Substance use disorder (SUD) is a problematic pattern of substance use that affects your health and well-being. Some of the most common substances include alcohol, opioids and marijuana. It can range from mild to severe (addiction). SUD is a treatable mental health condition. Help is available when you’re ready.
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Substance use disorder (SUD), formerly known as drug addiction, is a mental health condition where you experience a problematic pattern of substance use that affects your health and quality of life.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Substances change how your brain functions over time. They release dopamine, a chemical in your brain that makes you feel good — until the substance wears off. Your brain and body want to continue this good feeling, even if it’s unhealthy. It can significantly impact your emotional well-being, relationships, education and career. And in many cases, it’s life-threatening.
SUD exists on a spectrum and may be mild, moderate or severe. No matter where you are, know that this condition is treatable and help is available when you’re ready.
Some of the most common types include:
It’s common to have more than one SUD at a time, like alcohol use disorder and tobacco use disorder. This is known as a polysubstance use disorder.
Alcohol use disorder is the most common type of SUD in the U.S.
The symptoms and effects of substance use disorder vary based on the type of substance you use. There are two groups of symptoms based on when or if the substance is in your body. These include:
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According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, the signs of substance use disorder include:
Seeking medical care as soon as you have signs of substance use disorder is essential.
The exact cause of a substance use disorder isn’t well understood. However, research shows that the changes to your brain’s reward system due to a substance’s addictive potential may cause the condition.
Studies found that many factors may be involved in the development of an SUD. These could include:
The progression to a substance use disorder often follows this pattern:
This is just an example, as this condition looks very different and ranges in severity from person to person.
Substance use disorder affects people of all ages, races, sexes, genders and socioeconomic levels.
You may be more at risk of developing it if you:
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One of the more common and most deadly complications of substance use disorder is overdose. An overdose happens when you take too much of a substance. This is a medical emergency.
Different substances affect different parts of your body. For example, if you overdose on opioids, it targets the part of your brain that regulates your breathing. If not treated quickly, your breathing slows or stops completely, leading to death.
SUD complications are extensive and vary based on severity and type. Common complications may include:
There isn’t a single test available to diagnose substance use disorder. Instead, healthcare providers rely on a thorough evaluation of your medical history and behaviors surrounding substance use. They may order drug tests to see how much and how many types of substances are in your body at a time. They may also evaluate prescription drug monitoring program reports (a database of distributed controlled substances).
A provider will also ask about your mental health history, as it’s common to have an SUD and a mental health condition.
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According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a person must have at least two signs in the symptoms section over 12 months to be diagnosed with substance use disorder.
It’s important to remember that this condition exists on a spectrum of severity:
The first step of substance use disorder treatment is withdrawal management. This is where you stop taking the substance, allowing it to leave your body. Depending on the severity, a healthcare provider may offer medications to lessen the effects of withdrawal symptoms, as they can be rough physically and mentally.
After detox, you may continue a course of treatment with:
SUD treatment is highly individualized. You might need different types of treatment at different times during your recovery. Several types of treatment settings, including inpatient and outpatient settings, as well as short-term care and long-term therapeutic communities, are available.
Many different types of therapy can help treat SUD and any other co-occurring mental health conditions. Some examples of effective therapies for adults with SUDs include:
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Participating in self-help programs, like Narcotics Anonymous, can also play a significant role in SUD treatment. These programs support behavioral modification through self-help and peer support. Group therapy supports people with SUD in maintaining abstinence and restraint.
Healthcare providers may recommend therapies alone or in combination with medications.
Medications can help modify your brain chemistry to help treat certain SUDs. They can also relieve cravings and withdrawal symptoms.
The following U.S. Food and Drug Administration (FDA)-approved medication-assisted treatments are available:
You can’t prevent all cases of substance use disorder because there are a lot of factors (many of which are outside of your control) that could play a role in how the condition develops. However, you can take steps to reduce your risk.
Education in schools, communities and families may reduce your risk of using a substance or misusing a prescription medication for the first time. Other ways to prevent SUD include:
The risk of substance use increases during times of stress and change. For an adult, a divorce, loss of a job or death of a loved one may increase the risk of substance use. For a teenager, moving, family divorce or changing schools can increase their risk. It’s important to turn to healthy coping mechanisms during these times of change, like exercising, meditating or learning a new hobby. Consider seeing a mental health professional if you’re having difficulty managing stress.
The prognosis (outlook) for this condition varies based on several factors, including:
Substance use disorder is a lifelong disease. But recovery is possible. Different tools work for different people. Many find success through support groups (like Narcotics Anonymous) and ongoing therapy.
Relapses are common with SUD. A relapse is returning to a substance after stopping it for a period of time. You’ll need to detox again and restart your treatment cycle from the beginning. This can be a frustrating process. Relapses can happen years after you last took a substance. It helps to have a strong support system to rely on if you may be at risk of relapse.
Your healthcare provider should review your treatment plan regularly. It’s normal for your goals or lifestyle to change. This may mean you try a different type of therapy or a new medication. A provider can help you make adjustments throughout your life as needed.
If you’re currently using a substance regularly and are concerned it’s turning into a habit you’re unable to stop on your own, talk to a healthcare provider. A provider can also give you guidance on how to have a conversation with your children about SUD and get them help if you think they’re at risk.
Substance use disorder (SUD) is a complex mental health condition. Substances change the way your brain works, which makes it hard to stop taking a substance, even if you want to. While it may be one of the most difficult things to do, it’s OK to ask for help when you need it.
Treatment is challenging. Detoxing is unpleasant. Therapy is emotionally exhausting. But recovery is rewarding. You may want to reach out to a friend or loved one for support as you start your treatment journey. Their encouragement could be the motivation you need to talk to a healthcare provider.
You may need continuing care throughout your life, as SUD is a chronic condition. Know that your care team will be with you every step of the way.
Last reviewed on 09/09/2024.
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