About 20.3 million Americans report a substance use disorder (SUD) in the past year. SUD is a medical term that refers to misuse of drugs and alcohol. People generally call SUD “addiction.”

SUD is a chronic, relapsing illness. SUDs include alcohol use disorder (often called alcoholism), opioid use disorder (often in the form of addiction to pain medication or heroin) and disorders involving misuse of other substance Think of SUD the same way you think of other chronic illnesses like diabetes or high blood pressure. With treatment and lifestyle changes, people can manage their illnesses and live productive lives. But the illness can recur and require a change in treatment, lifestyle, or both.

Most people recover from SUD. Compared to many other medical and psychiatric illnesses, SUD has a good prognosis. About 42% to 66% of people with SUD eventually will never use substances again, although it can take time to reach that point.

People with SUD often want to stop or cut down on using drugs or alcohol but cannot. They continue their use despite negative effects and often knowingly put themselves in danger because of their use. When someone has an SUD, over time they feel the need for more and more of the drug to get the same effect.

Opioid use disorder includes misuse of prescription opioid medications such as hydrocodone or oxycodone or illegal drugs such as heroin. Addiction to prescription painkillers often begins with a valid prescription for an opioid pain medication.

  • 1 out of 4 people prescribed opioids for long-term pain become addicted.
  • 4 out of 5 people treated for OUD started with a prescription for pain medication.
  • Prescription opioid addiction often leads to heroin use as a cheaper alternative.

Opioids are highly addictive and change the way the brain works. Most people with OUD are just regular people with families, jobs, and goals. Medication and other treatment can help people to get back to their lives.

Alcohol is the most misused substance in the U.S. Massachusetts has higher rates of excessive drinking, espcially among women and adults over 65, than the national average. The risk of developing AUD is haigher for people who started drinking at a younger age (under 15), mental health conditions, history of trauma, and family history of alcohol misuse.

The symptoms of AUD are the same as those of SUD. In addition, they may want to drink so badly it consumes their thoughts, cut back on activities or relationships that are important to them in order to drink, and experience withdrawal symptoms when the effects of alcohol wear off (e.g, shakiness, sweating, nausea).

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines “heavy” alcohol use as more than 4 drinks per day for a man and 3 drinks for women. “Binge drinking” involves a man drinking 5 or a women 4 drinks in about 2 hours. Both of these types of drinking are considered problematic and dangerous.

Behavioral Treatment: Individual, group, or family therapy, in a residential, inpatient, outpatient, or community setting.

Medications: FDA-approved medications for OUD include buprenorphine (Subutex®, Sublocade®, Suboxone®), methadone, and naltrexone (Vivitrol®). Medications for alcohol use disorder include acamprosate, disulfiram (Antabuse®), and naltrexone (Vivitrol). Some of these medications work by reducing cravings, while others block the mind-altering effects of the substance.

Recovery Supports: People can sustain their recovery by maintaining good overall health, participating in meaningful activities such as community involvement, work, and social engagement, and getting support from groups like AA/NA, family, and friends.

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