Substance Use Disorders: What to Know

Substance use disorders describe a specific set of disorders—including the abuse of alcohol, opioids, sedatives, hypnotics, and anxiolytics—which impair the individual in some way. According to the Diagnostic and Statistical Manual for Mental Disorders (DSM-5), “The essential feature of a substance use disorder is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems.”

This class of disorders is quite widespread, as according to the Centers for Disease Control and Prevention (CDC), for instance, estimate that the number of alcohol abuse-related deaths in the past year is 30,722. This does not include mortalities from other substance-related deaths, such as from opioid overdoses, which is said to be on the rise.

In general, substance use disorders contain certain features in order for the disorder to label clinically present in an individual. The DSM-5, which is a manual used by mental health professionals such as psychologists, health care professionals, and social workers to identify and diagnose a disorder, makes clear that there are at least four criteria that are related to substance use disorders. They are:

1. Impaired Control. Impaired control contains specific subcategories such as, “The individual may take the substance in in larger amounts or over a longer period than it was originally intended,” or “The individual may express a persistent desire to cut down or regulate substance use and may report multiple unsuccessful efforts to decrease or discontinue its use.”

2. Social Impairment. Social impairment occurs when an individual who is abusing a substance “. . . fails to fulfill major role obligations at work, school, or home.” What is more, in this situation, the individual may continue to abuse the substance despite the behavior negatively impacting his or her social, professional, or home life.

3. Risky Use. Risky Use is what the phrase sounds like: It occurs when an individual abuses a substance in a situation that will invite risk. In particular, “[Risky Use] may take the form of recurrent substance use in situations where it is physically hazardous.” In other words, the individual may continue to abuse a substance even with the prior knowledge of it’s harmful effects in hazardous situations.

4. Pharmacological Criteria. Despite its complex sounding name, pharmacological criteria simply involves tolerance. Because substance abuse disorder involves “a cluster of cognitive, behavioral, and physiological symptoms,” individuals who abuse substances tend to develop physiological tolerance toward a substance. To put is specifically: “Tolerance is signaled by requiring a markedly increased dose of the substance to achieve the desired effect or a markedly reduced effect when the usual dose is consumed.”

These above mentioned criteria are, according to the DSM-5, broad categories and each contain several subcategories to identify and diagnose substance use disorders; however, the categories listed above provide a good introduction in to the topic. Finally, if you or someone you know appears to exhibit the criteria mentioned above, seek immediate help from a professional.

Substance use disorders remain a serious set of diagnosable disorders that have a wide prevalence in our culture, and, perhaps the best way to combat them is to observe the signs, become informed, and seek appropriate professional help.


Diagnostic and Statistical Manual for Mental Disorders (5th Ed.).

Brooke Lamberti

Brooke Lamberti is a content writer based out of Scranton, Pennsylvania. She received a Bachelor of Science in Psychology from Marywood University, and has prior career experience working in social work and domestic violence advocacy. She has a passion for writing and helping others.

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