Substance Use Disorder (SUD) 

​First, if you are a CRNA or student nurse anesthetist with substance use disorder (SUD), help is available:

 
Help for Drugs/Alcohol

New - Substance Abuse and Mental Health Services Administration (SAMHSA) 2018 National Survey on Drug Use and Health (NSDUH). 2018 NSDUH Report Data Findings Report and presentation of data: recorded webcast and slides (PDF | PPT). Highlights include:

• Opioid epidemic:
  • New users of heroin significantly decreased related to 2016
  • Significant decreases in pain reliever misuse observed for all ages
  • Downward trend in heroin users
  • Estimated 2.1M with opioid use disorder
• Marijuana:
  • Significant increases in use by young adults (18-25 y.o.): past month and daily/near daily use; with significant increases in use by young adult women
  • Pregnant women using substances in greater numbers including significant increases in daily or near daily marijuana use
  • Frequent marijuana use associated with opioid misuse, heavy alcohol use, and depression in youth 12-17 and young adults 18-25. 
• Young adults had increasing rates of serious mental illness, major depressions, and suicidality
• Co-occurring substance use and mental disorders are common
• Major gaps in treatment received by affected individuals
  

2016 U.S. Surgeon General report Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health provides a comprehensive review of the neurobiological basis for substance use disorder, and what works in prevention, treatment, and recovery. Highlights, see the Key Findings and Reasons for Hope and Optimism.  

Terminology - substance use disorder and addiction: 

• Substance-use disorder (SUD): Diagnostic term in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders referring to recurrent use of alcohol or other drugs that causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home. Depending on the level of severity, this disorder is classified as mild, moderate, or severe. 
• Addiction: The most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug. In the DSM-5, the term addiction is synonymous with the classification of severe substance-use disorder.  

Reference: N Volkow et al. Neurobiologic Advances from the Brain Disease Model of Addiction​. N Engl J Med 2016;374:363-71. 

See also American Society of Addiction Medicine (ASAM) Definition of Addiction

​"Addiction-ary" and why the language we use is important 

Substance use disorders are neurobiological disorders, not a choice to abuse or become dependent on a substance. We're working to update the AANA webpages to only clinical, non-stigmatizing language of substance use disorder (includes addiction) and eliminate the older terms terminology of chemical dependency and substance abuse. For more on this topic, see "Language, Substance Use Disorders, and Policy: The Need to Reach Consensus on an "Addiction-ary" by Kelly et al., Alcoholism Treatment Quarterly, January 2016.