By Staff Reports
(DGIwire) – In 2013, the American Psychiatric Association (APA) published the latest version of its standard reference—the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). In doing so, the APA replaced the categories of substance abuse and substance dependence with a single category: substance use disorder. Here are six of the most common substance abuse disorders in the U.S.:
- Alcohol use disorder: According to the Centers for Disease Control and Prevention (CDC), alcohol use causes 88,000 deaths a year. There are three different levels of drinking: moderate, binge and heavy. The Substance Abuse and Mental Health Service Administration (SAMHSA) defines heavy drinking as five or more drinks on the same occasion on each of five or more days in the past 30 days.
- Tobacco use disorder: The CDC reports that more than 480,000 deaths each year are caused by cigarette smoking. In 2014, an estimated 66.9 million Americans ages 12 or older were current users of a tobacco product, according to SAMHSA.
- Cannabis use disorder: Marijuana is the most-used drug after alcohol and tobacco in the U.S.; according to SAMSHA data, in 2014, about 22.2 million people ages 12 and up reported using marijuana in the past month.
- Stimulant use disorder: The most commonly abused stimulants are amphetamines, methamphetamine and cocaine. In 2014, reports SAMSHA, an estimated 913,000 people ages 12 and older had a stimulant use disorder because of cocaine use alone.
- Hallucinogen use disorder: Hallucinogens can be chemically synthesized (as with LSD) or may occur naturally (as with psilocybin mushrooms). In 2014, approximately 246,000 Americans had a hallucinogen use disorder, says SAMHSA.
- Opioid use disorder: In 2014, an estimated 1.9 million people had an opioid use disorder related to prescription pain relievers and an estimated 586,000 had an opioid use disorder related to heroin use, SAMHSA reports.
“The sheer variety of substance use disorders might lead some to believe they have completely different underlying causes,” says Roger Crystal, MD, Chief Executive Officer of Opiant Pharmaceuticals, Inc., a specialty pharmaceutical company. “In fact, the overstimulation of the brain’s reward system is a common element in these disorders.”
Opiant is studying the use of opioid antagonists in various delivery forms, in particular using nasal sprays, for the treatment of substance abuse disorders, eating disorders and addictive disorders. The company has planned a series of clinical studies to begin in late 2016 and going forward. The company has already developed NARCAN® Nasal Spray, which is being marketed by its partner and licensee, Adapt Pharma.
The brain’s reward circuitry is thought to be what regulates the occurrence of these disorders. Increased levels of certain chemicals called neurotransmitters—such as opioids, endorphins and dopamine—activate the brain’s reward circuitry. However, it has been shown that opioid antagonists can block the effects of these chemicals and make these types of behaviors less tempting to those who would otherwise obsessively engage in them.
“The ability to administer a rapidly effective treatment could disrupt the activation of reward circuitry and perhaps ultimately lead to a reduction in engaging in various types of addictive behaviors,” adds Crystal.