A Clinical Approach for Recovery from Substance Use Disorder

Gain knowledge on the clinical approach to substance use disorder and its impact on treatment and patient outcomes.

Understanding Substance Use Disorder: Causes, Identification, Management, and Health Impacts

Imagine waking up every day with an insatiable hunger that makes it tough to make basic decisions like going to work or spending time with your family. In 2024, a startling 16.8% of Americans, or approximately 48.4 million people aged 12 and older, suffered from drug use disorder (SUD). Uncontrolled use of substances like alcohol, cocaine, or even prescription medications despite the damage they cause is a result of a complicated, curable brain condition called substance use disorder (SUD). It is not a sign of weakness or bad decisions.

It is no longer possible to perceive SUD via a judgmental lens. Experts from groups like the National Institute on Drug Abuse (NIDA) now highlight its scientific origins: recurrent drug use modifies reward, stress, and self-control pathways in the brain, making quitting seem difficult without assistance. With drug use disorders affecting 28.2 million individuals (an increase) and alcohol use disorders affecting 27.9 million people (a slight decrease from prior years), the crisis affects every segment of society, from adults coping with chronic pain or mental health issues to youth struggling with peer pressure. Sadly, more than half of people with SUD also struggle with co-occurring mental disorders like anxiety or depression, which creates a vicious cycle that is difficult to escape on one’s own.

Still, there is hope. Changes may be made by early detection with simple screenings, efficient management techniques, and cutting-edge methods like integrated chiropractic therapy, which reduces pain without the need for opioids by using spine adjustments and exercises. Nurse practitioners also play a vital role by providing holistic care, ergonomic guidance, and treatment coordination for both mental and physical health. We’ll explore the fundamentals of SUD in this book, including its classifications and symptoms, how to spot and treat it, how it affects the body, including the bones and muscles, and how holistic approaches may aid in recovery. Understanding SUD is the first step in healing, whether you’re looking for information for yourself or a loved one.

What Is Substance Use Disorder?

SUD happens when someone can’t control their use of substances like alcohol or drugs, even when it causes harm. Experts define it as a treatable, long-term illness that impacts the brain and behavior. The Centers for Disease Control and Prevention (CDC) calls it a group of diseases marked by ongoing use despite problems in health, work, or relationships (Centers for Disease Control and Prevention, 2024). It’s like the brain gets rewired to crave the substance, making it hard to stop.

The National Institute of Mental Health (NIMH) explains SUD as a mental disorder where people lose control over legal or illegal substances. It ranges from mild to severe, with addiction as the worst form (National Institute of Mental Health, n.d.). Addiction means compulsive use despite bad outcomes, driven by brain changes in areas for reward, stress, and self-control.

Why does SUD develop? It’s a mix of biology, environment, and personal factors. Genes can make some people more vulnerable, while stress, trauma, or early exposure raises risks. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in 2022, 48.7 million Americans aged 12 and older had SUD, showing how common it is (Substance Abuse and Mental Health Services Administration, 2023).

SUD isn’t a choice or weakness—it’s a disease like diabetes or heart problems. The National Institute on Drug Abuse (NIDA) stresses using kind language, like “person with SUD” instead of “addict,” to reduce shame and encourage help (National Institute on Drug Abuse, 2021). This shift helps people seek treatment without fear.

Key Facts About SUD

• Affects brain circuits for pleasure and stress.
• Often linked to mental health issues like anxiety or depression.
• It can lead to relapse even after long abstinence.
• Treatable with meds, therapy, and support.

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Different Categories of Identifying SUD

SUD is identified by patterns of use and types of substances. The American Psychiatric Association lists 10 categories of substances that can lead to SUD: alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives/hypnotics/anxiolytics, stimulants (like amphetamines or cocaine), tobacco, and others.

Each category has unique effects, but all activate the brain’s reward system, causing pleasure that leads to repeated use. From the 2022 national survey, alcohol use disorder affected 29.5 million people, while drug use disorder hit 27.2 million (Substance Abuse and Mental Health Services Administration, 2023). Opioids, including prescription painkillers and heroin, caused 6.1 million cases.

Identification relies on symptoms like using more than planned, failing to cut back, spending time on the substance, cravings, neglecting duties, relationship problems, risky use, tolerance, and withdrawal (National Institute on Drug Abuse, 2018). Severity is mild (2-3 symptoms), moderate (4-5), or severe (6+).

Common Substance Categories and Signs

• Alcohol: Frequent binge drinking, blackouts, legal issues. Affects 10.5% of Americans.
• Opioids: Drowsiness, slowed breathing, needle marks. High overdose risk; 2.2% prevalence.
• Stimulants: Increased energy, paranoia, and weight loss. Includes cocaine (0.5%) and meth (0.6%).
• Cannabis: Memory issues, lack of motivation. Disorder in 6.7%.
• Tobacco: Coughing, nicotine dependence. Often co-occurs with other SUDs.

