Substance Use Disorders

by

Anna Mangum, Diana Ling, Mary Velasquez

• LAST MODIFIED: 19 February 2025
• DOI: 10.1093/obo/9780195389678-0342

Introduction

Substance use disorders (SUDs) are medical and mental health conditions that affect millions of people worldwide, of all ages, races, genders and socioeconomic levels. Men are affected at a higher rate than women, but substance misuse among women is increasing. SUDs range from mild to severe and occur when the use of alcohol and/or other legal or illicit drugs cause clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, and/or home. The disorders are recurrent and often serious, but treatable, and many people do recover. The most severe SUDs are sometimes called “addictions,” though the terms “addiction” or “addicts” can be stigmatizing. This terminology often poses a barrier to seeking and receiving help. In more recent work, the term that is used in professional and clinical contexts is “substance misuse.” According to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision, SUDs encompass ten separate classes of legal and illicit drugs: alcohol; caffeine; cannabis (marijuana); hallucinogens; inhalants; opioids; sedatives, hypnotics or anxiolytics; stimulants (amphetamine-type substances, cocaine, etc.); and tobacco. The overall costs of SUDs to individuals, their families, and their communities are staggering. These costs include compromised physical and mental health; reduced quality of life; increased crime and violence; increased motor vehicle crashes; abuse and neglect of children; loss of productivity; and health care costs. The United States ranks twenty-seventh among developed countries in life expectancy; the rate has plateaued and is declining for certain subpopulations. This trend is due largely to substance misuse. This article outlines a comprehensive range of resources on the complex, evolving subject of SUDs, through a social work lens. It begins with a general overview of SUDs, followed by works on diagnosis, and resources regarding SUDs and certain subpopulations: people of color, people with mental illness, older adults, youth, and lesbian, gay, bisexual, transgender, questioning, intersex, asexual and other gender/sexual identity (LGBTQIA+) people. References focusing on screening, brief intervention, and referral to treatment (SBIRT); and treatment approaches are also included. Specific subsections are devoted to outlining resources on alcohol, marijuana/cannabis, opioids and tobacco use disorders as well. The article concludes with resources regarding significant policy dimensions of SUDs and the neuroscience behind these disorders.

General Overviews

The sources in this section provide an overview of the complex and broad topic of SUDs. Sher 2016 and the American Psychological Association offer wide-ranging reviews of key topics within substance use research and treatment. Begun and Murray 2020 and McNeece and DiNitto 2011 provide a comprehensive social work perspective on SUDs, including epidemiology, etiology, intervention, and research. DiClemente 2018, written by a co-developer of the transtheoretical model of behavior change, provides a foundational understanding of the application of this model to SUDs. Fisher and Harrison 2017 examines SUDs through the lens of school mental health practitioners. McCabe, et al. 2017 examines trends in the use by adults of more than one substance. The US Surgeon General’s 2016 “Report on Alcohol, Drugs and Health” (US Surgeon General 2016), the first of its kind, offers a valuable overview of these disorders and their impacts in the United States, as well as federal policy implications. Sussman and Ames 2008 offers a comprehensive examination of SUDs’ prevention and treatment, while Avery and Avery 2019 provides an in-depth look at stigma, which is central to many aspects of SUDs. The Substance Abuse and Mental Health Services Administration (SAMHSA) also maintains a searchable database of peer-reviewed articles using SAMHSA data that is updated quarterly.

• American Psychological Association. Substance Use Disorders and Addictions Series.

  This five-part series of videos is designed to provide clinicians with evidence-based information about SUDs and addictive behaviors. Experts provide commentary on topics such as screening, brief intervention, and referral to treatment for SUDs and addictions.

• Avery, J., and J. Avery. 2019. The stigma of addiction: An essential guide. Cham, Switzerland: Springer Nature.

  DOI: 10.1007/978-3-030-02580-9

  Provides a valuable overview of stigma, which is a critically important concept in SUDs. Particularly relevant topics include the stigma of addiction within families, romantic relationships, and within the health-care professional community.

• Begun, A. L., and M. Murray, eds. 2020. The Routledge handbook of social work and addictive behaviors. Abingdon, UK: Routledge.

  This comprehensive handbook, appropriate for a variety of audiences, discusses a variety of SUDs through a social work lens, with an emphasis on biopsychosocial, lifespan, and person-in-environment perspectives.

• DiClemente, C. C. 2018. Addiction and change: How addictions develop and addicted people recover. 2d ed. New York: Guilford Press.

  The Transtheoretical Model (often known as the Stages-of-Change Model) is a widely known framework for conceptualizing health and mental health behavior change. The author, co-developer of the model, provides an overview of the model as it applies to SUDs, and how people establish and reinforce new behaviors as part of treatment and recovery. The book addresses crucial questions of why, when, and how to intervene with both those who have or are at risk of SUDs.

• Fisher, G. L., and T. C. Harrison. 2017. Substance abuse: Information for school counselors, social workers, therapists, and counselors. 6th ed. Boston: Pearson.

  A practical handbook for mental health practitioners providing substance use-related services in school-based settings.

• McCabe, S. E., B. T. West , E. M. Jutkiewicz, and C. J. Boyd. 2017. Multiple DSM‐5 substance use disorders: A national study of US adults. Human Psychopharmacology: Clinical and Experimental 32.5: e2625.

  DOI: 10.1002/hup.2625

  Examines the growing trend of poly- or multi-substance use by studying the lifetime, prior‐to‐past‐year, and past‐year prevalence and correlates associated with multiple DSM‐5 SUDs for ten drug classes among US adults based on a large nationally representative sample.

• McNeece, C. A., and D. M. DiNitto. 2011. Chemical dependency: A systems approach. 4th ed. Boston: Pearson.

  Provides a systems and social work perspective on SUDs. This comprehensive resource outlines the major models and theories of addiction as well as treatment and policy.

• Sher, K. J., ed. 2016. The Oxford Handbook of Substance Use and Substance Use Disorders: 2 vols. New York: Oxford Univ. Press.

  This two-volume handbook gives a comprehensive overview of SUDs, including etiology, co-occurring disorders, effects on health and society, treatment, and prevention. It also discusses the roles of screening and motivational interviewing in addressing SUDs.

• Substance Abuse and Mental Health Services Administration (SAMHSA). Publications Using SAMHSA Data.

  A regularly updated bibliography of relevant government publications is provided at this site.

• Sussman, S., and S. L. Ames. 2008. Drug abuse: Concepts, prevention, and cessation. Leiden, The Netherlands: Cambridge Univ. Press.

  DOI: 10.1017/CBO9780511500039

  A comprehensive source on SUDs, organized into neurobiological, cognitive, microsocial, and macrosocial and physical environmental considerations.

• U.S. Department of Health and Human Services, Office of the Surgeon General. 2016. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health. U.S. Department of Health and Human Services.

  This federal government report, the first of its kind by a Surgeon General, explains the neurobiological basis for SUDs and provides the frameworks for improving diagnosis, prevention, and treatment of alcohol and drug misuse. It also describes evidence-based prevention strategies, effective treatment strategies, and recovery support services. Additionally, the report describes recent changes in health-care financing, including changes in health insurance regulations, which support the integration of clinical prevention and treatment services for SUDs into mainstream health care.