Abstract
Substance use disorders are highly prevalent and are responsible for considerable morbidity and mortality. Although some symptoms of substance use disorders are drug specific, all drugs of misuse share common some combination of impaired control, social impairment, risk use, and pharmacologic symptoms, including tolerance and physical dependence. The etiology of substance use disorders is multifactorial. The public health model of disease emphasizes interactions among the individual, the drug, and the environment in which the drug is used. Medical complications from drug use disorders are often related to factors that cut across many of the drugs of misuse, including paraphernalia (e.g., unsterile needles), adulterants, and lifestyle issues. However, key drug-specific issues include opioid-induced respiratory depression and cocaine-induced ventricular tachyarrhythmias, vasoconstrictive effects, and grand mal seizures. Treatment of substance use disorders varies according to the drug. Effective pharmacotherapies are prominent in the treatment of opioid use disorders, but psychosocial treatments are emphasized for the treatment of cocaine, methamphetamine, or cannabis use disorders.
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