Substance use disorder (SUD) is characterized by a pattern of using alcohol or another substance that results in disruption of your daily life or noticeable distress. This pattern affects your brain and your behavior and makes you unable to control your substance use.

Often, people with SUD have other mental disorders like anxiety and depression. Substance use can also be a response to symptoms of other mental disorders. This doesn’t mean these disorders cause each other, but they often occur together.

What does SUD look like?

Being dependent on substances changes a person’s brain structure. This can cause changes in personality, intense cravings, and other abnormal behaviors. It also makes it difficult to stop using the substance without symptoms of withdrawal.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists 11 criteria for identifying substance use disorder. The higher the number of symptoms a person aligns with, the more severe their disorder may be:

• Using more of a substance that intended or using it for longer than you’re meant to.
• Trying to cut down or stop using the substance but being unable to.
• Experiencing intense cravings or urges to use the substance.
• Needing more of the substance to get the desired effect (also called tolerance).
• Developing withdrawal symptoms when not using the substance.
• Spending more time getting and using drugs and recovering from substance use.
• Neglecting responsibilities at home, work or school because of substance use.
• Continuing to use even when it causes relationship problems.
• Giving up important or desirable social and recreational activities due to substance use.
• Using substances in risky settings that put you in danger.
• Continuing to use despite the substance causing problems to your physical and mental health.

What causes SUD?

SUD has similar risk factors as other mental disorders, including:

• Environment. Stressful or traumatic environments, in childhood and adulthood, can contribute to the development of SUD.
• Genetics. Substance dependency can run in families.
• Co-occurring mental disorders. People with other mental disorders may turn to substances to self-medicate, which can make symptoms worse over time and can lead to the development of SUD.

How do I know if I have SUD?

If you have noticed a pattern of substance use in your life or in someone you know, it is important to speak up about it. Recognition of the pattern is the first step in getting help. A doctor can further determine your diagnosis and help you get connected to treatment options.

How is SUD treated?

For most people, a combination of medication and therapy is beneficial in recovery from a substance use disorder. Medication can be used to treat co-occurring disorders, relieve withdrawal symptoms and control cravings. Other strategies used in treatment may include:

• Hospitalization to manage medical withdrawal.
• Therapeutic communities or sober houses.
• Intensive outpatient programs.
• Residential treatment, also called rehab.
• Mutual-aid groups like Alcoholics Anonymous, Narcotics Anonymous and SMART Recovery.
• Self-help groups that include family members, like Al-Anon or Nar-Anon.

If you have received a substance use disorder diagnosis, start your treatment plan with the Mental Health 417 treatment finder.

Information adapted from DSM-5, American Psychiatric Association, National Institute of Mental Health and Mental Health First Aid.