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What Is Substance Use Disorder? Symptoms, Diagnosis, and Treatment
Substance use disorder (SUD) is a mental condition that causes a person to use substances even in the face of negative consequences.
According to the National Institute of Mental Health, substance use disorder affects a person’s brain function and behavior, making them unable to control how they use substances (legal or illegal). Those substances can include prescription medications, illegal drugs, and alcohol.
SUD affects individuals, families, and society, causing health complications, social issues, personal financial challenges, and economic damage to the country.
This article will discuss the nature of substance use disorder (SUD), the types of substance use disorders, the condition’s symptoms, different treatment options, and more.
Understanding Substance Use Disorder (SUD)
SUD is a chronic medical condition in which substance use disrupts daily life. The DSM-5 classifies SUD as mild, moderate, or severe based on diagnostic criteria including a person’s tolerance to the substance in question, withdrawal symptoms, and loss of control over when and where they use the substance.
According to Psychiatry.org, those with SUD are intensely focused on using certain substances, including alcohol, tobacco, opioids, cannabis, and or other psychoactive substances, to the point that they’re unable to function on a day-to-day basis. People keep using the substance even when they know it is causing or will cause problems. In addition to the substances listed above, people with SUD may also struggle with several substances such as cannabis, stimulants, and opioids, among others.
Common Types of Substance Use Disorder
Six common types of substance use disorder include:
- Alcohol (alcohol use disorder)
- Opioids (opioid use disorder)
- Cannabis (cannabis use disorder)
- Cocaine (cocaine use disorder)
- Stimulants (stimulant use disorder)
- Multiple substances (polysubstance use disorder)
Symptoms of Substance Use Disorder
The symptoms of substance use disorder include behavioral signs (being unable to stop thinking about the substance or engaging in risky behaviors involving the substance), as well as physical and emotional signs (withdrawal symptoms when not using the substance or mood swings). Symptoms of substance use disorder include the following:
Behavioral Signs
- Increased substance-seeking behaviors
- Neglect of responsibilities at work, school, or home
- Strained relationships due to substance use
- Risky behaviors (driving under the influence)
Physical and Emotional Signs
- Withdrawal symptoms (nausea, tremors, anxiety)
- Tolerance (needing more of a substance for the same effect)
- Poor physical health (weight loss, infections, liver damage)
- Mood swings, depression, or anxiety
Causes and Risk Factors
Common causes and risk factors for substance use disorder include a family history of addiction, a history of trauma, exposure to peer pressure or substance use, and co-occurring mental health conditions like depression or bipolar disorder.
Biological Factors
- Genetics: A family history of addiction increases the chance that an individual will develop a substance abuse disorder.
- Brain chemistry: Changes in dopamine pathways reinforce addiction and make a person seek out the substance to experience increased dopamine release.
- Neuroadaptations: Long-term substance use alters brain function, making it harder for someone who has used a substance for a long time to quit without help.
Environmental and Social Factors
- Peer pressure increases the chance that someone will try a particular substance and cultural influences, like TV commercials, can make substance use seem both positive and desirable.
- Exposure to trauma or adverse childhood experiences (ACEs) can lead to an individual attempting to escape or self-medicate using substances, particularly drugs and alcohol.
- Availability and accessibility of substances also increase the chances that someone will experiment with substances and develop a substance use disorder.
Co-Occurring Mental Health Conditions
- SUD often coexists with anxiety, depression, and PTSD, which may be a primary cause for substance use in the first place or a symptom of use.
- A person with PTSD may misuse alcohol to self-medicate, worsening both conditions. Someone who suffers from generalized anxiety disorder due to childhood trauma might turn to alcohol or drugs for similar reasons.
- The combination of SUD and co-occurring mental health condition(s) complicates treatment. Often, conventional treatment for substance use disorder isn’t sufficient. Integrated treatment for co-occurring disorders improves outcomes.
How Substance Use Disorder Is Diagnosed
Substance use disorder is diagnosed by medical professionals using DSM-5 criteria and different diagnostic tools to measure patterns of substance use and its impact on the person’s daily life. Diagnostic tools include:
- Clinical interviews and self-report questionnaires
- Drug testing
- Mental health assessments
Comprehensive Addiction Treatment
Addiction Treatment Centre in New York Outpatient Programs
Treatment Options for Substance Use Disorder
Treatments for SUD include cognitive behavioral therapy, dialectical behavior therapy, group counseling, medication-assisted treatment like combining counseling with buprenorphine, and holistic therapies, like meditation and nutrition therapy.
