Substance Use Disorder

Substance use disorder (SUD) has become an epidemic in North America. Lives are lost every day, and thousands of families are grieving and mourning their loved ones lost to this nightmare.

We hear about it daily in the news; we see the images, hear the frustration, the sadness and helplessness of affected family members. We also see the impact it has on health care providers and our already stretched healthcare system.

While there are many addictive substances like alcohol, marijuana, nicotine, caffeine, and sleeping pills, this article will primarily address opioid abuse – the fastest growing crisis in Canada. It addresses how teens and adults can be influenced and become addicted, and how it affects them both physically, emotionally, and mentally.

Diagnosis, treatment, and prevention are reviewed. We will also learn how to best understand and support the people we know and love, who are struggling with substance addiction dependency.

Drug Toxicity in BC and Across Canada

According to British Columbia Public Safety and Solicitor General, since 2016, close to 14,000 people in British Columbia have lost their lives due to unregulated drugs.

Man drinking a bottle of alcohol

Drug addict injecting himself

Starting in 2010, BC overdose related deaths were mainly from prescription opioids, but that changed to epidemic proportions due to easy access of illegal synthetic toxic opioids, such as fentanyl.

In 2023, an average of 7 persons died each day in BC due to unregulated opioids. Our province has the highest drug related deaths in Canada.

Across Canada, the Government of Canada states that in 2023, 5,975 persons died due to opioid toxicity: that is a staggering 22 deaths per day, with an increase of 8% from 2022.

This also impacts our already fragile Canada healthcare system. In 2023, there were 4,646 hospital stays, (17 per day); 21,708 emergency hospital visits, (80 per day); and an increase of 18% from 2022.

In the first 9 months of 2023, Emergency Medical Services responded to 33,015 persons suspected toxic drug overdose (the equivalent of 121 per day). Read here for more info.

What is Substance Use Disorder (SUD)?

The National Institute of Mental Health described Substance Use Disorder (SUD) as “a treatable mental disorder that affects a person’s brain and behaviour, leading to their inability to control their use of substances like legal or illegal drugs, alcohol, or medications.”

Substance use disorder is not only associated with hard core drugs, such as oxytocin, heroin and fentanyl laced opioids, but also common substances such as caffeine, nicotine, vaping, marijuana, sedatives, and alcohol.

According to the Mayo Clinic, “Drug addiction is a disease that affects a person’s brain and behavior, leading to an inability to control the use of a legal or illegal drug or medicine despite the harm it causes to oneself”.

Over time, one will not get the same effect as the initial dose and increases its amount to get the desired effect. Those who are addicted will use the drug to cope and to continuously feel good, leading to a dependency. Their attempts to stop using the drug may lead to more cravings and feeling physically ill with withdrawal symptoms.

Centre for Addiction & Mental Health (CAMH) describes addiction using the 4 Cs:

Craving
loss of Control of amount or frequency of use
Compulsion to use.
use despite Consequences.

Who is Most Vulnerable?

Sad and alone boy most vulnerable to being targetted by drug pushers

Substance abuse does not discriminate.

It is not only the homeless and marginalized who are at risk, but also youths from loving homes, young ambitious adults, and law-abiding adult citizens, of all races, gender, and socio-economic backgrounds.

However, males between the ages of 18-25 years do show the highest prevalence for SUD.

The National Institute on Drug Abuses (NIDA) states that causes of substances abuse can occur when coping with life’s challenges from financial strain, job loss, divorce, death of a loved one, anxiety and depression to name a few.

With adults, addiction can start innocently with a prescription for painkillers, or a well-intentioned friend giving their prescription meds to another.

Youth and teens are just as vulnerable as adults, if not more, as they are dealing with psychological and emotional growing pains. Additionally, they are curious about trying new and different substances, especially if introduced to them by their peers. According to Dr Gabor Mate in his book Hold On To Your Kids: Why Parents Need To Matter More Than Peers, children are increasingly turning “to their peers for direction—their values, identity, and codes of behavior.”

According to Psychology Today, youth are at higher risk of developing SUD because they are at an age when the rational parts of their brains are not yet fully-developed – this doesn’t happen until their 20’s. In other words, the brains of youth are wired for risk taking.

The part of the brain that experiences pleasure and reward is fully developed in teens due to an evolutionary survival process. As Psychology Today states, “Teenagers are like race cars without fully functional brakes”.

Risk factors for SUD can increase when one or more of the following is present: