There dependence on substances It represents a complex and widespread phenomenon that involves not only those who are directly affected by it, but also families, schools and society as a whole. Often it begins silently, with the occasional intake of a substance that, over time, can turn into a constant and difficult to control need.
In Italy, according to the annual report to Parliament on the phenomenon of drug addictions 2025, about 37% of students (young people between 15 and 19 years old) reports having consumed an illegal psychoactive substance at least once in life and about 25% report that they had done it over the past year.
In this article we will deepen what is the dependence on substanceswhat physical, psychological and behavioral symptoms can help you recognize it and how it develops. We will also analyze multifactorial causes, the different types of drugs and addictions, and therapeutic paths available to return to their well -being. If you, or someone you care about, are looking for clear and reliable information, you will find a step -by -step guide that can orient you towards the most suitable professional support.
What is substances dependence
According to the DSM-5 (diagnostic and statistical manual of mental disorders), the dependence on substances or disorder by use of substances (DUS) It is “a pathological mode of use of the substance that causes clinically significant impairment or discomfort”, which manifests itself with at least two of the following events within 12 months:
- The substance is used frequently in greater quantities or for a longer period of time than expected.
- There is a persistent desire or unsuccessful efforts to stop or control the use of the substance.
- A lot of time is devoted to the activities necessary to obtain the substance, use it or recover from its effects.
- Desire or strong desire or need to use the substance.
- Recurring use of the substance that leads to the inability to carry out essential tasks to work, at school or home.
- Continuous use of the substance despite persistent or recurring social or interpersonal problems caused or exacerbated by the effects of the use of the substance.
- The use of the substance involves the withdrawal or reduction of important social, work or leisure activities.
- Recurring use of the substance in situations that involve physical risks.
- Continued use of the substance despite the knowledge of a persistent or recurring physical or psychological problem that could be caused or exacerbated by the substance.
- Tolerance, that is, the need to gradually increase the doses to obtain the same effects, due to the adaptation of the body to the substance.
- Abstinence, or the set of unpleasant physical and psychological symptoms (such as tremors, anxiety, nausea) that manifest themselves when it is reduced or interrupted the use of the substance after a period of prolonged consumption.
Types of dependence
There dependence It can be understood how physics or psychological :
- There physical dependence, induced by many substances of abuse, acts on the brain and physique, changing the way it distinguishes pleasant unpleasant sensations. The symptoms of abstinence are the consequence of this state.
- There psychological dependence it concerns the need to use the substance (craving). It is a real craving, sometimes uncontrollable, linked to desiring thought and the sensations that the substance makes you feel at the time of hiring.
Symptoms of substances dependence: how to recognize it
Taking the diagnostic criteria of the DSM-5 as a basis, the signals of a dependence on substances can manifest themselves on a physical, psychological and behavioral level. Recognizing them is the first step to ask for help.
Physical symptoms
- Tolerance: the need to gradually increase the dose to obtain the desired effect.
- Abstinence: The appearance of unpleasant symptoms (e.g. tremors, sweating, nausea) when stopping or reduces use.
- Changes in appearance: neglect in personal hygiene, loss or sudden weight gain.
Psychological symptoms
- Craving: An intense and uncontrollable desire to use the substance.
- Loss of control: The inability to stop using the substance despite the desire to do it.
- Mood alterations: Irritability, anxiety, mood changes, depression.
Behavioral symptoms
- Abandonment of activities: Loss of interest for hobbies, work, school or social activities.
- Social isolation: tendency to isolate themselves from friends and family to hide their behavior.
- Risk behavior: Spend huge sums of money, lie or implement illegal behavior to get the substance.
Why does an addiction develop? The main causes
The addiction does not derive from a single cause, but it is a multifactorial condition that arises from the interaction of different elements.
- Biological and genetic factors: There is a genetic predisposition that can make some individuals more vulnerable. The substances act on the brain reward system, creating a difficult reinforcement cycle to stop.
- Psychological factors: Pre -existing conditions such as trauma, depression, anxiety disorders or low self -esteem can push the use of substances as an attempt to self -medicate or escape from suffering.
- Social and environmental factors: A difficult family context, the pressure of the peer group, easy accessibility to substances and environmental stress are significant risk factors, especially in adolescent age.