Behavioral Therapies
- Cognitive Behavioral Therapy (CBT): CBT helps people with SUD identify and change negative thought patterns that often support their substance use.
- Dialectical Behavior Therapy (DBT): DBT focuses on helping people develop emotional regulation and coping strategies.
- Community Reinforcement Approach (CRA): CRA encourages people to engage in meaningful activities with friends, family, and their community to build a life that competes with substance use.
- Group counseling: Group counseling provides people with peer support and allows them to both share their experiences and learn from the experiences of others dealing with similar challenges.
Medication-Assisted Treatment (MAT)
MAT uses FDA-approved medications to manage withdrawal and cravings. The three most commonly used medications include the following:
- Methadone and buprenorphine: Both methadone and buprenorphine reduce opioid dependence.
- Naltrexone: Naltrexone blocks opioid effects and reduces alcohol cravings.
- Disulfiram and acamprosate: Disulfiram and acamprosate help support alcohol recovery.
Medication is only one part of the MAT treatment combination. Those struggling with SUD also use behavioral therapy (CBT, DBT, group counseling, etc.), because the medication helps with cravings and withdrawal symptoms, but the underlying usage habits and initial reasons for using the substance must be treated as well.
Holistic and Alternative Therapies
Prevention and Early Intervention
While substance use disorder is treatable, prevention is the better course of action and education, guidance from parents and other authority figures, access to community programs, and early intervention can all play roles.
- Youth education: Early education on the dangers of substance use can help people understand the impacts that addiction can have on their lives.
- Parental guidance: Open communication and boundary-setting from parents (and other authority figures) can help children and teens understand the risks different substances pose.
- Community programs: Support networks and prevention initiatives give people a place to turn for help both before developing a substance use disorder and when deciding to quit.
- Early intervention: Early intervention programs are designed to help people recognize the signs of misuse and seek help early, whether for themselves or others.
Living with Substance Use Disorder
While substance abuse disorder is treatable, it is not curable and those suffering from it will need to learn management techniques to live with it. These tools include:
- 12-Step programs: Alcoholics Anonymous, Narcotics Anonymous, and other programs provide group therapy, sponsors, and a structure to help people move forward with their lives.
- CRAFT Family training: Family training teaches loved ones how to communicate positively with their loved one who is struggling, how to set healthy limits and boundaries, and gives them support to continue supporting the loved one throughout their recovery.
- Long-term recovery strategies: Relapse prevention plans and lifestyle changes can help reduce the risk of relapse while removing triggers and creating healthier lifestyles.
Conclusion
SUD is a complex but treatable condition that can affect anyone from any background. Early intervention, evidence-based treatments, and holistic approaches improve recovery outcomes. Support systems and education play important roles in prevention and long-term well-being.
FAQ
Substance use disorder (SUD) is a medical condition where a person compulsively uses substances despite harmful consequences.
SUD is diagnosed using DSM-5 criteria, which considers behavioral, physical, and psychological patterns of substance use.
SUD symptoms include cravings, withdrawal, increased tolerance, neglect of responsibilities, and strained relationships.
SUD is caused by genetic predisposition, brain chemistry, environmental factors, and co-occurring mental health disorders.
Common types of SUD include alcohol use disorder, opioid use disorder, cannabis use disorder, cocaine use disorder, simulant use disorder, sedative use disorder, and polysubstance use disorder.
Medication-assisted treatment (MAT) uses medications like methadone, naltrexone, and buprenorphine to reduce cravings and withdrawal symptoms in combination with psychotherapy to provide both medication and talk therapy.
Yes, SUD often co-occurs with anxiety, depression, and PTSD, and requires treatments that take both into account.
Effective prevention strategies for SUD include education, parental guidance, community programs, and early intervention.
Families can support a loved one with SUD with therapy, open communication, and active involvement in recovery programs. Wholeview recommends CRAFT, Community Reinforcement and Family Training for the loved ones of someone struggling with SUD.
No, SUD is not curable. It is a chronic medical condition that can be effectively managed with treatment, lifestyle changes, and support systems. Most people who struggle with SUD need ongoing care to maintain their recovery. The good news is that the outcomes for SUD are very similar to the outcomes for other chronic medical disorders such as diabetes and hypertension.
At Wholeview, our medical providers use pharmacogenetic testing to help personalize medication plans for patients with mental health conditions. This process begins with a simple cheek swab collected at home, which is then analyzed in a lab to identify genetic variations that affect how patients metabolize and respond to medications. The resulting report categorizes medications into groups based on their likely effectiveness and risk of side effects.
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