Substance abuse in the context of Abuse

Suicide is the act of intentionally causing one's own death. Risk factors for suicide include mental disorders, neurodevelopmental disorders, physical disorders, and substance abuse. Some suicides are impulsive acts driven by stress (such as from financial or academic difficulties), relationship problems (such as breakups or divorces), or harassment and bullying. Those who have previously attempted suicide are at a higher risk for future attempts. Effective suicide prevention efforts include limiting access to methods of suicide such as firearms, drugs, and poisons; treating mental disorders and substance abuse; careful media reporting about suicide; improving economic conditions; and dialectical behaviour therapy (DBT). Although crisis hotlines, like 988 in North America and 13 11 14 in Australia, are common resources, their effectiveness has not been well studied.

Suicide is the 10th-leading cause of death worldwide, accounting for about 1.5% of deaths. In a given year, this is roughly 12 per 100,000 people. Though suicides resulted in 828,000 deaths globally in 2015, up from 712,000 deaths in 1990, the age-standardized death rate decreased by 23.3%. By gender, suicide rates are generally higher among men than women, ranging from 1.5 times higher in the developing world to 3.5 times higher in the developed world; in the Western world, non-fatal suicide attempts are more common among young people and women. Suicide is generally most common among those over the age of 70; however, in certain countries, those aged between 15 and 30 are at the highest risk. Europe had the highest rates of suicide by region in 2015.

Recidivism (/rɪˈsɪdɪvɪzəm/; from Latin: recidivus 'recurring', derived from re- 'again' and cadere 'to fall') is the act of a person repeating an undesirable behavior after they have experienced negative consequences of that behavior, or have been trained to extinguish it. Recidivism is also used to refer to the percentage of former prisoners who are rearrested for a similar offense.

The term is frequently used in conjunction with criminal behavior and substance abuse. Recidivism is a synonym of relapse, which is more commonly used in medicine and in the disease model of addiction.

Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has developed within the individual from psychoactive substance consumption that results in the experience of withdrawal and that necessitates the re-consumption of the drug. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions, but not dependence.

The International Classification of Diseases classifies substance dependence as a mental and behavioural disorder. In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (released in 2013), substance abuse and substance dependence were eliminated and replaced with the single diagnosis of substance use disorders. This was done because "the tolerance and withdrawal that previously defined dependence are actually very normal responses to prescribed medications that affect the central nervous system and do not necessarily indicate the presence of an addiction."

Self-harm is intentional behavior that causes harm to oneself. This is most commonly regarded as direct injury of one's own tissues, usually without suicidal intention. Other terms such as cutting, self-abuse, self-injury, and self-mutilation have been used for any self-harming behavior regardless of suicidal intent. Common forms of self-harm include damaging the skin with a sharp object or scratching with the fingernails, hitting, or burning. The exact bounds of self-harm are imprecise, but generally exclude tissue damage that occurs as an unintended side-effect of eating disorders or substance abuse, as well as more societally acceptable body modification such as tattoos and piercings.

Although self-harm is by definition non-suicidal, it may still be life-threatening. People who do self-harm are more likely to die by suicide, and 40–60% of people who die by suicide have previously self-harmed. Still, only a minority of those who self-harm are suicidal.

Morphine, formerly known as morphium, is an opiate found naturally in opium, a dark brown resin produced by drying the latex of opium poppies (Papaver somniferum). It is mainly used as an analgesic (pain medication). There are multiple methods used to administer morphine: oral; sublingual; via inhalation; injection into a muscle, injection under the skin, or injection into the spinal cord area; transdermal; intravenously; or via rectal suppository. It acts directly on the central nervous system (CNS) to induce analgesia and alter perception and emotional response to pain. Physical and psychological dependence and tolerance may develop with repeated administration. It can be taken for both acute pain and chronic pain and is frequently used for pain from myocardial infarction, kidney stones, and during labor. Its maximum effect is reached after about 20 minutes when administered intravenously and 60 minutes when administered by mouth, while the duration of its effect is 3–7 hours. Long-acting formulations of morphine are sold under the brand names MS Contin and Kadian, among others. Generic long-acting formulations are also available.

