Mental Health II

Dr Taher
Substance use disorders
• Substance use disorders (SUDs)
includes persistent use of drugs
(psychoactive substances)causing harm
to the person and serious adverse
consequences to the individual’s
personal and social life.
Substance
dependence or
Addiction
• Substance dependence is the
medical term used to describe
use of drugs or alcohol that
continues even when significant
problems related to their use
have developed.
• Addiction is the sever form of
substance use disorder
Signs of dependence

Tolerance to or need for increased amounts of the drug to get an effect

Withdrawal symptoms that happen if you decrease or stop using the drug that you find
difficult to cut down or quit

Spending a lot of time to get, use, and recover from the effects of using drugs

Withdrawal from social and recreational activities

Continued use of the drug even though you are aware of the physical, psychological, and
family or social problems that are caused by your ongoing drug use
Reasons for using substance
Out of curiosity to experience the effects of a psychoactive substance

As a way of coping for stressful situations such as financial difficulty, marital issues etc

Due to underlying psychiatric illness such as depression, anxiety

Cultural factors

A drug prescribed for physical ailment: for eg: opioids for pain, benzodiazepines for
insomnia
 What substances are associated with substance use disorder?

• Alcohol.
• Caffeine.
• Cannabis (marijuana).
• Hallucinogens, such as PCP and LSD.
• Hypnotics, sedatives and anxiolytics (anti-anxiety drugs), such as sleeping pills,
benzodiazepines and barbiturates.
• Inhalants, such as paint thinners, aerosol sprays, gases and nitrites (poppers).
• Prescription and non-prescription opioids, such as codeine, oxycodone and heroin.
• Prescription and non-prescription stimulants, such as Adderall®, cocaine and
methamphetamine.
• Tobacco/nicotine, such as smoking cigarettes and electronic cigarettes (e-cigarettes or
vaping).
 Substance use epidemiology

• Alcohol:
1. According to the World Health Organization (WHO), in 2016, 3 million deaths (5.3% of
all global deaths) were attributable to alcohol consumption.
2. In the United States, the National Survey on Drug Use and Health (NSDUH) reported
that in 2019, approximately 85.6% of people aged 18 or older reported that they drank
alcohol at some point in their lifetime.
• Tobacco:
1. The World Health Organization (WHO) estimates that tobacco use is responsible for
over 8 million deaths each year globally.
2. In the United States, according to the Centers for Disease Control and Prevention
(CDC), in 2019, about 14% of adults (34.1 million people) were current cigarette
smokers.
 Substance use epidemiology

• Illicit Drugs:
1. The United Nations Office on Drugs and Crime (UNODC) reported in its World Drug Report
2020 that an estimated 269 million people worldwide used drugs at least once in 2018.
2. Opioid misuse has been a significant concern. In the United States, the National Institute
on Drug Abuse (NIDA) reported that in 2019, approximately 10.1 million people aged 12
or older misused opioids in the past year.
• Cannabis:
1. The United Nations World Drug Report 2020 estimated that around 192 million people
used cannabis in 2018, making it the most widely used illicit drug globally.
2. In the United States, NSDUH data from 2019 showed that about 43.5 million individuals
aged 12 or older used marijuana in the past year.
 How does substance use disorder develop?

• The progression to a substance use disorder often follows this

pattern:

• Experimental use (or prescription use).

• Occasional use (or using prescriptions not as directed).
• Heavy use.
• Substance use disorder.
 Factors contribute to the development of substance use
disorder

• The substance’s effect on your brain chemistry.

• Genetics.
• Mental health conditions.
• Access and exposure to the substance.
• Adverse childhood experiences
How is substance use disorder diagnosed

• A single test can’t diagnose substance use

disorder. Instead, healthcare providers rely on
a thorough evaluation of your medical history
and behaviors surrounding substance use.
They may order drug tests and evaluate
prescription drug monitoring program reports.

• A provider will also ask about your mental

health history, as it’s common to have an SUD
and a mental health condition.
 Treatment for substance use disorder

DETOXIFICATION. COGNITIVE AND MEDICATION-ASSISTED

BEHAVIORAL THERAPIES. THERAPIES.
 • Substance use has significant
implications for public health, as
it can contribute to a range of
physical, mental, and social
health problems. Addressing
substance use from a public
health perspective involves
implementing strategies to
prevent substance abuse,
provide effective treatment, and
reduce the associated harm to
Substance use individuals and communities.
and public health
 • Health Consequences:
• Physical Health: Substance use can
lead to a range of physical health
issues, including cardiovascular
problems, liver disease, respiratory
issues, and an increased risk of
infectious diseases (e.g., HIV,
hepatitis).
• Mental Health: Substance use is
often linked to mental health
Effects of disorders, such as anxiety,
depression, and psychosis. It can
substance use on exacerbate existing mental health
public health conditions or contribute to the
development of new ones.
 Effects of substance use on public health

