Substance Use Disorder

Cayat, Ric Charles Jordan M. Teves, Mark Rendel

In Partial Fulfillment of the Requirements in the Su !ect Current Issues

Su mitted to Sir Farland "alera

Substance Use Disorder Introduction What is Substance Use Disorder? According to Diagnostic and Statistical Manual of Mental Disorders [DSM-5] (2013) Substance use disorder is ter!ed as substance abuse and substance de"endence into a single disorder !easured on a continuu! fro! !ild to se#ere$ %ac& s"ecific substance (ot&er t&an caffeine '&ic& cannot be diagnosed as a substance use disorder) is addressed as a se"arate use disorder (e$g$ alco&ol use disorder sti!ulant use disorder etc$) but nearl( all substances are diagnosed based on t&e sa!e o#erarc&ing criteria$ )n t&is o#erarc&ing disorder t&e criteria &a#e not onl( been co!bined but strengt&ened$ *&ereas a diagnosis of substance abuse "re#iousl( re+uired onl( one s(!"to! !ild substance use disorder in DSM-5 re+uires t'o to t&ree s(!"to!s fro! a list of 11$ Drug cra#ing 'ill be added to t&e list and "roble!s 'it& la' enforce!ent 'ill be eli!inated because of cultural considerations t&at !a,e t&e criteria difficult to a""l( internationall($ )n DSM-)- t&e distinction bet'een abuse and de"endence 'as based on t&e conce"t of abuse as a !ild or earl( "&ase and de"endence as t&e !ore se#ere !anifestation$ )n "ractice t&e abuse criteria 'ere so!eti!es +uite se#ere$ .&e re#ised substance use disorder a single diagnosis 'ill better !atc& t&e s(!"to!s t&at "atients e/"erience$ Additionall( t&e diagnosis of de"endence caused !uc& confusion$ Most "eo"le lin, de"endence 'it& 0addiction1 '&en in fact de"endence can be a nor!al bod( res"onse to a substance$ Substance use disorder 'as t&e ter! t&at 'as used b( t&e res"ondents instead of addiction because for t&e! it 'as !ore sociall( acce"table and !ore acce"ted in t&e !edical field$ Why a social issue? )n t&e 2013 *orld Drug 2e"ort of United 3ations 4ffice on Drugs and 5ri!e (2013) at t&e global le#el t&ere &as been an increase in t&e "roduction and !isuse of ne' "s(c&oacti#e substances t&at is substances t&at are not under international control$ .&e !anufacture and use of substances t&at are under international control re!ain largel( stable as co!"ared 'it& 2006 alt&oug& trends in drug su""l( and de!and &a#e been une+ual across regions and countries and across drug t("es$ Me!ber States t&at are "art( to t&e t&ree international drug control 5on#entions '&ic& 'ere ado"ted to "rotect t&e &ealt& and 'elfare of !an,ind re!ain co!!itted to t&e drug control s(ste!$ %#idence s&o's t&at '&ile t&e s(ste! !a( not &a#e eli!inated t&e drug "roble! it continues to ensure t&at it does not escalate to un!anageable "ro"ortions$

*e &a#e to ad!it t&at globall( t&e de!and for drugs &as not been substantiall( reduced and t&at so!e c&allenges e/ist in t&e i!"le!entation of t&e drug control s(ste! in t&e #iolence generated b( traffic,ing in illicit drugs in t&e fast e#ol#ing nature of ne' "s(c&oacti#e substances and in t&ose national legislati#e !easures '&ic& !a( result in a #iolation of &u!an rig&ts$ .&e real issue is not to a!end t&e 5on#entions but to i!"le!ent t&e! according to t&eir underl(ing s"irit$ *&ile intensified co!"etition in traffic,ing in cocaine &as led to gro'ing le#els of #iolence in 5entral A!erica t&e "roble! 'ill not be resol#ed if drugs are legali7ed$ 4rgani7ed cri!e is &ig&l( ada"ti#e$ )t 'ill si!"l( !o#e to ot&er businesses t&at are e+uall( "rofitable and #iolent$ 5ountering t&e drug "roble! in full co!"liance 'it& &u!an rig&ts standards re+uires an e!"&asis on t&e underl(ing s"irit of t&e e/isting drug 5on#entions '&ic& is about &ealt&$ Ad#ocac( for a stronger &ealt& "ers"ecti#e and an interconnected re-balancing of drug control efforts !ust ta,e "lace$ As e/"erience &as s&o'n neit&er su""l( reduction nor de!and reduction on t&eir o'n are able to sol#e t&e "roble!$ 8or t&is reason a !ore balanced a""roac& in dealing 'it& t&e drug "roble! is a necessit($ .&is includes !ore serious efforts on "re#ention and treat!ent not onl( in ter!s of "olitical state!ents but also in ter!s of funds dedicated for t&ese "ur"oses$ .&is (ear9s *orld Drug 2e"ort s&o's t&e e/tent of t&e "roble! associated 'it& ne' "s(c&oacti#e substances and t&e deadl( i!"act t&e( can &a#e on t&eir users$ .&e issue of ne' "s(c&oacti#e substances is one t&at t&e international co!!unit( 'ill re#ie' at t&e &ig&-le#el session of t&e 5o!!ission on 3arcotic Drugs in 201:$ As is t&e case 'it& traditional drugs international action against t&ese substances !ust focus on addressing bot& su""l( and de!and$ .&e "aucit( of ,no'ledge on t&e ad#erse i!"acts and ris,s to "ublic &ealt& and safet( cou"led 'it& t&e fact t&at ne' "s(c&oacti#e substances are not under international control underscores t&e i!"ortance of inno#ati#e "re#ention !easures and s&aring of good "ractices bet'een countries$ .&e !ultitude of ne' "s(c&oacti#e substances and t&e s"eed 'it& '&ic& t&e( &a#e e!erged in all regions of t&e 'orld is one of t&e !ost notable trends in drug !ar,ets o#er t&e "ast fi#e (ears$ *&ile t&e e/isting international control s(ste! is e+ui""ed to deal 'it& t&e e!ergence of ne' substances t&at "ose a t&reat to "ublic &ealt& it is currentl( re+uired to "ro#ide a res"onse co!!ensurate 'it& t&e un"recedented fast e#ol#ing nature of t&e "&eno!enon of ne' "s(c&oacti#e substances$ So!e countries &a#e ado"ted inno#ati#e a""roac&es to curb t&e rise of t&ese substances but t&e global nature of t&e "roble! re+uires a res"onse based on international coo"eration and uni#ersal co#erage$ Suc& a res"onse s&ould !a,e use of all t&e rele#ant "ro#isions of t&e e/isting international drug 5on#entions$ )n addition in strengt&ening t&e international control s(ste! a s(ste!atic e#aluation of t&e a""ro"riateness of so!e of t&e inno#ati#e a""roac&es at t&e national le#el s&ould be encouraged$