Common side effects of morphine include drowsiness, euphoria, nausea, dizziness, sweating, and constipation. Potentially serious side effects of morphine include decreased respiratory effort, vomiting, and low blood pressure. Morphine is highly addictive and prone to abuse. If one's dose is reduced after long-term use, opioid withdrawal symptoms may occur. Caution is advised for the use of morphine during pregnancy or breastfeeding, as it may affect the health of the baby.

A criminal court may impose a "mandate" as part of a legal process on a person accused of a crime consisting of an obligation to engage in certain conditions or activities in exchange for suspension or reduction in penalty; such as, conditions of probation, conditional discharges, or other conditional sentences. For example, a defendant convicted of driving while intoxicated or drug possession may be mandated to engage in alcoholism or substance abuse rehabilitation. The term is paradoxical because acceptance of the "mandate" is a voluntary act by the defendant, who also has the option of serving what would most generally (though the relative weight is a matter determined by the individual's perspective and readiness to change) be viewed as a harsher alternative, such as incarceration. In this sense, the mandate is not truly mandatory, but is instead a type of legal fiction wherein the court assumes an illusion of power which, in actuality, is constrained by the defendant's free will.

An eating disorder (ED) is a mental disorder defined by abnormal eating behaviors that adversely affect a person's physical or mental health. These behaviors may include eating too much food or too little food, as well as body image issues. Types of eating disorders include binge eating disorder, where the person suffering keeps eating large amounts in a short period of time typically while not being hungry, often leading to weight gain; anorexia nervosa, where the person has an intense fear of gaining weight, thus restricts food and/or overexercises to manage this fear; bulimia nervosa, where individuals eat a large quantity (binging) then try to rid themselves of the food (purging), in an attempt to not gain any weight; pica, where the patient eats non-food items; rumination syndrome, where the patient regurgitates undigested or minimally digested food; avoidant/restrictive food intake disorder (ARFID), where people have a reduced or selective food intake due to some psychological reasons; and a group of other specified feeding or eating disorders. Anxiety disorders, depression and substance abuse are common among people with eating disorders. These disorders do not include obesity. People often experience comorbidity between an eating disorder and OCD.

The causes of eating disorders are not clear, although both biological and environmental factors appear to play a role. Cultural idealization of thinness is believed to contribute to some eating disorders. Individuals who have experienced sexual abuse are also more likely to develop eating disorders. Some disorders such as pica and rumination disorder occur more often in people with intellectual disabilities.

Lifestyle medicine (LM) is a branch of medicine focused on preventive healthcare and self-care dealing with prevention, research, education, and treatment of disorders caused by lifestyle factors and preventable causes of death such as nutrition, physical inactivity, chronic stress, and self-destructive behaviors including the consumption of tobacco products and drug or alcohol abuse. The goal of LM is to improve individuals' health and wellbeing by applying the 6 pillars of lifestyle medicine (nutrition, regular physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connection) to prevent chronic conditions such as cardiovascular diseases, diabetes, metabolic syndrome and obesity.

Lifestyle medicine focuses on educating and motivating patients to improve the quality of their lives by changing personal habits and behaviors around the use of healthier diets which minimize ultra-processed foods such as a Mediterranean diet or whole food, plant-predominant dietary patterns. Poor lifestyle choices like dietary patterns, physical inactivity, tobacco use, alcohol addiction and dependence, drug addiction and dependence, as well as psychosocial factors, e.g. chronic stress and lack of social support and community, contribute to chronic disease. In the clinic, major barriers to lifestyle counseling are that physicians feel ill-prepared and are skeptical about their patients' receptivity. However, by encouraging healthy decisions, illnesses can be prevented or better managed in the long-term.

Medical toxicology is a subspecialty of medicine focusing on toxicology and providing the diagnosis, management, and prevention of poisoning and other adverse effects due to medications, occupational and environmental toxicants, and biological agents. Medical toxicologists are involved in the assessment and treatment of a wide variety of problems, including acute or chronic poisoning, adverse drug reactions (ADRs), drug overdoses, envenomations, substance abuse, industrial accidents, and other chemical exposures.

Medical toxicology is officially recognized as a medical subspecialty by the American Board of Medical Specialties. Its practitioners are physicians, whose primary specialization is generally in emergency medicine, occupational medicine, or pediatrics.