• Injury and Mortality:

• Accidents and Injuries: Substance use, particularly alcohol and
drug intoxication, is a major contributor to accidents and
injuries, including motor vehicle accidents, falls, and other
unintentional injuries.
• Overdose Deaths: Opioid and other drug overdoses have
become a significant public health crisis, leading to a
substantial increase in mortality rates in some regions.
 Effects of substance use on public health

• Infectious Diseases:
• Transmission of Diseases: Sharing needles among people who
inject drugs can lead to the transmission of bloodborne
diseases, such as HIV and hepatitis C. Risky behaviors
associated with substance use can also contribute to the
spread of sexually transmitted infections.
 Effects of substance use on public health

• Maternal and Child Health:

• Prenatal and Neonatal Effects: Substance use during pregnancy
can have adverse effects on both the mother and the
developing fetus, leading to complications such as preterm
birth, low birth weight, and neonatal abstinence syndrome
 Effects of substance use on public health

• Social and Economic Impact:

• Family Disruption: Substance use can strain relationships,
leading to family conflicts, breakdowns, and the disruption of
normal family functioning.
• Workplace Productivity: Substance use can impact workplace
productivity due to absenteeism, impaired performance, and
increased accidents. It may also result in unemployment or
difficulty maintaining steady employment.
 Effects of substance use on public health

• Criminal Justice System Involvement:

• Legal Issues: Substance use often contributes to criminal
behavior, leading to legal issues such as arrests, convictions, and
incarceration. Substance-related crimes can strain the criminal
justice system and contribute to overcrowded prisons.
 Effects of substance use on public health

• Financial Strain:
• Healthcare Costs: Substance use-related health problems
contribute to increased healthcare costs, including emergency
room visits, hospitalizations, and long-term medical care.
• Economic Burden: Substance use places a significant
economic burden on societies, including costs related to
treatment, law enforcement, lost productivity, and social
welfare programs.
 Effects of substance use on public health

• Stigma and Discrimination:

• Social Stigma: Individuals struggling with substance use often
face social stigma and discrimination, which can hinder their
willingness to seek help and contribute to social isolation.
 Public health interventions

• Prevention
• Treatment and Rehabilitation
• Harm Reduction
• Policy and Regulation
• Epidemiological Surveillance
• Mental Health Integration
• Public Awareness and Stigma Reduction
 Prevention

• Education and Awareness: Public health campaigns aim to

educate individuals about the risks and consequences of
substance use, emphasizing prevention through information
dissemination.
• Community Programs: Prevention efforts often involve
community-based programs that focus on building protective
factors, such as strong family bonds, positive peer influences,
and school engagement.
 Treatment and Rehabilitation

• Access to Treatment: Public health initiatives work to improve

access to effective treatment for individuals with substance use
disorders. This includes expanding treatment facilities, providing
financial assistance, and reducing barriers to seeking help.
• Medication-Assisted Treatment (MAT): MAT programs use
medications in combination with counseling and behavioral
therapies to help individuals overcome addiction to substances
such as opioids or alcohol.
 Policy and Regulation

• Tobacco Control Policies: Public health efforts have led to the

implementation of tobacco control policies, including taxation,
advertising restrictions, and smoke-free policies, to reduce
smoking rates and related health problems.
• Legalization and Regulation: In the case of substances like
cannabis, public health considerations may influence decisions
about legalization, with an emphasis on regulating production,
distribution, and use to minimize harm.
 Epidemiological Surveillance

• Monitoring Substance Use Trends: Public health agencies

regularly monitor and analyze data on substance use trends to
identify emerging issues, target interventions, and allocate
resources effectively.
• Surveillance of Risk Factors: Understanding risk factors for
substance use, such as poverty, trauma, and mental health
issues, helps inform prevention strategies.
 Mental Health Integration

• Dual Diagnosis Treatment: Given the high comorbidity between

substance use and mental health disorders, integrating mental
health services with substance use treatment is crucial for
addressing both issues comprehensively.
 Public Awareness and Stigma Reduction

• Destigmatization Campaigns: Reducing stigma around

substance use and addiction is crucial for encouraging
individuals to seek help without fear of judgment. Public health
campaigns aim to change societal perceptions and promote
empathy.
 Harm Reduction

• Needle Exchange Programs: Harm reduction strategies include

needle exchange programs that aim to reduce the transmission
of bloodborne diseases among individuals who inject drugs.
• Supervised Consumption Sites: Some places offer supervised
consumption sites where individuals can use substances under
the supervision of trained staff, reducing the risk of overdose
and promoting access to treatment.
 Thank you
Any Questions?