 Body )n a tal, about life before during and after re&abilitation t&ere 'ere fi#e "eo"le '&o s&ared t&eir e/"eriences and t&e stories t&e( s&ared 'ere t&e data 'e used$ .&ese fi#e "eo"le ca!e fro! Serenit( at t&e ;uarr($ 8irst of 'as 2o!!el '&o 'as an alco&olic &e is <ust fi#e !ont&s sober t&at is '&( &e 'as unable to s&are a lot of infor!ation since &e is still in t&e "rocess of reco#er($ According to 2o!!el being an alco&olic is difficult it lead to !an( "&(sical co!"lications '&ic& is '&( &e decided to enter t&e re&abilitation center$ After fi#e !ont&s of treat!ent &e &as a lot of regrets or 0marami daw siyang pagsisisi$1 =e also reali7ed all t&e t&ings t&at &e &as done 'rong$ 2o!!el also +uoted t&at 0Alcohol is a drug. Ayaw ko ngtumira! Going straight na ako. Masarap maging sober$1 =e also re!inded t&e (out& '&o attended t&e said tal, to sto" drin,ing and to sto" using drugs$ .&e second to s&are 'as >ouie '&o is no' eig&t !ont&s clean or eig&t !ont&s drug-free$ ?efore entering t&e facilit( &e 'as diagnosed 'it& &eart co!"lications @0A of &is &eart 'as clogged and t&is 'as &is reason to enter t&e facilit($ After eig&t !ont&s of treat!ent &e said to &i!self t&at 0Hindi na ako babalik. Sinusumpa ko na ang drugs$1 =e also told t&e audience not to tr( drugs because (ou 'ill reall( regret tr(ing it$ 3e/t 'as t&e onl( girl '&o s&ared &er stor( Ms$ Biselle$ S&e did drugs for about 1: (ears and no' s&e is 11 !ont&s clean$ S&e t&oug&t t&at drugs 'ere t&e 0cool thing1 t&at9s '&( s&e tried to use it$ S&e also told us t&at s&e is #er( good in "retending t&at9s '&( &er "arents and colleagues 'ere una'are t&at s&e 'as into drugs$ *&ile doing drugs s&e 'as also into ga!bling and '&en s&e 'as @ (ears old s&e 'as alread( into alco&ol$ Drugs and ga!bling are #ices t&at are &ard to sustain because of its &ig& cost$ .&at9s '&( s&e lost &er <ob and an i!"ortant relations&i" basicall( e#er(t&ing t&at 'as i!"ortant to &er 'as lost$ .&at is '&en s&e decided to enter t&e facilit($ S&e is no' glad to reco#er$ S&e e#en told t&e audience t&at u" until no' s&e still t&in,s li,e a c&ild but s&e9s #er( &a""( about it$ After Biselle it 'as Cen9s turn$ Cen 'as a drug addict for 13 (ears$ During t&ose (ears &e 'as also addicted to ga!bling and alco&ol$ =is !indset during t&at ti!e 'as t&at &e does not &a#e a "roble!$ According to &i! &e 'as #er( arrogant t&at ti!e$ =is t&in,ing 'as &i! against t&e 'orld$ *it& t&at t&e ne/t t&ing t&at &a""ened to &i! 'as t&at &e lost &is fa!il( and li,e Biselle &e also lost e#er(t&ing$ =e ended u" in slu!s and streets$ Kaya bago ako magkalat ng todo pumasok na ako ditto sa facility. got educated. !ow" my life is my priority. My brain is still in reco#ery. $ero may mga kailangan paring iwasan na sitwasyon" bagay" at tao.% .&e one '&o 'ra""ed u" t&e tal, 'as Sir 2enato '&o 'as an alco&olic and drug addict for 25 (ears$ During t&ose 25 (ears &e 'as in and out of <ail re&abilitation centers and e/"erienced #irtual deat&s$ According to &i! t&e ter! 0addict1 'as #er( stig!ati7ing$ =e is also fro! a 'ell-off fa!il( and 'as s"oiled as a c&ild$ =e also &ad a good education and did 'as not contented 'it& '&at &e &as$ *&en &e 'as a ,id &e &ad a false sense of confidence and a feeling of entitle!ent$ So &e 'as in#ol#ed in 'rong grou" of friends and t&at is '&ere it all started$ =e told us t&at 0&#ery user is a pusher. Kailangang magtulak$1 *&en &e 'as in <ail &e 'as undergoing correction$ =e 'as !ore e/"osed to s"iritual as"ect of &is life$ .&at is '&en &e decided to sto" and enter t&e facilit($ *it& &is sta( in t&e