These categories help doctors classify and treat SUD. Dr. Alexander Jimenez, a chiropractor and nurse practitioner, notes in his practice that pain from SUD often leads to musculoskeletal issues, pushing for drug-free management (Jimenez, n.d.).

The Process of Identifying Patients with SUD

Identifying SUD starts with routine screening in all health settings, from doctors’ offices to emergencies. NIDA recommends asking everyone about substance use to catch it early (National Institute on Drug Abuse, n.d.). Tools like AUDIT for alcohol or DAST-10 for drugs make it objective.

Brief pre-screens are quick, like AUDIT-C (3 questions on drinking) or SASQ (one question on heavy drinking days) (National Institute on Alcohol Abuse and Alcoholism, 2023). Positive results lead to full screens like ASSIST for multiple substances or CUDIT-R for cannabis.

If positive, evaluate with a full history. The AMA guide suggests team-based care: talk non-judgmentally, use motivational interviewing to build readiness (American Medical Association, 2021). Check for co-occurring issues like mental health—half of SUD cases have them (National Institute of Mental Health, n.d.).

Steps in Identification:

• Pre-screen everyone: “How many times in the past year have you used a recreational drug?”
• Full screen if positive: Use tools like TAPS for adults or SUBS for general use.
• Assess risk: Low (reinforce healthy choices), moderate (brief talk), high (refer to specialist).
• Document and follow up: Track behaviors like tolerance or withdrawal.

Dr. Jimenez observes that screening for pain-related SUD in chiropractic settings helps spot risks early (Jimenez, n.d.).

Managing Patients with SUD

Management focuses on detox, meds, therapy, and support for long-term recovery. SAMHSA emphasizes integrated care for SUD and mental health (Substance Abuse and Mental Health Services Administration, 2023). Start with detox under medical watch to handle withdrawal safely.

For alcohol, use meds like naltrexone to reduce cravings. Opioids need MAT like buprenorphine to prevent relapse (National Institute on Drug Abuse, 2020). Tobacco: Nicotine patches plus counseling.

Therapy includes CBT to change thinking, motivational interviewing to build will, and groups like AA. Only 14.9% with SUD get treatment, so access is key (Substance Abuse and Mental Health Services Administration, 2023).

Management Steps

• Detox: Meds for symptoms, monitoring in hospital if severe.
• Meds: Tailor to substance, e.g., disulfiram for alcohol aversion.
• Therapy: Individual or group to address triggers.
• Support: Family involvement and peer groups for ongoing support.
• Follow-up: Regular checks to prevent relapse.

Nurse practitioners (NPs) play a big role, prescribing MAT, giving ergonomic advice for pain, and coordinating care (American Association of Nurse Practitioners, 2024). They provide full management, from screening to referrals.

How SUD Affects the Body, Including the Musculoskeletal System

SUD harms nearly every body system. Brain changes lead to addiction, while physical effects include liver damage from alcohol or lung issues from smoking. The NIMH notes SUD alters behavior and control (National Institute of Mental Health, n.d.).

Musculoskeletal effects are common. Alcohol causes myopathy—muscle weakness and wasting—by interfering with repair (WebMD, 2024). Opioids lead to tendon rupture and fibrosis (PubMed, 1982). Stimulants like cocaine cause muscle pain and cramping (Physiology, 2019). Cannabis and others disrupt bone health, raising fracture risk (PMC, 2024).

Dr. Jimenez sees SUD worsening pain, leading to misalignment that is treatable without drugs (Jimenez, n.d.). Teens with pain show higher SUD rates (JOSPT, 2017).

Body Effects

• Heart: Irregular beats from stimulants.
• Liver: Cirrhosis from alcohol.
• Muscles: Weakness, pain, toxicity.
• Bones: Lower density, easy breaks.
• Nerves: Neuropathy from long-term use.

Integrative Chiropractic Care and Nurse Practitioner Role in SUD

Integrative chiropractic care uses spinal adjustments and exercises to fix alignment, easing pain that might fuel SUD. It reduces risk by managing pain naturally, avoiding opioids (Isaiah House, n.d.). Adjustments help with withdrawal aches and improve mood.

Dr. Jimenez combines chiropractic with functional medicine for drug-free recovery, noting better outcomes (Jimenez, n.d.). Surveys show chiropractors often see SUD patients and need training (PMC, 2023).

NPs provide full care: screening, prescribing, advising on ergonomics to prevent pain, and coordinating with therapists (NP Journal, 2024). They handle co-occurring issues by developing plans with various treatments.

Chiropractic Benefits

• Adjustments reduce stress and aid detox.
• Exercises build strength and prevent relapse.
• Holistic: Lowers SUD risks by addressing the root causes of pain.

