Little Cities of Hope The Nature of Substance Use Disorder

By Joe ChristmanWhat is Substance Use Disorder?According to SAMSHA, Substance Abuse and Mental Health Services Administration, substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability and failure to meet major responsibilities at work, school or home.The American Society of Addiction Medicine, ASAM, in a 2011 public policy statement define addiction to be a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life.Addiction is also a developmental disease often beginning during childhood or adolescence and may last a lifetime if left untreated.The debate or disagreements about the nature of substance use disorders remain: essentially, is it a voluntary or involuntary behavior and should it be criminalized or treated like a health issue?There is a stigma surrounding a substance use disorder or addiction that, in my view, is a major obstacle to effective treatment, meaningful dialogue and positive efforts to reduce deaths and provide recovery for people who use opioids to regain control of their lives.I acknowledge that the first time someone takes an opioid it is most often by choice to achieve a desired emotional state or a pleasurable experience or following a prescribed treatment plan for pain control. After 30 years of research, we know that the ability to choose can be affected by the opioid. The National Institute on Drug Abuse, NIDA, has proven that addiction is a complex brain disease that takes hold in the brain and causes a person’s ability to control their behavior to become disrupted, thereby demonstrating the compulsive nature of the substance use disorder.So, what is our community to do? First and foremost is to reduce or remove the stigma surrounding substance use disorders by recognizing both criminalized and non-criminalized opioid use. Certainly, people need to be held accountable for their actions, but in order to break the cycle, there must be some hope injected into the equation. Medically Assisted Treatment (MAT) is accessible and counseling and harm-reduction programs are available, and naloxone is a lifesaving option readily available.It’s a great start, but in order to land the plane it is going to take our community to ensure that someone with a substance use disorder feels like there is more to it then “we have help available.” We need to foster an environment where those suffering from a substance use disorder, addiction or a choice will accept that help and receive our support and that is the nature of substance use disorder.How can I learn more?Learn more about recovery and its multiple pathways at the upcoming Recovery Day on Sept. 7 from 12-3 p.m. at the Price City Peace Gardens.Learn more about community resources and Opioid Use Disorder at the upcoming Community Education Dinner on Nov. 4 at USU Eastern in Price, UT at 5 p.m. Register on Eventbrite today:

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