
Mary Anne, whose family let her drink at home, wouldn’t ever think of “using drugs.” Lisa, who chose pot at that party, believed it was much less messy than booze. They share the common misconception that “alcohol is not a drug.” In fact, alcohol is one of many psychoactive drugs—substances that affect the brain in very specific ways, including causing addiction. People can become addicted to alcohol just as they can become addicted to the whole range of other drugs—from pot to heroin to nicotine or even caffeine. Substances like some cough syrups or prescription medications contain a variety of ingredients that create an addictive reaction. Addictive substances may differ, but addictions themselves have so much in common that members of the medical profession use the term substance use disorder (SUD) to refer to any kind of dependence on an external chemical substance.
The most common types of SUD are alcoholism and drug addiction. Addiction is a physical, mental, and emotional dependence on chemicals known as psychoactive drugs. Alcoholism, for example, is an addiction to alcohol. Addiction is a disease that includes the following four symptoms:
1) Craving— a strong and often overpowering urge to use a psychoactive drug.
2) Loss of control— not being able to stop using once a drug has been introduced to the body.
3) Physical dependence— the need to maintain the level of drugs in the body in order to avoid withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety.
4) Tolerance— the need to use increasingly large quantities of a drug to get the same sensation.
Alcoholism and addiction are considered “bio-psychosocial” disorders, in which biological (physical), psychological (mental), and social (interpersonal) factors are intertwined. Physical dependency on a chemical can lead to behavior that is extremely painful to the substance abusers and to all those connected to them. In some cases, a preexisting mental or psychological problem can cause an individual to self-medicate with an addictive drug. A social aspect of the disorder can refer to the impact of family on addiction, and vice versa.
Since in today’s world “society” extends way beyond one’s home, a wide range of influences, including the media, have an impact on attitudes and addiction—and substance abusers can affect a wide range of social groups. A unique characteristic of both alcoholism and addiction is a process called denial. Denial is an inability on the part of substance abusers (as well as, often, their family and friends) to admit that the addiction exists.

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