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Substance use disorder

Dependentia a substantiis · Závislost na návykových látkách

What it is

Reward circuitry hijacked; use continues despite clear harm. The US opioid epidemic began with painkillers sold as rarely addictive — Purdue pleaded guilty over OxyContin marketing in 2007 and 2020.

Symptoms & signs

  • Craving
  • tolerance
  • withdrawal
  • loss of control
  • neglected roles
  • relapse after stopping

🚩 Get help if…

  • call 112 / 911 now Slow or stopped breathing, blue lips or cannot be woken — overdose
  • call 112 / 911 now Seizure, hallucinations or shaking when stopping alcohol
  • call 112 / 911 now Chest pain or collapse after stimulants
  • see a doctor soon Fever and a red swelling at an injection site

Where it strikes

Medical treatment

  • Opioids: methadone, buprenorphine, naltrexone
  • alcohol: naltrexone, acamprosate
  • nicotine: varenicline, NRT
  • contingency management
  • residential rehab
  • deep TMS to stop smoking — FDA-cleared 2020

Natural & lifestyle

  • 12-step and SMART recovery groups
  • exercise
  • sleep and nutrition repair
  • removing cues
  • mindfulness relapse prevention

Emerging & experimental

  • Psilocybin for alcohol use disorder
  • GLP-1 agonists reducing craving
  • TMS for cocaine use (trials)
  • anti-fentanyl vaccines

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • High-dose baclofen for alcohol — used in France; trials disagree mixed evidence
  • Ear acupuncture (NADA protocol) — widely used in clinics; trials disagree mixed evidence
  • Kudzu extract — small trials reduce drinking early / small studies
  • Ibogaine for opioid withdrawal — striking reports; heart-rhythm deaths have occurred early / small studies

ICD codes