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What Is Substance Use Disorder and How Is It Treated?

Mary-Lauren O’Crowley, NCC, LPC 

Substance abuse is not just about using illicit drugs and drinking alcohol excessively. It is the dependence on any substance that alters mood. That is why reliance on substances like marijuana and prescription medication is also part of this disorder. Most known substances that lead to abuse have psychoactive elements which stimulate the central nervous system (CNS). They interfere with both mood and cognition. Examples include alcohol, cocaine, heroin, tobacco, and prescription medications that mediate the CNS’s mood and cognition pathways. 

 What Happens When You Take Psychoactive Substances?

         Psychostimulants trigger the release of dopamine, serotonin, and norepinephrine. These three biomolecules are neurotransmitters that affect mood, concentration, cognition, motivation, appetite, reward, and sleep. Dopamine causes arousal and intensifies mood. While both dopamine and norepinephrine activate the neural pathways responsible for reward and motivation, dopamine is more central in this role, as it increases feelings of euphoria. Similarly, psychoactive substances trigger repetitive behavior that ultimately keeps the reward circuit stimulated. This constant stimulation, however, creates a feedback loop that reinforces the use of psychoactive substances, triggering dependence and addiction. 

         Another downside to these artificial stimuli is that their effect on the brain is more intense than natural stimuli. The impact also lasts longer than natural stimulation. Once the body creates a reward feedback loop, natural stimuli become insufficient to activate the pathway. Additionally, subsequent stimulation demands higher doses of the substance to achieve that needed “high.” Such characteristics also increase the chances of dependability, tolerance, and addiction. 

         Another neurotransmitter central to that warm, fuzzy feeling, serotonin influences mood, appetite, and sleep. The presence of serotonin shuts down the stress-response circuit. Meaning, your body ultimately becomes less anxious and reactive to stressors. It also sustains feelings of happiness; However, due to the high concentration of serotonin released, the euphoria created pales in comparison to the diminished mood, anxiety, and other mental and physical ramifications once the neurotransmitter wears off. High levels of serotonin augment its impact on the neural pathways it mediates. Consequently, when the concentrations fizzle out, your sensitivity to pain, anxiety, and fear increases. The aftermath is a vicious addiction cycle to maintain that impermanent feel-good state.  

The Absence of Self-Control in Addiction

         Unfortunately, substance use disorder cannot be rectified by self-discipline. Although indulging in the psychoactive substance, at first, is a choice, once the brain forms that reward and feel-good loop, a person’s control over the behavior goes out the window. At this point, a person struggling with substance abuse and addiction should seek out treatment. 


Addiction is often too complex and its hold to tight to be dealt with alone. Treatment targets both physical and mental well-being and behavior patterns. There is no one-size-fits-all treatment for substance abuse. Treatment is customized to the individual, the substance at play, and other pertinent factors. Your therapist will want to understand what led you down the path of addiction, your triggers, and what you have been doing to cope. Treatment can be done in the hospital, at home, or in rehabilitation centers depending on your condition and its severity. All types of treatment include intensive counseling and/or medication and detoxification.  


 Therapy can be instrumental in the treatment of substance use. It can be done both individually or in a group setting. One-on-one counseling can be crucial in understanding one’s condition, fostering self-reflection, and promoting long-term healing. Group sessions cultivate support and a sense of universality that can be a motivator in staying sober.   


         Medication has various roles in the treatment of mental and physical disorders. Some medications can inhibit the binding of a psychostimulant into receptors – this is common in alcohol addiction. Other medications can help to reduce the severity of withdrawal symptoms like insomnia, agitation, and restlessness. Medication can also be used to treat underlying or co-occurring disorders whose symptoms may have led the individual to turn to a substance as a means of coping. 

If you or someone you know is struggling with substance use, please reach out to our intake specialists at Symmetry Counseling today, and discover how therapy in Chicago can help you! 


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