NP Contributions

• Comprehensive assessments.
• Ergonomic tips for daily life.
• Coordinate meds, therapy, and support.

Conclusion

Although substance use disorder (SUD) is a curable illness that need not define a person’s life, it continues to be a significant public health concern. We can assist individuals in regaining control by understanding their origins, identifying early indicators through regular screenings, and using effective management strategies such as medication, therapy, and support groups. Recall that SUD has significant effects on the body and brain, including weakening of the bones and muscles, yet integrative methods provide hope. Chiropractic therapy lowers the risks associated with SUD by restoring alignment and reducing pain without the need for drugs via spinal adjustments and exercises. From developing comprehensive care plans that address both physical and emotional needs to offering ergonomic advice, nurse practitioners provide crucial assistance.

Current data demonstrates the scope of the problem: Similar to 2022 data, about 48.5 million Americans aged 12 and older had a past-year SUD in 2023, with 28.6 million suffering from alcohol use disorder and 27.8 million from drug use disorder (Substance Abuse and Mental Health Services Administration, 2024). The good news is that 73.1% of individuals who acknowledge they have a drug use disorder report being in recovery, demonstrating that change is achievable.

Crucial Lessons for Healing:

• Use tools like AUDIT or DAST-10 during routine medical visits to help save lives via early identification.
• Combining medical therapies with chiropractic and NP support may yield better results.
• Millions of people recover every year with the correct support, so you’re not alone.

Don’t wait if you or a loved one is experiencing SUD; call local clinicians or hotlines like SAMHSA’s at 1-800-662-HELP right now. We can stop this pandemic and create healthy futures with understanding, compassion, and action.

References

• American Association of Nurse Practitioners. (2024). Nurse practitioners guide patients on the road to recovery. https://www.aanp.org/news-feed/nurse-practitioners-guiding-patients-on-the-road-to-recovery
• American Medical Association. (2021). Substance use disorder how-to guide. https://www.ama-assn.org/system/files/bhi-sud-how-to-guide.pdf
• Centers for Disease Control and Prevention. (2024). Treatment of substance use disorders. https://www.cdc.gov/overdose-prevention/treatment/index.html
• Jimenez, A. (n.d.). Dr. Alexander Jimenez’s website. https://dralexjimenez.com/
• Jimenez, A. (n.d.). LinkedIn profile. https://www.linkedin.com/in/dralexjimenez/
• National Institute on Alcohol Abuse and Alcoholism. (2023). Screen and assess: Use quick, effective methods. https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/screen-and-assess-use-quick-effective-methods
• National Institute on Drug Abuse. (n.d.). Screening tools and prevention. https://nida.nih.gov/nidamed-medical-health-professionals/screening-tools-prevention
• National Institute on Drug Abuse. (2018). Understanding drug use and addiction: drug facts. https://nida.nih.gov/publications/drugfacts/understanding-drug-use-addiction
• National Institute on Drug Abuse. (2021). Words matter: Preferred language for talking about addiction. https://nida.nih.gov/research-topics/addiction-science/words-matter-preferred-language-talking-about-addiction
• National Institute on Drug Abuse. (2020). Common comorbidities with substance use disorders research report. https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-use-disorders
• National Institute of Mental Health. (n.d.). Substance use and co-occurring mental disorders. https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health
• Novus Health. (2024). The effects of alcohol on the musculoskeletal system. https://novushealth.co.uk/2024/07/the-effects-of-alcohol-on-the-musculoskeletal-system-what-you-need-to-know/
• PubMed. (1982). Adverse effects of drugs on muscle. https://pubmed.ncbi.nlm.nih.gov/6128217/
• PubMed Central. (2024). Understanding the effect of recreational drug use on bone health. https://pmc.ncbi.nlm.nih.gov/articles/PMC11402883/
• PubMed Central. (2023). Identifying and addressing patient substance use: A survey of chiropractors. https://pmc.ncbi.nlm.nih.gov/articles/PMC10316550/
• Physiology. (2019). Muscle toxicity of drugs: When drugs turn physiology into pathophysiology. https://journals.physiology.org/doi/full/10.1152/physrev.00002.2019
• Substance Abuse and Mental Health Services Administration. (2023). 2022 NSDUH annual national report. https://www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-nnr.pdf
• Substance Abuse and Mental Health Services Administration. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health. https://www.samhsa.gov/data/sites/default/files/reports/rpt47095/National%20Report/National%20Report/2023-nsduh-annual-national-report.pdf
• The Journal of Orthopaedic and Sports Physical Therapy. (2017). Increased substance use and poorer mental health in adolescents with musculoskeletal pain. https://www.jospt.org/doi/10.2519/jospt.2017.7441
• WebMD. (2024). What to know about alcoholic myopathy. https://www.webmd.com/mental-health/addiction/what-to-know-alcoholic-myopathy