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Tolerance and Addiction in Substance Use
Disorders

1.3-5 What are substance use disorders?
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1.3-5 What ar e substance use disorders?

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What ar

substance use disorders?
What ar
Let’s imagine a day in the life of a legal-drug-using adult. The day begins with a couple shots
of espresso to feel alert, then an Adderall pill to help focus on a morning meeting. At midday,
an energy drink offsets post-lunch drowsiness, and vaping calms anxiety before a presenta-
tion. Later, a friend suggests meeting for after-work drinks. It used to take only a drink or two
to feel relaxed, but now it’s three or four. Back home, two Advil PMs before bed help induce
Distributed by Bedford, Freeman & Worth Publishers. Not for redistribution.
sleep. The alarm beeps just a few hours later. Then the daily cycle of drug use resumes. Over
time, our imagined person — and many actual people — may struggle to keep up with work
and family responsibilities, experience strained relationships, and have difficulty limiting their
substance use. How do we know when substance use becomes a problem?
Copyright © Bedford, Freeman & Worth Publishers.

The substances our imaginary person uses are psychoactive drugs — chemicals that
alter the brain, producing changes in perceptions and moods. Most of us manage to use
some psychoactive drugs in moderation and without disrupting our lives. But sometimes,

drug use crosses the line between moderation and substance use disorder ( Table 1.3-2 ).

TABLE 1.3-2 When Is Drug Use a Disorder?

According to the American Psychiatric Association (2013), a person may be diagnosed with
substance use disorder when drug use continues despite significant life disruptions. The
resulting brain changes may persist after quitting use of the substance (thus leading to strong
cravings when exposed to people and situations that trigger memories of drug use). The
severity of substance use disorder varies from mild (two to three of the indicators listed below)
to moderate (four to five indicators) to severe (six or more indicators). If you are concerned
about your substance use or that of a loved one, contact your school counselor, health clinic,
or physician.

Diminished Control
1. Uses more substance, or for longer than intended.
2. Tries unsuccessfully to regulate use of substance.

3. Spends much time acquiring, using, or recovering from effects of substance.
4. Craves the substance.
Diminished Social Functioning

5. Use disrupts commitments at work, school, or home.
6. Continues use despite social problems.
7. Causes reduced social, recreational, and work activities.
Hazardous Use
psychoactive drug a chemical
substance that alters the brain, 8. Continues use despite hazards.
causing changes in perceptions
and moods. 9. Continues use despite worsening physical or psychological problems.
substance use disorder Drug Action
a disorder characterized by
continued substance use despite 10. Experiences tolerance (needing more substance for the desired effect).
resulting life disruption.

11. Experiences withdrawal (unpleasant mental or physical reactions) when attempting to end use.

40 Unit 1 Biological Bases of Behavior

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