The Disorder

Individuals who have a substance misuse problem often use substances such as drugs and alcohol for non-medical purposes. Although alcohol is a legal substance it can be misused which often leads to very negative impacts occurring on an individual and their daily functioning.

Alcohol and drugs can have an impact on every organ within the body and chronic abuse can lead to serious medical issues including damage to liver, cardiovascular system, immune system, nervous system, pancreas, endocrine system and gastro-intestinal tract.

Some of the statistics within the United Kingdom regarding substance misuse include approximately 30% of suicides and 50% of murders being linked to being intoxicated prior to the incidences occurring.

The Symptoms

Often individuals who have substance misuse problems exhibit symptoms such as sudden change in behaviour, mood swings; irritable and grumpy and then suddenly happy and bright, withdrawal from family members, poor personal hygiene, loss of interest in hobbies, sports, and other favorite activities, changed sleeping pattern; up at night and sleeps during the day, red or glassy eyes and sniffly or runny nose. They may also be sensitive to unpleasant feelings, impulsive, have low tolerance to frustration, have a low boredom threshold, feel hopeless, difficulty controlling anger, depressed, anxious and carry out behaviours for attention.

The Treatment

When an individual requires treatment for substance misuse and choses Cognitive Behavioural Therapy as the preferred option for therapy a detailed assessment is carried out by the therapist. Then together both the client and therapist try and distinguish how these problems evolved and what cycle of events lead to the substance misuse. Following on from this the clients goals are identified so that a treatment plan for therapy can be established that is realistic to the individual.

Through the use of cognitive strategies the therapist can help the individual in reducing the intensity and demands of the individuals urges and create a stronger repertoire of coping strategies for dealing with such urges.

A review of the individual’s faulty thinking patterns is carried out which helps both parties to understand more about the individual’s relationship between the problematic behaviour and why they are carrying it out.


The treatment that is offered for substance misuse is based on the five stages of change model developed by Prochaska and Di Climente (1983). This model helps the therapist and the client to identify what level of change they are currently at which helps to drive the treatment that is offered.

Stage 1 is the pre-contemplation stage do not intend to take action in the foreseeable future and are possibly in denial about the extent of their drug/alcohol dependency. Stage 2 is the contemplation stage where individuals are beginning to look at some of their problem behaviours but are not able to give them up at this stage. Stage 3 is the preparation stage this is where individuals have made a plan to quit, may have cut down some of their behaviours, can see the benefit of quitting but have not yet put into place a comprehensive plan for how to change completely. Stage 4 is the action stage, during the action stage individuals have quit using, are avoiding their triggers and are asking others for support. Stage 5 is the maintenance stage. This is the final stage in the cycle individuals have not used substances in a long time, are accepting themselves and may be helping others who have substance misuse problems.

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