Substance use disorders (SUD)

When the brain is over stimulated from the chemicals in substances, it produces an intoxication, or a feeling of excitement, pleasure, or calm. Wanting more of that feeling reinforces more use of that substance, therefore creating a cycle to repeat the behavior.

Here are some examples of substances that activate the brain and create feelings of intoxication.³

• Alcohol
• Cocaine, methamphetamine, and other stimulants
• Inhalants, such as paint thinners and glue
• Marijuana
• Opioid pain killers, such as codeine, oxycodone, and heroin
• PCP, LSD, and other hallucinogens
• Sedatives, hypnotics, and medicines for anxiety such as tranquilizers
• Tobacco/nicotine

Substance use refers to occasional use of drugs or alcohol. People can use substances without developing an SUD.

Substance use disorder, however, is a complex disease that involves an overpowering desire to use a substance despite harmful consequences. Repeated use creates a tolerance, which means more of the chemical is needed to feel good, even if it’s known to be unhealthy. Someone struggling with an SUD can also develop a physical and psychological dependence to substances,⁴ resulting in withdrawal symptoms (feeling sick, anxious, irritable, etc.) when the substance is stopped.⁵

There are a lot of reasons why people start using drugs or alcohol, and it’s different for each person. As mentioned earlier, SUD can affect anyone, of any background. But many reasons for substance use can be traced back to the below causes.⁶

1. To cause good feelings

• More energy
• Enhanced focused and attention
• Calmness
• Relaxation
• More creativity
• Drowsy

2. To self-medicate

• Treat underlying pain
• Treat mental health condition(s)

3. To improve performance

• Help people study
• Complete demanding work
• Allow for exceptional performance in sports

4. To experiment and fit in

• Peer pressure for teens and young adults

Yes. Many people don’t realize that an SUD is the result of changes in the brain that make drug, tobacco, or alcohol use difficult to stop without sufficient support.⁷

In fact, using brain imaging, the American Psychiatric Association confirms that repeated substance use can change brain chemistry and brain function causing people “to have intense cravings, changes in personality, abnormal movements, and other behaviors.”⁸ The continued use of substances can disrupt and impair parts of the person’s life, like decision-making, behavior, memory, and more.⁹

Stigma and SUDs

It’s important that we move away from the public stigma that struggling with a substance is a choice or character flaw instead of what we know it to be — a chronic, treatable disorder.¹⁰ Many patients can recover and go on to lead healthy and productive lives.

What are ways I can help destigmatize substance use disorders?

• Avoid placing blame. Remember that with SUDs, the brain chemistry and function have undergone changes which in turn reinforce the substance use itself. It isn’t that an individual doesn’t want to stop, it’s that it may be difficult to stop without adequate support.

• Replace stigmatizing language to person-first. Meaning, a person is not an “addict” or “substance abuser”, a person has a substance use disorder. Focusing on the person not the condition conveys dignity and respect for the individual.¹¹

• Understand substance use disorders. They are chronic, treatable medical conditions. And much like ongoing health conditions such as diabetes or high blood pressure, there is evidence-based treatment that can lead to full recovery.

Every person has their own reason for overusing drugs or alcohol. Therefore, treatment doesn’t look the same for everyone. The most important thing is to find what works best for each individual.

Start with talking with a doctor or a trusted health adviser. Remember, it’s never too late to ask for help.

Treatment options can include:

• Behavioral therapy
• Counseling
• Hospital-based care
• Intensive outpatient treatment/partial hospital
• Medications
• Outpatient treatment
• Recovery support (like Alcoholics Anonymous or Narcotics Anonymous)
• Residential/inpatient treatment

REMEMBER: Substance use disorders are treatable. It’s often a challenging journey and it’s not unusual for it to involve relapse. But know that even if someone relapses, it’s not a sign of failure. Recovery is still possible.

Where to find support.

• Visit or call one of our Florida Blue Centers (1-877-352-5830) and talk with one of our community specialists. They can help connect you to resources in your area and answer questions. Florida Blue Centers are available to everyone, whether you’re a Florida Blue member or not.
• Florida Blue members can call our behavioral health care partner, Lucet, at 1-866-287-9569. They can help you locate a licensed therapist that’s right for you, usually within one week.
• You can call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357) or go to FindTreatment.gov at any time to learn more about substance use treatment and recovery support resources near you.
• Connect with ATLAS®, a company that provides a free online tool to help people find addiction treatment that will meet the unique needs of themselves or a loved one. ATLAS lists all licensed Florida addiction treatment facilities for any substance use disorder, including alcohol and opioid use disorder.
• Call 911 if you or someone you know is in life-threatening danger or having a mental health crisis.
• If you or someone you know is struggling with suicidal thoughts, call or text the National Suicide Lifeline at 988. Counselors are available 24 hours a day, seven days a week.

¹ https://www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-nnr.pdf

² https://www.cdc.gov/drugoverdose/featured-topics/substance-use-disorders/index.html

³ https://www.psychiatry.org/patients-families/addiction-substance-use-disorders/what-is-a-substance-use-disorder

⁴ https://my.clevelandclinic.org/health/diseases/16652-drug-addiction-substance-use-disorder-sud

⁵ https://nida.nih.gov/research-topics/criminal-justice/science-drug-use-resource-justice-sector

⁶ https://www.psychiatry.org/patients-families/addiction-substance-use-disorders/what-is-a-substance-use-disorder 

⁷ https://www.psychiatry.org/patients-families/addiction-substance-use-disorders

⁸ https://nida.nih.gov/research-topics/stigma-discrimination#references

⁹ https://www.psychiatry.org/patients-families/addiction-substance-use-disorders

¹⁰ https://nida.nih.gov/nidamed-medical-health-professionals/health-professions-education/words-matter-terms-to-use-avoid-when-talking-about-addiction#:~:text=Stigma%20and%20Addiction&text=Stigma%20is%20a%20discrimination%20against,at%20fault%20for%20their%20condition

¹¹ https://nida.nih.gov/research-topics/addiction-science/words-matter-preferred-language-talking-about-addiction  

¹²  https://nida.nih.gov/publications/drugfacts/understanding-drug-use-addiction

Florida Blue contracts with Lucet to provide behavioral health services.

ATLAS is an independent resource that can assist in finding addiction treatment support that will meet individual needs.

988 is the call number for the National Suicide Prevention Lifeline, an independent company offering mental health counselling via phone call or text.

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