sarah has not seen her uncle in three years. she is shocked when she finally does see him at a thanksgiving dinner she is hosting because he has changed drastically. he is extremely thin, has lost a lot of teeth and looks about 20 years older. he seems anxious and depressed, even paranoid. she is further upset when she realizes he has stolen a large amount of cash from herdresser. sarah suspects he has a substance use disorder. use of what substance would most likely cause all of what sarah has observed?