What Are Substance Abuse Disorders?

Some types of substance abuse disorders include: 

• Opioid use disorder 
• Marijuana use disorder 
• Nicotine use disorder 
• Stimulant use disorder 
• Sedative use disorder 
• Hallucinogen use disorder 
• Alcohol use disorder

Addictions are the most severe form of substance abuse disorder. People who suffer from addiction are often aware of their problem but are unable to stop, even if they want to. 

Symptoms of substance abuse disorders involve distorted thinking and behaviors that fall under four categories: 

• Impaired control
  • Intense craving or strong urge to use the substance
  • Desire or failed attempts to cut down or control use of substance 
• Social problems
  • Interpersonal problems with others
  • Failure to complete major tasks at work, school, or home
  • Personality changes
  • Social, work, or leisure activities are given up or cut back because of substance use
• Risky use
  • Substance use even in risky settings
  • Continued use despite known problems
• Drug effects
  • Intoxication: intense pleasure, euphoria, calm, increased perception, enhanced senses, and other feelings caused by the substance
  • Abnormal movements 
  • Tolerance (needing larger amounts to get the same effect)
  • Withdrawal symptoms (different for each substance)

Continual substance use can cause changes in brain function that can last long after the immediate effects of the substance wears off. 

Other psychiatric disorders often accompany substance abuse disorders. 

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines substance abuse disorders as mild, moderate, or severe based on the number of diagnostic criteria met by an individual. 

Diagnostic criteria for substance use disorders includes evidence of: 

• Impaired control 
• Social impairment
• Risky use
• Pharmacological criteria

Treatment for substance abuse disorders first involves recognizing there is a problem. If the person does not perceive a problem with substance abuse, it may be difficult for them to recover. 

Substance abuse disorders often require multiple types of treatment, and a combination of medication and individual or group therapy tends to be most effective. 

Recovery plans are tailored to a person’s specific needs and may include:

• Hospitalization for medical withdrawal management (detoxification)
• Therapeutic communities (highly controlled, drug-free environments) or sober houses
• Outpatient medication management and psychotherapy
• Intensive outpatient programs
• Residential treatment (“rehab”)
• Support groups helpful (Alcoholics Anonymous, Narcotics Anonymous, SMART Recovery)
• Self-help groups for family members (Al-Anon or Nar-Anon Family Groups)