsychic events, these two biological categories can subsume most of the stated nonbiological correlates of substance abuse.
There are several forms of substance use disorders including abuse and dependence. These should be contrasted to normal experimentation, normal use without problems, and limited instances of misuse that are more appropriately attributed to situational factors than an underlying psychiatric disorder.
There are several types of substances of abuse, and some of these are not typically viewed as problematic. Major categories include alcohol; sedatives/ hypnotics; nicotine; marijuana; opioids, such as heroin; stimulants, including amphetamines, cocaine, crack, and caffeine; inhalants, such as glue, paint, nitrous oxide (laughing gas), and shoe polish; hallucinogens, including phencyclidine (PCP or "angel dust"), LSD ("acid"), MDMA (an amphetamine-like drug with hallucinogenic effects, also known as X or ecstasy); anabolic steroids; and even some types of prescription drugs, such as Valium.
When diagnoses are given for substance use disorders, diagnoses should be given in terms of a specific type of substance. A diagnosis of "substance abuse" would be too general because it does not specify the substance causing the problem. Having problems with one substance does not automatically mean that a person has problems with all substances. Thus, any diagnosis for a substance use disorder should be substance-specific; examples might include alcohol abuse, inhalant abuse, marijuana dependence, marijuana abuse, cocaine dependence, or stimulant abuse.
For the substance abuse category, the key features of the disorder are patterns of repeated problems in individual functioning in terms of roles at work, school, or home; legal status; use of the substance in hazardous situations, or the consequences of the use on interpersonal relationships. For the substance dependence category, the key features of the disorder are patterns of repeated problems in several areas that are distinct from those considered for abuse. Diagnosis of dependence relies on factors such as tolerance, withdrawal, new or worsened physical or emotional problems directly resulting from the use of the substance, loss of control over the use of the substance, unsuccessful efforts to cut down or quit coupled with intense desire to quit, excessive periods of time spent obtaining, using, or recovering from using the substance, and the displacement of social or occupational activities in order to use the substance.
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