Q & A: How Do We Diagnose Substance Use Disorder

Michelle Rosenker

November 14, 2019

Q: What is substance use disorder?

A: Substance use disorder is the clinical term used to describe the chronic, relapsing brain disease otherwise known as addiction. Someone with a substance use disorder experiences an inability to control his or her use of one or more dangerous substances. A primary characteristic of substance use disorder occurs when a person’s quality of life and overall functionality are negatively impacted by their abuse of addictive substances.

Q: What types of substances do people with substance use disorders most commonly abuse?

A: According to the Substance Abuse and Mental Health Services Administration (SAMHSA), there are more than 20 million people who are struggling with a substance use disorder in the United States. The vast majority of these people—roughly 16 million—are addicted to alcohol. The rest are addicted to other substances, including:

  • Opioids (OxyContin, fentanyl, heroin, hydrocodone, Percocet)
  • Stimulants (cocaine, crack, meth, Adderall, Ritalin)
  • Benzodiazepines (Ativan, Valium, Xanax, Klonopin)
  • Hallucinogens (Ecstasy, ketamine, PCP)
  • Inhalants (computer cleaner, glue, paint thinner)
  • Marijuana

It is extremely common for people with a substance use disorder to abuse more than drug at one time. This is known as polysubstance abuse.

Q: What are the symptoms of substance use disorder?

A: Substance use disorders impact people differently. This occurs because each person has factors that are unique to them, such as where they live, what type of substance they are abusing, and what the status of their physical and mental health is. As a result, there are several various symptoms of substance use disorder, however there are just as many common ones. According to the Mayo Clinic, substance use disorders are often defined through the following symptoms:

  • Experiencing withdrawal symptoms when unable to take the substance or substances of choice
  • Continually requiring more of the drug or alcohol in order to feel under the influence
  • Having intense urges to use the drug or to drink
  • Not meeting obligations at work, home, or school due to the substance abuse or preoccupation with it
  • Making attempts to stop using drugs or alcohol but being unsuccessful

These are just some of the several symptoms of substance use disorder. The more advanced the substance use disorder becomes, the more severe and numerous the symptoms can become.

Diagnosis

Q: How is a substance use disorder diagnosed?

A: A substance use disorder is a disease, meaning that it can be professional diagnosed. While someone who is addicted to drugs or alcohol might already know that they have a substance use disorder or those around him or her are aware of it, receiving the diagnosis is still important. The official diagnosis can help guide a person towards the appropriate type of treatment for his or her specific needs. So, how is a substance use disorder diagnosed?

A substance use disorder is diagnosed by a professional such as a doctor, psychiatrist, counselor, social worker, or other specialist who is experienced in diagnosing this disease. In order to make a full diagnosis of a substance use disorder, a professional conducts an interview that can answer questions about the person’s:

  • Living environment
  • Mental health
  • Physical health
  • Social factors
  • Interpersonal relationships

In combination with this interview, professionals must refer to the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) to make this diagnosis, as well as determine the severity of it. There are 11 criteria in the DSM to help diagnose substance use disorders, such as tolerance, withdrawal, hazardous use, and repeated attempts to quit with no success. The severity of a substance use disorder is determined by how many of the 11 criteria a person is experiencing. The greater number of criteria, the more severe the substance use disorder.

Q: Can other issues be uncovered during a substance use disorder diagnosis?

A: When someone is being interviewed to determine if he or she has a substance use disorder, it is not uncommon for other issues to be recognized and diagnosed simultaneously. In fact, this is very common, as nearly 50 percent of people with a substance use disorder also have a co-occurring mental health condition. When this occurs, it is known as a dual diagnosis. Many people with a substance use disorder also struggle with symptoms related to depression, anxiety, personality disorders (including borderline, antisocial, dissociative) and schizophrenia. Fortunately, dual-diagnosis treatment does exist.

In some cases, the mental illness is the primary concern while the substance use disorder is secondary. In other cases, it is the opposite, where the substance use disorder is the main issue with the mental illness being secondary. Regardless of which issue is more prominent, there are dual diagnosis treatment programs available for those with this condition.

Q: What happens after receiving a diagnosis of substance use disorder?

A: A person has several options after he or she is diagnosed with a substance use disorder. Of course, he or she can ignore the diagnosis and continue with his or her substance use. However, it is highly recommended that with a diagnosis, a person also receives a plan for care.

When a substance use disorder is diagnosed in a private setting, such as at a doctor’s office, the professional making the diagnosis is obligated to provide options for care. He or she can suggest local treatment centers or programs, or even recommend out-of-state options depending on the needs of the person. From there, the patient must take action on his or her own to get the help needed.

Others get their substance use disorder diagnosis after they have been admitted to a treatment center. The professionals at the treatment center will determine the diagnosis and then develop an individualized treatment plan for the person based on his or her needs.

Are You Struggling with Substance Abuse?

If you are abusing drugs or alcohol and you cannot stop, reach out to us right now. There is no shame in having a substance use disorder. It is a disease that requires the correct treatment in order to manage it. You deserve to live a life free of dangerous substances like drugs and alcohol.

Do not waste another moment. Call us right now to get the help you need to begin living a happy, healthy life of recovery.