Disinhibition, also referred to as behavioral disinhibition, is medically recognized as an orientation towards immediate gratification, leading to impulsive behaviour driven by current thoughts, feelings, and external stimuli, without regard for past learning or consideration for future consequences. It is one of five pathological personality trait domains in certain psychiatric disorders. In psychology, it is defined as a lack of restraint manifested in disregard of social conventions, impulsivity, and poor risk assessment. Hypersexuality, hyperphagia, substance abuse, money mismanagement, frequent faux pas, and aggressive outbursts are indicative of disinhibited instinctual drives.

Certain psychoactive substances that have effects on the limbic system of the brain may induce disinhibition.

Physical dependence is a physical condition caused by chronic use of a tolerance-forming drug, in which abrupt or gradual drug withdrawal causes unpleasant physical symptoms. Physical dependence can develop from low-dose therapeutic use of certain medications such as benzodiazepines, opioids, stimulants, antiepileptics and antidepressants, as well as the recreational misuse of drugs such as alcohol, opioids and benzodiazepines. The higher the dose used, the greater the duration of use, and the earlier age use began are predictive of worsened physical dependence and thus more severe withdrawal syndromes. Acute withdrawal syndromes can last days, weeks or months. Protracted withdrawal syndrome, also known as post-acute-withdrawal syndrome or "PAWS", is a low-grade continuation of some of the symptoms of acute withdrawal, typically in a remitting-relapsing pattern, often resulting in relapse and prolonged disability of a degree to preclude the possibility of lawful employment. Protracted withdrawal syndrome can last for months, years, or depending on individual factors, indefinitely. Protracted withdrawal syndrome is noted to be most often caused by benzodiazepines as well as opioids. To dispel the popular misassociation with addiction, physical dependence to medications is sometimes compared to dependence on insulin by persons with diabetes.

Psychological dependence is a cognitive disorder and a form of dependence that is characterized by emotional–motivational withdrawal symptoms upon cessation of prolonged drug use or certain repetitive behaviors. Consistent and frequent exposure to particular substances or behaviors is responsible for inducing psychological dependence, requiring ongoing engagement to prevent the onset of an unpleasant withdrawal syndrome driven by negative reinforcement. Neuronal counter-adaptation is believed to contribute to the generation of withdrawal symptoms through changes in neurotransmitter activity or altered receptor expression. Environmental enrichment and physical activity have been shown to attenuate withdrawal symptoms.

Alcohol abuse encompasses a spectrum of alcohol-related substance abuse. This spectrum can range from being mild, moderate, or severe. This can look like consumption of more than 2 drinks per day on average for men, or more than 1 drink per day on average for women, to binge drinking.

Alcohol abuse was a psychiatric diagnosis in the DSM-IV, but it has been merged with alcohol dependence in the DSM-5 into alcohol use disorder.

Self-love, defined as "love of self" or "regard for one's own happiness or advantage", has been conceptualized both as a basic human necessity and as a moral flaw, akin to vanity and selfishness, synonymous with amour-propre, conceitedness, egotism, narcissism, et al. However, throughout the 20th and 21st centuries self-love has adopted a more positive connotation through pride parades, Self-Respect Movement, self-love protests, the hippie era, the modern feminist movement (3rd & 4th wave), as well as the increase in mental health awareness that promotes self-love as intrinsic to self-help and support groups working to prevent substance abuse and suicide.

Acquired brain injury (ABI) is brain damage caused by events after birth, rather than as part of a genetic or congenital disorder such as fetal alcohol syndrome, perinatal illness or perinatal hypoxia. ABI can result in cognitive, physical, emotional, or behavioural impairments that lead to permanent or temporary changes in functioning. These impairments result from either traumatic brain injury (e.g. physical trauma due to accidents, assaults, neurosurgery, head injury etc.) or nontraumatic injury derived from either an internal or external source (e.g. stroke, brain tumours, infection, poisoning, hypoxia, ischemia, encephalopathy or substance abuse). ABI does not include damage to the brain resulting from neurodegenerative disorders.

While research has demonstrated that thinking and behavior may be altered in virtually all forms of ABI, brain injury is itself a very complex phenomenon having dramatically varied effects. No two persons can expect the same outcome or resulting difficulties. The brain controls every part of human life: physical, intellectual, behavioral, social and emotional. When the brain is damaged, some part of a person's life will be adversely affected.