Types of substances and their consequences
The abuse substances are classified according to their effects on the nervous system. Each category involves specific risks and consequences for physical and mental health.
- Stimulating substances (e.g. cocaine, amphetamine): They increase energy and attention, but long -term use can cause cardiovascular damage, paranoia and psychosis.
- Depressing substances (e.g. opioids, benzodiazepine): They reduce brain activity, inducing relaxation. The main risk is respiratory depression, which can be fatal, especially in case of overdose.
- Hallucinogen or despair (e.g. lsd, ketamine): they alter the perception of reality. They can trigger persistent psychosis or perceptual disorders.
- Cannabis: It can cause relaxation but also anxiety, panic attacks and, in predisposed subjects, can increase the risk of psychotic disorders.
Classification of substances according to the DSM-5
According to the DSM-5-TR, the psychoactive substances are divided into precise categories based on their effects on the central nervous system and the dependence development potential. The main classes identified are: alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives/hypnotic/anxiolytics, stimulants (including amphetamine and cocaine), tobacco and other substances (including steroids and drugs not classified elsewhere). Each category is associated with specific risks and symptoms: for example, stimulants can cause agitation, paranoia and cardiovascular damage; Opioids can lead to respiratory and overdose depression; While hallucinogens deeply alter perception and can trigger psychotic disorders. This official classification is essential for a correct diagnosis and for the definition of the most appropriate therapeutic path.
The clinical characteristics of addiction
People who use substances often look for temporary solutions to their internal conflicts, and believe they have control over use. Over time, in reality, it is the substance that takes over and becomes theessence of the person.
The substance can also be used as a tool for soothe the symptoms of others mental disorderslike the excessive concerns of anxiety disordersor the sensations of anguish and emptiness of depressive disorders or in bipolar disorder. It can also be used by those who shy away the moments of sociality, due to specific phobiasor to regular intense emotional states in the borderline personality disorder.
The birth and the first relationships
A diagnosis The addiction can be done by going to investigate the first years of the patient’s life and the first relationships, as a newborn, with the reference figures.
After birth, the child senses that there is the possibility of a relationship with another human being who will take care of him. This hope needs continuous confirmations by the adult, through the care and the breastfeeding. In these moments, in fact, the child does not only receive physical and material care, but also makes his own qualitative characteristics of the relationshiplike human warmth and the attention that the reference figures invest in taking it on.
There affective presence Of the adult is essential for the growth of the child but, if this over time is continuously disconnected, the child will feel to receive only a material care, losing more and more confidence in the possibility of being loved by someone else.
Arrival in adolescence
During adolescencein the face of the first comparisons with peers, the deficiencies of the relationships had in the first years of life can reactivate, and the tendency to search for a relationship of material type could be presented.
The drug therefore can represent the only possibility of filling that physical need. The substance like this is replaced by relationshipscoming to condition the individual’s moods.
Is it possible to heal?
The path of treatment For these patients it is complex: it is necessary to evaluate the many facets of addiction to identify the most suitable intervention.
It is important, first of all, to contact public structures such as services for the treatment of addictions (Ser.d). These services create a support network around the person and, if necessary, offer drug therapy useful to start physical separation from the substance.
There family therapywhere possible, is important to support families and help them find new methods of communication and relationship. Finally, it is possible to treat dependence through psychotherapeutic path who goes to solve the patient’s most personal problems and help him get back in contact with his Internal realitywith the sphere of deepest affections and relationships.
All through the therapy space Where a new relationship with the psychotherapist who can lead the patient to find the lost trust is built after sitting. For those wishing to deepen the topic I recommend the book Substances dependence. A world without dreamsfrom which some of the information contained in this article was taken.
Finding well -being: a possible path
Dating a dependence on substances is a profound challenge, but it is important to remember that it is not alone and that healing is possible. The path requires courage and the right support, but every step towards awareness is a step towards the recovery of one’s well -being and life.
If you feel that you or a loved one are fighting, Asking for help is an act of strength. A professional can offer the tools and support necessary to understand the roots of the problem and build new strategies to manage it. If you think you need a support, you can start a path with a UNBRAVO: fill in the questionnaire to find your psychologist online and take the first step towards change.
