Substance use disorder can lead to short- and long-term negative health effects. These effects can be physical and mental and can range from moderate to severe.

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Drug abuse vs. substance use disorder

This article references the term “drug abuse,” which is a stigmatizing term. Instead, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) uses the term substance use disorder (SUD). The manual defines SUD as a disorder involving the continued use of substances despite personal, professional, and health-related problems caused by the usage that negatively affect a person’s day-to-day life.

Generally, drug misuse or SUD refers to the use of psychoactive drugs, which are substances that affect the brain. The effects on the body depend on the type of substance a person uses and their health history.

Examples of common psychoactive drugs include:

This article discusses the physical and mental effects of substance use disorder.

Psychoactive drugs are chemical compounds that affect the mind and body.

Taking different drugs may cause:

  • changes in coordination
  • blood pressure and heart rate changes
  • feelings of being more awake or sleepy
  • improved sociability
  • pain relief
  • changes in the appearance of a person’s body

When chronic substance use occurs over a long period, these short-term physical effects may cause long-term changes to a person’s brain and body.

The specific physical effects of substance use may vary among individuals and depend on the substance, dosage, delivery method, and length of use.

Substance use can sometimes lead to serious health consequences, including overdose and death.

Short-term physical effects

Using any drug can cause short-term physical effects. The following are examples of common drugs, their short-term physical effects, and potential health risks due to SUD.

  • alcohol
  • methamphetamines
    • increased wakefulness and physical activity
    • decreased appetite
    • increased breathing
    • increased or irregular heart rate
    • increased blood pressure
    • increased temperature
  • cocaine
    • narrowed blood vessels
    • enlarged pupils
    • increased body temperature, heart rate, and blood pressure
    • headache
    • abdominal pain and nausea
    • erratic and violent behavior
    • heart attack
    • stroke
    • seizure
    • coma
  • benzodiazepines
    • slurred speech
    • dizziness
    • problems with movement
    • slowed breathing
    • lowered blood pressure
  • heroin and other opioids
    • dry mouth
    • itching
    • nausea
    • vomiting
    • slowed breathing and heart rate
  • tobacco and nicotine
    • increased blood pressure
    • increased breathing
    • increased heart rate
  • tobacco or nicotine:
    • greatly increased risk of cancer — lung cancer due to smoking or oral cancer due to chewing
    • chronic bronchitis
    • emphysema
    • heart disease
    • leukemia
    • cataracts
    • pneumonia

Long-term physical effects

Using substances for an extended time may have long-term health consequences. These lasting effects depend on multiple factors, including the substance, the amount, and how long a person has used it.

Examples of commonly used drugs and potential long-term physical effects of SUD include:

  • alcohol:
    • stroke
    • liver disease and inflammation (alcoholic liver disease)
    • pancreatitis
    • digestive problems
    • cancer of breast, mouth, throat, esophagus, voice box, liver, colon, and rectum
    • weakened immune system
    • alcohol use disorder or alcohol dependence
  • methamphetamines:
    • severe dental problems
    • weight loss
    • intense itching leading to skin sores
    • risk of HIV, hepatitis, and other diseases from shared needles
  • cocaine and heroin — when a person snorts them, these drugs may cause:
    • loss of sense of smell
    • nosebleeds
    • nasal damage and trouble swallowing
  • other effects include:
    • infection and death of bowel tissue from decreased blood flow
    • inadequate nutrition and weight loss
    • collapsed veins
    • abscesses
    • infection of the lining and valves of the heart
    • constipation and stomach cramps
    • liver or kidney disease
    • pneumonia
    • fatal overdose
  • tobacco or nicotine:
    • greatly increased risk of cancer — lung cancer due to smoking or oral cancer due to chewing
    • chronic bronchitis
    • emphysema
    • heart disease
    • leukemia
    • cataracts
    • pneumonia

Long-term SUD may affect a person’s memory, behavior, learning, consciousness, and concentration.

Substances, such as alcohol, cannabis, stimulants, and opioids, are psychoactive drugs that may change an individual’s brain function and structure after chronic use. This can result in cognitive and behavioral changes and deficits that may remain even after someone stops using.

The exact mental or cognitive effects of SUD may vary depending on the type of drug and the duration of use.

SUD may also exacerbate symptoms of other mental disorders, and early drug use is a strong risk factor for the later development of substance use disorders. It may also be a risk factor for developing other mental illnesses.

For example, frequent cannabis use in adolescents can increase the risk of psychosis in adulthood in individuals who carry a particular gene variant.

