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Substance-Related and Addictive Disorders Addiction Treatment Center Orange County California

Substance related and non-substance addictive disorders are categorized together due to the common condition involved, of addiction or addictive behaviors that may interfere with regular functioning of an individual. Substance use in itself is not considered a disorder, however when continued use and repeated relapses that ultimately change the brain’s structure is when it becomes a disorder that needs to be treated.

Clinically Reviewed by: Charee Marquez, LMFT

Substance-Related Disorders

Substance-related disorders involve the use of drugs, alcohol, or prescribed medications leading to distressing consequences impacting physical and mental health, social and family responsibilities, and regular activities.

Substances commonly used:
  • Alcohol
  • Heroin
  • Crack Cocaine
  • Oxycodone
  • Codeine
  • Morphine
  • Fentanyl
  • Hallucinogens (LSD)
  • Inhalants
  • Tobacco
  • Cannabis (Marijuana)

Non-Substance-Related or Addictive Disorders

Behavioral addictions that are not dependent on substance use are categorized under Addictive disorders. The effects and impacts of addictive disorders may be similar to substance-related disorders including physical and mental health, social and family responsibilities, and regular activities.

Non-substance causes:
  • Gambling
  • Internet Gaming

Causes of Substance-Related and Addictive Disorders

There is no single cause of substance abuse or addictive disorders, as they are usually a result of a variety of factors, beginning with exposure to an addictive substance or non-substance.

Genetic

Variations in brain chemistry and genes may determine how an individual responds to a certain substance. Such variations may affect how a substance is consumed, and may lead to dependence and overuse.

Psychodynamic

An individual’s behavior and response to certain substances may be influenced by their experiences and exposure during childhood. Children and adolescents exposed to addictive substances are likely to continue other addictive substances in their adulthood.

Stress

Chronic stress caused by health problems, financial troubles, or dysfunctional relationships may induce an individual to use substances to alleviate their anxiety, however when the usage increases, it can lead to substance abuse disorders.

Mental Illness

Self-medicating for mental health issues such as depression, PTSD, or other disorders with drugs or alcohol may initially seem like it will help them but they almost always become addictive with long term dependence.

Signs and Symptoms of Substance-Related and Addictive Disorders

  • Increased amounts of intake of substances, caused due to increased tolerance
  • Desire to quit but being unable to control intake of substances
  • Spending inordinate amounts of time, money and energy to obtain substances
  • Constantly worrying about getting the next dose
  • Intense cravings for addictive substances
  • Losing interest in regular social activities, relationships and responsibilities
  • Risky undertakings to obtain consistent supplies of the substance
  • Signs of withdrawal when not using, such as shakiness, sweating, headaches, etc.
  • Dilated pupils, glazed eyes, slurred speech
  • Lying, stealing and absenteeism

Addiction and dependence on substances may be demonstrated through many different signs and symptoms, physical and/or behavioral. When substance usage creates challenges and becomes an impairment to daily life it is categorized as a disorder.

Treatment of Substance-Related and Addictive Disorders

Detoxification

The first step in the treatment of substance-related disorders is to remove the toxins from an individual’s body through the process of chemical detoxification. Withdrawal from an addictive substance can be life-threatening, so medically assisted detoxification is imperative.

Therapy

Behavioral therapies and Cognitive therapies have been two recent developments that have been shown to be effective in treatment of addiction and co-occurring mental illnesses. Modalities such as Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Eye Movement Desensitization and Reprocessing (EMDR) and Mindfulness-based Cognitive Therapy (MBCT) can be effective on treating addictive behaviors.

Does Insurance Cover Substance Related Treatment?

Typically, yes. Insurance coverage for substance-related disorders can vary based on the individual’s insurance plan, the specific services needed, and the policies of the insurance provider. Substance-related disorders include conditions related to the misuse or dependence on substances such as alcohol, drugs, or prescription medications.

Here are some considerations regarding insurance coverage for substance-related disorders:

  1. Type of Insurance Plan:

    • Different types of insurance plans, such as private insurance, Medicaid, or Medicare, may have varying levels of coverage for substance-related disorder treatment.
  2. In-Network vs. Out-of-Network Providers:

    • Insurance plans typically have a network of preferred providers. In-network providers are often covered at a higher rate than out-of-network providers.
  3. Verification of Benefits:

    • It’s important to contact the insurance provider to verify specific coverage details for substance-related disorder treatment. This includes checking copayments, deductibles, and any out-of-pocket expenses.
  4. Medical Necessity:

    • Insurance coverage is often tied to the medical necessity of the treatment. A healthcare professional may need to provide documentation demonstrating the necessity of specific treatments or therapies for substance-related disorders.
  5. Preauthorization:

    • Some insurance plans may require preauthorization or approval before certain treatments or therapies are covered for substance-related disorders. Understanding and following the preauthorization process, if required, is essential.
  6. Coverage Limits:

    • Insurance plans may have limits on the number of therapy sessions, the duration of coverage, or the types of treatments covered for substance-related disorders.
  7. Parity Laws:

    • Mental Health Parity and Addiction Equity Act (MHPAEA) in the United States may apply to ensure that coverage for substance-related disorders is comparable to medical and surgical coverage.
  8. Individual Plan Details:

    • Each insurance plan is unique, and coverage details can vary widely. Understanding the specific terms and conditions of the individual’s insurance plan is crucial.

It’s important for individuals seeking treatment for substance-related disorders to work closely with healthcare professionals and the insurance company to navigate the coverage process. Treatment facilities and mental health professionals often have staff members who can assist in verifying benefits and understanding the insurance coverage available.

Seeking Treatment? We Can Help!

At California Prime Recovery, as an in-network provider we work with most insurance plans, such as:

If you or a loved one are struggling with mental health challenges or substance abuse, reach out to California Prime Recovery today. Our team of compassionate professionals is here to support your journey towards lasting well-being. Give us a call at 866-208-2390

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