TREATMENT

Substance Use Disorder Program

Substance use disorder, commonly known as addiction, is a complex condition that involves uncontrollable use of a substance like alcohol, tobacco, or illicit drugs, to the point that someone’s ability to function in daily life is impaired.[1]

Though substance use disorder can be a devastating condition, effective treatment can support long-term recovery and a healthier life.

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    What Is a Substance Use Disorder (SUD)?

    A substance use disorder is a medical condition that’s defined by the inability to control the use of a certain substance, despite health or interpersonal problems. The use of drugs or alcohol crosses into a substance use disorder when someone compulsively misuses a substance and continues to use it, even if they recognize the negative impact it has in their life.[2]

    The American Psychiatric Association (APA) established diagnostic criteria for substance use disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5):

    • Alcohol use disorder
    • Cannabis use disorder, or marijuana use disorder
    • Inhalant use disorder
    • Opioid use disorder
    • Sedative, hypnotic, or anxiolytic use disorder
    • Phencyclidine use disorder’
    • Other hallucinogen use disorder (excluding phencyclidine)

    Stimulant use disorder, which includes methamphetamine use disorder and cocaine use disorder[3]

    Symptoms of Substance Use Disorder

    The signs and symptoms of a substance use disorder can vary by the substance but may include:

    • Having frequent fights, accidents, or legal trouble
    • Missing school or work
    • Secretive or suspicious behavior
    • Changes in appetite or sleep
    • Personality or attitude changes
    • Mood swings or irritability
    • Unusual activity levels
    • Bloodshot eyes or small pupils
    • Lack of motivation
    • Poor physical appearance
    • Sudden weight changes
    • Unusual odors
    • Slurred speech or tremors
    • Changes in social circle
    • Asking for money[5]

    Substance Use Disorder Treatment Process

    Treating a substance use disorder requires individualized treatment plans that take into account the specific substance use disorder and the individual’s history, goals, and challenges. The first step in seeking treatment is a thorough assessment from medical professionals.

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    Medical Detox

    Depending on the substance, medical detoxification is the start of treatment. This is a week-long process – or sometimes longer – to provide a safe, comfortable environment while the drug clears the system. With substances like alcohol and opioids, withdrawal can be life-threatening, so medical detox is important for managing your symptoms and keeping you safe.

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    Inpatient Treatment

    Inpatient treatment, also known as residential treatment, offers 24/7 care and monitoring in a residential or hospital setting. This is a good choice for people who need intensive care to manage their external triggers and environment. Medical care and different types of therapies are provided.

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    Outpatient Treatment

    Outpatient treatment is a step down from inpatient treatment that allows you to attend treatment sessions at a facility while balancing the responsibilities of day-to-day life. You spend a few hours in sessions, then return home to spend time with family and sleep in your own bed. Depending on the plan, you could attend most of the week or just a few days a week.

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    Aftercare

    Addiction recovery is a lifelong process. Aftercare is a type of ongoing treatment service that helps you stay on track after transition from inpatient or outpatient treatment to everyday life. This covers a range of resources, including legal support, career counseling, substance monitoring, coaching, relapse prevention, and more.

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    Substance Use Disorder and Mental Health

    Substance use disorder and mental health disorders like anxiety, depression, and bipolar disorder often occur simultaneously, which is known as a co-occurring disorder or dual diagnosis.

    With co-occurring disorders, both the mental health disorder and the drug or alcohol addiction have their own symptoms – as well as overlapping symptoms – that can exacerbate one another.[7] Untreated, both conditions worsen.

    The best treatment for co-occurring disorders is an integrated approach to treat both the substance abuse issue and mental health disorder simultaneously. No matter which came first, overcoming co-occurring disorders hinges upon effective treatment for both conditions.

    Mental Disorder

    Diagnostic Criteria for Substance Use Disorder

    Types of substance abuse can include a range of different substances, including stimulants, opioids, and alcohol. The disorder can range from mild to severe, depending on the diagnostic criteria.

    The APA has 11 criteria for a substance use disorder diagnosis in the DSM-5:

    • The inability to reduce or stop the use of substances
    • Taking a substance for longer periods or in larger amounts than intended
    • Experiencing intense cravings for substances
    • Spending an inordinate amount of time getting, using, and recovering from substances
    • Continuing to use substances despite interpersonal or social problems
    • Failing to fulfill obligations at home, work, or school because of substance use
    • Using a substance in risky or dangerous situations
    • Giving up social, recreational, or occupational activities due to substance use
    • Continuing substance use despite physical or mental problems
    • Tolerance, or the need for more of the substance to achieve previous effects
    • Withdrawal, or unpleasant symptoms that occur when substance use stops[6]

    SUDs are classified as mild if the individual meets between 2 and 3 criteria; moderate if they meet 4 or 5 criteria; and severe if they meet 6 or more criteria.

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    Therapies Used to Treat Substance Use Disorders

    The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends these therapies for substance use disorder:

    Cognitive Behavioral Therapy (CBT)

    CBT is a psychotherapy that focuses on learning to identify unhealthy thought patterns and behaviors and overcome them. This is one of the most effective treatment options for substance use and co-occurring mental health disorders.

    Motivational Interviewing

    Motivational interviewing helps people recognize the way addiction impacts their lives and relationships. Once identified, people are better equipped to overcome apathy or ambivalence and develop self-motivation.

    Contingency Management

    Contingency management seeks to repair the problematic reward processes that fuel drug and alcohol use by incentivizing sobriety. People can earn rewards for taking medication, passing drug detection tests, and attending therapies, for example.

    Community Reinforcement

    Contingency management seeks to repair the problematic reward processes that fuel drug and alcohol use by incentivizing sobriety. People can earn rewards for taking medication, passing drug detection tests, and attending therapies, for example.

    Dual Diagnosis Mental Health Disorder Treatment

    If you have a co-occurring mental health disorder with a substance use disorder, dual diagnosis treatment addresses both disorders simultaneously to support better outcomes. Depending on your needs, dual diagnosis can take place in an inpatient or outpatient setting.[4]

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    Frequently Asked Questions

    What Is a SUD? Chevron Down
    What’s the Difference Between Substance Use Disorder and Addiction? Chevron Down
    What Is the Most Common Substance Use Disorder? Chevron Down
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