Overview of Substance Use Disorders-Video

Video Transcription
Video Summary
Dr. Myra Mathis provides an in-depth overview of substance use disorders (SUD) as part of the Providers Clinical Support System (PCSS) training series. The training aims to equip healthcare professionals with evidence-based knowledge for preventing and treating opioid and other substance use disorders, focusing on accurate terminology, epidemiology, neurobiology, chronic disease framework, comorbidities, and integrated care models.<br /><br />Substance use ranges from abstinence, low-risk use, risky use, to harmful use meeting DSM-5 criteria for SUD, which requires the presence of at least two of 11 specific behavioral and physiological symptoms within a year. The severity is classified as mild, moderate, or severe, with polysubstance disorders assessed individually. Clinically appropriate, non-stigmatizing language is emphasized, avoiding terms like “misuse,” “relapse,” or “clean/dirty” toxicology results.<br /><br />Epidemiologically, about 14.5% of Americans aged 12+ had a past-year SUD in 2020, with alcohol use disorder the most prevalent, followed by illicit drugs such as opioids and methamphetamines. Variations exist by age, gender, race, socioeconomic status, and region. Notably, overdose deaths surged sharply from 2019, especially among Black and Indigenous populations and adolescents exposed to fentanyl.<br /><br />Neurobiologically, addiction disrupts brain reward pathways, particularly dopamine circuits, overriding executive controls and reinforcing drug use over natural rewards. Social environment and stressors significantly influence these processes. Addiction is a chronic brain disease with genetic, psychological, and environmental risk factors, sharing similarities with other chronic illnesses like diabetes and depression.<br /><br />Addiction is frequently comorbid with medical and psychiatric conditions and linked to direct and indirect harms, including infectious diseases from injection drug use. Treatment engagement is low, with only 10% receiving specialty care. Integration of addiction treatment into general medical, psychiatric, and emergency settings improves outcomes, underscoring the importance of multidisciplinary teams that include prescribers, therapists, social workers, and peer supports.<br /><br />The training concludes by highlighting PCSS resources such as mentor programs and discussion forums to support providers with clinical questions and ongoing education, promoting a systemic approach to addressing SUD and improving patient care.
Keywords
Substance Use Disorders
PCSS Training
Opioid Addiction
DSM-5 Criteria
Epidemiology of SUD
Neurobiology of Addiction
Chronic Disease Model
Comorbidities
Integrated Care Models
Non-stigmatizing Language