Short-term mental effects

Examples of common drugs and their short-term mental effects include:

  • alcohol:
    • feelings of euphoria
    • reduced anxiety
    • easing of social interactions
    • irritability and anxiety upon withdrawal
  • cannabis:
    • enhanced sensory perception
    • feelings of euphoria and relaxation
    • anxiety
    • irritability upon withdrawal
  • benzodiazepines:
    • drowsiness
    • concentration issues
    • dizziness
    • reduced anxiety
    • problems with memory
  • heroin:
    • feelings of euphoria
    • restlessness upon withdrawal
  • prescription opioids:
    • pain relief
    • drowsiness
    • feelings of euphoria
  • methamphetamine:
    • increased wakefulness
    • anxiety upon withdrawal

Long-term mental effects

Examples of common drugs and mental effects associated with long-term SUD include:

  • alcohol:
    • depression
    • anxiety
    • learning and memory problems
    • social problems
  • prescription opioids:
    • increased risk of overdose
  • methamphetamines:
    • anxiety
    • confusion
    • insomnia
    • mood problems
    • violent behavior
    • paranoia
    • hallucinations
    • delusions
  • heroin:
    • risk of overdose
  • tobacco and nicotine:
    • in teens, they can affect the development of brain circuits that control attention and learning
    • irritability, attention and sleep problems, and depression upon withdrawal
  • cannabis:
    • mental health problems
    • irritability, trouble sleeping, anxiety upon withdrawal

To get a diagnosis of SUD, a person has to qualify for 11 criteria that the DSM-5 outlines.

These include:

  • using more of a substance than a person intends or using it for longer than they mean to
  • trying to cut down or stop using the substance but being unable to
  • experiencing intense cravings or urges to use the substance
  • needing more of the substance to get the desired effects (tolerance)
  • developing withdrawal symptoms when not using the substance
  • spending more time getting and using drugs and recovering from substance misuse
  • continuing to use even when it causes relationship problems
  • giving up important or desirable social and recreational activities due to substance use
  • using substances in potentially harmful settings that put a person in danger
  • continuing to use despite the substance causing problems to physical and mental health

SUD prevalence

Government data shows that SUD tends to be more common among Black people than Hispanics, Asians, and people who are white. SUD is more common in males among people who are white, Black or African Americans, American Indians or Alaska Natives, and those who identify as two or more races.

However, it is difficult to determine the accuracy of data on racial disparities. In the United States, historically, the “war on drugs” has meant that Black Americans are 6–10 times more likely to be incarcerated for drug offenses even though they are not necessarily more likely to use illegal drugs. This imbalance may impact prevalence data.

In addition, SUD from illegal opioids is a large public health problem in the U.S. that can lead to overdose and death. In some cases, SUD can result from prescription opioids, but the bulk of the crisis stems from illegal or “street” drugs.

More than 760,000 people have died since 1999 from opioid overdoses. In 2018, two out of three overdoses had links to opioid use.

Finding the right treatment program may feel overwhelming. Here are a few things a person can consider when seeking treatment for SUD.

  • Consider whether inpatient or outpatient services would be most suitable.
  • Find local treatment centers using the Substance Abuse and Mental Health Services Administration’s treatment finder tool.
  • Know that state-run treatment centers and programs may be free of charge.
  • Look for programs that use evidence-based treatment strategies.

SUD is a complex but treatable disease that affects a person’s cognitive function and behavior. No single treatment is right for everyone.

However, effective treatment for SUD should address all of a person’s mental and physical health needs.

Treatment aims to help individuals develop a healthier relationship with drugs, helping them live productive lives in relationships with their family, work, and society.

Treatment may involve some of the following components:

  • Medications: Can help minimize withdrawal symptoms and prevent the return to unsafe use.
  • Behavioral counseling: Helps individuals modify their attitudes and behaviors related to substance use, increase healthy life skills, develop problem-solving skills, and stick to treatment plans.
  • Group therapy: Gives people the chance to acknowledge, share, and work through the psychological aspects of recovery with a group of peers under professional guidance.
  • Additional support: May include vocational training and other resources that address problems associated with SUD, such as mental health conditions, unemployment, and medical conditions.

Here are some common questions and answers regarding SUDs.

How do I know if I or someone I know is misusing drugs?

Healthcare professionals use 11 criteria to determine if an individual has SUD. Some of them include:

  • using more of a substance than a person intends
  • using it for longer than they mean to
  • trying to cut down or stop using the substance but being unable to
  • experiencing intense cravings or urges to use the substance
  • needing more of the substance to get the desired effects
  • developing withdrawal symptoms when not using the substance

What are the risk factors for drug misuse?

Certain factors may increase an individual’s risk for SUD. These risk factors include:

  • family history of substance use
  • difficulties with parental monitoring
  • parents substance use
  • family rejection of sexual orientation or gender identity
  • association with substance-using peers
  • lack of school connectedness
  • academic achievement difficulties
  • childhood sexual abuse
  • mental health issues

SUD can affect several aspects of a person’s physical and psychological health.

Certain substances may lead to drowsiness and slow breathing, while others may cause insomnia, paranoia, or hallucinations. Chronic substance use has links to cardiovascular, kidney, and liver disease.

In addition to physical and mental effects, substance use can adversely affect a person’s relationships, home and work life, and mental health.

Care providers should tailor treatment to a person’s needs. Community-based organizations and state-funded treatment programs usually involve a combination of behavioral therapy, group therapy, and medication.