Substance use disorder is defined in the DSM-5-TR. It includes alcohol, stimulants, opioids, sedatives, cannabis, and tobacco, among others.
Substance use disorder is a
Keep reading more to learn about how substance use disorder is defined, treatment, and resources for help.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) is the most recent guide for identifying and diagnosing mental health disorders. It provides criteria for various conditions and is used in clinical, research, and legal settings.
Substance use disorder is included in the DSM-5-TR.
| Criteria Type | Description |
| Impaired control over substance use | – Consuming the substance in larger amounts and for a longer amount of time than intended. – Persistent desire to cut down or regulate use. The individual may have previously attempted to stop unsuccessfully. – Spending a great deal of time obtaining, using, or recovering from the effects of substance use. – Experiencing craving, a pressing desire to use the substance. |
| Social impairment | – Substance use impairs ability to fulfill major obligations at work, school, or home. – Continued use of the substance despite it causing significant social or interpersonal problems. – Reduction or discontinuation of recreational, social, or occupational activities because of substance use. |
| Risky use | – Recurrent substance use in physically unsafe environments. – Persistent substance use despite knowledge that it may cause or exacerbate physical or psychological problems. |
| Pharmacologic | – Tolerance: Individual requires increasingly higher doses of the substance to achieve the desired effect, or the usual dose has a reduced effect; individuals may build tolerance to specific symptoms at different rates. – Withdrawal: A collection of signs and symptoms that occurs when blood and tissue levels of the substance decrease. Individuals are likely to seek the substance to relieve symptoms. No documented withdrawal symptoms from hallucinogens, PCP, or inhalants. – Note: Tolerance and withdrawal in the context of appropriate medical treatment (i.e., pain medication used as prescribed) do not count as criteria for an SUD. |
The severity ranges from mild to severe, with mild substance use disorder comprising 2 to 3 symptoms and severe comprising 6 or more.
Repeated substance use can lead to changes in the brain’s structure and function, particularly in areas related to judgment, decision making, learning, memory, and behavioral control. These changes can persist after the immediate effect of the substance wears off.
This condition can also affect an individual’s relationships, including those with family members, friends, and coworkers.
All individuals with substance use disorder can benefit from treatment, regardless of severity. The first step in treatment is recognizing that help is needed.
A formal assessment of symptoms should be conducted by a medical professional to identify if a substance use disorder is present. From there, treatment can look like a combination of medication and individual or group therapy. This is because substance use disorder can affect many aspects of a person’s life.
Treatment can also include one or more of the following:
- hospitalization or outpatient guidance for medical withdrawal management
- therapeutic communities (highly controlled, drug-free environments) or sober houses
- outpatient medication management and psychotherapy
- intensive outpatient programs
- residential treatment
- mutual-aid groups (Alcoholics Anonymous, Narcotics Anonymous, SMART Recovery)
- self-help groups that include family members (Al-Anon or Nar-Anon Family Groups)
Help is out there
If you suspect that you or a loved one is experiencing substance use disorder, know that you are not alone. There are a variety of resources that you can reach out to for help:
- 988 Suicide and Crisis Lifeline
- American Addiction Centers
- findtreatment.gov
- Mental Health and Substance Use Insurance Help
- SAMHSA
Substance use disorder is a chronic condition where an affected individual uses alcohol, tobacco, or other psychoactive substances to the extent that it negatively affects their everyday life.
An individual may continue to use, even if they know it is negatively affecting them. It is important to note that substance use disorder is not a character flaw, and it is not as simple as resisting the temptation to take drugs.
However, substance use disorder is treatable. There are multiple resources out there that can help.