facilit( &e reali7ed t&at &e s&ould be able to s&are and i!"art '&at &e learned during &is sta($ 0 '#e e(perienced the change with myself and to be able to sustain that change should be able to share this with others. '#e been there and done that. !ow am trying to make a positi#e contribution to the society$1 .&e good t&ing about Mr$ 2enato is t&at &e is no' stud(ing to beco!e an addiction counselor$ According to &i! t&is is &is 'a( of &el"ing out$ )n addition &e told t&e audience t&at 0)eco#ery takes a lifetime. )eco#ery is my deathbed$1 Conclusion

*it& t&e data t&at 'e gat&ered fro! t&e fi#e s"ea,ers t&ere 'ere certain "ieces of infor!ation t&at 'e find interesting$ 8irst of 'as '&en (ou get addicted to drugs it is not onl( drugs t&at (ou get de"endent on but also 'it& ot&er substances li,e alco&ol$ Second 'as 'e &eard it fro! t&e! t&at alco&ol is !ore fatal t&an illicit drugs$ .&ird is t&at reco#er( ta,es a lifeti!e$ *e t&oug&t t&at after (our session 'it& t&e re&abilitation center (ou are no' 'ell$ ?ut seeing t&e! it reall( loo,s li,e reco#er( 'ill ta,e a lifeti!e$ 8ourt& substance use destro(s not onl( (ourself but also t&e "eo"le around (ou$ >astl( substance abusers do not onl( co!e fro! t&e lo' or "oor class of t&e societ( but also !ore often 'it& t&e &ig& social class$

Insights

5&arlesD Betting to interact 'it& t&ese "eo"le reall( frig&tened !e a little$ 4f course so!e of t&e! are still in t&e "rocess of reco#er($ ) do not ,no' '&at t&eir ne/t !o#e 'ill be$ ?ut t&e funn( t&ing is t&at t'o out of 5 do not loo, li,e substance abusers or substance de"endents$ .&e societ( reall( is un"redictable$ ) also feel "roud for t&ese "eo"le since t&e( are 'illing to c&ange and t&e( are 'illing to &el" t&ose '&o are still in t&e dar, side$ .&ese "eo"le for !e are t&e !ost ca"able of &el"ing ot&er abusers since t&e( are t&e ones '&o 'ere once t&ere and 'as able to co!e out or o#erco!e t&e great &urdle in t&eir li#es$ U"on obser#ation so!e of t&e! 'ere reall( tr(ing to fit in t&e grou"$ *&at to t&e! is 0cooler1 or '&at for t&e! is 0in1 ) guess it9s a !atter of '&o (ou are 'it& and '&o (ou c&oose to be 'it&$ .o cut t&e long stor( s&ort ) t&in, 'e s&ould be accountable of t&e actions 'e do$ *e s&ould be able to face t&e conse+uences of t&e decisions 'e !a,e$ *e s&ould not enter t&ings t&at 'e cannot control or 'e do not need to enter$

.e#esD All of us &as a dar, side in our li#es$ ?ut so!eti!es 'e cannot also bla!e so!e "eole '&( t&e( c&ose a 'rong "at& instead of a rig&t one$ 8or one reason 'e dont ,no' t&eir "ersonal bac,ground and '&o t&e( are inside t&eir fa!il($ Ma(be t&e decided to engage in t&at acti#ities to forget t&eir "roble! and frustration$ .&e lesson t&at ) learned fro! t&is researc& is loo,ing for '&at t&e( are rig&t no' and forgetting t&eir "ast$ .&is researc& re!inds !e t&e stor( about t&e "rodigal son$ *e so!eti!es fall and feel &o"eless but as 'e see t&e real "ur"ose of life 'e c&ange e#er(t&ing in oursel#es$