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What is Substance Use Disorder?

Substance use disorder (SUD) is a medical condition characterized by the continued use of substances like alcohol, opioids, cannabis, stimulants, and others despite experiencing significant impairment and distress as a result of that use. SUD was previously referred to as substance abuse and addiction, but the terminology was changed in the DSM-5 to reduce the stigma around the condition.
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Diagnosis

Diagnosing SUD requires assessing if someone meets 2-3 criteria over a 12-month period, such as taking more of a substance than intended, being unable to cut down on use, spending excessive time obtaining the substance, experiencing cravings, and continuing use despite it worsening physical and mental health. The more criteria met and the more severe the symptoms, the more serious the SUD diagnosis. Assessments take a person’s health, social, family, and legal history into account.

Behavioural patterns

Those with SUD often exhibit certain behaviours related to obtaining, using, and recovering from the effects of substances. This can include going through withdrawal when not using, lying about use, giving up activities to use, using dangerously like drunk driving, and experiencing financial problems or legal issues due to use. They may make attempts to curb use that fail, have romantic problems worsened by use, and require medical care for substance-related health issues.

Treatments

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Treatments for SUD aim to help people reduce or abstain from substance use, improve functionality in their lives, and develop healthier coping skills. This can involve detoxification programs for withdrawal management, inpatient or outpatient rehabilitation, cognitive behavioural therapy, support groups like Narcotics or Alcoholics Anonymous, and medication. Medications like methadone, buprenorphine, disulfiram, and naltrexone can help reduce cravings, block intoxication, and induce negative effects if the person uses substances.

SUD is considered a chronic relapsing condition, meaning it requires ongoing treatment and monitoring even after initial behaviour changes. Combining both talk therapy and medication often produces the best outcomes. With proper treatment, those with SUD can gain control over their substance use and regain stability in their personal and professional lives.