When individuals use drugs to such an extent that they have difficulty meeting social and occupational obligations, substance abuse had occurred. Relying on a drug because it makes difficult situation less stressful is called psychological dependency. Developing withdrawal symptoms, such as cramps, is called physiological dependency. When physiological dependence exists, individuals are said to be substance-dependent or addicted. The term substance abuse is used broadly and includes psychological and/or physiological dependence on a variety of drugs such as alcohol, cocaine, marijuana, sedatives, stimulants, and hallucinogens. Because substance abuse is so widespread, many practitioners of theories have devoted significant attention to this area. Examples of treating alcoholism or other drug abuse are used in existentialism, REBT, reality therapy and cognitive therapy. .
Freud put forth an idea of a death instinct that accounted for aggressive drives. These include unconscious desires to hurt others or oneself. Often conflict arises between the life instincts (Eros) and the death instincts (thanatos). When the hate comes out in a destructive anger, then the aggressive drive is stronger. Often the two instincts work together which maintains life but included the aggressive activities. .
Although the treatment of drug-abusing patients follows a cognitive model that is somewhat similar to the treatment of other disorders, there are significant differences. The Therapeutic relationship may be different because patients may not enter treatment voluntarily, may be involved in criminal activities, may not enter treatment voluntarily, may be involved in criminal activities, may have negative attitudes about therapy, and may be unwilling to be honest about there drug usage. When setting goal, therapist focus not only on being drug-free but also on how this will solve other problems.