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What is a Substance Use Disorder (SUD)?

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Medically Reviewed By: Diana Vo, LMFT

June 28, 2023 (Originally Published)

October 11, 2023 (Last Updated)

Table of Contents

Substance use disorder is the clinical term for drug addiction. Substance use disorder, sometimes abbreviated to SUD, is a multifaceted condition characterized by the uncontrollable and persistent use of addictive substances despite adverse outcomes.

Individuals with SUD exhibit an overwhelming preoccupation with specific substances which severely impairs their daily functioning. Those with substance use disorders continue to use drugs, alcohol, or medications despite being aware of the problems they cause.

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This guide examines the following issues:

  • What are substance use disorders?
  • What is the definition of substance use disorder?
  • Is addiction disorder a mental health condition?
  • What are the signs of substance use disorder?
  • Sud symptoms and SUD diagnosis.
  • How can you connect with treatment for substance use disorder in Southern California?

Is Substance Use Disorder a Psychiatric Disorder?

APA (American Psychiatric Association) recognizes substance use disorder as a psychiatric disorder. According to the revised fifth edition of APA’s Diagnostic and Statistical Manual of Mental Disorders DSM-5-TR – SUD falls under the category of substance-related disorders and addictive disorders.

A substance-related disorder involves a range of symptoms and behaviors related to uncontrolled and harmful substance use regardless of negative consequences. Addictive substances include:

  • Alcohol
  • Prescription medications
  • Illicit narcotics
  • Nicotine

The classification of substance use disorder as a psychiatric disorder acknowledges the complex interaction between biological, psychological, and social factors that contribute to the development and maintenance of addiction.

As a psychiatric disorder, SUD is diagnosed based on specific criteria outlined in DSM-5-TR. These criteria include the presence of symptoms like impaired control over substance use, spending lots of time using substances, and the development of tolerance and withdrawal symptoms as a result of sustained use.

Recognizing SUD as a psychiatric disorder helps to destigmatize and promote understanding of those grappling with substance use issues. With a comprehensive assessment, diagnosis, and appropriate treatment interventions by mental health professionals, it is possible for those with addictions to move beyond substance use disorder.

Symptoms of Substance Use Disorder

The symptoms of substance use disorder are outlined in DSM-5-TR as follows:

  1. Exceeding recommended dosage or prolonging substance use beyond intended limits.
  2. Desire to decrease or discontinue substance use but struggling to achieve it.
  3. Devoting substantial time to acquiring, using, or recovering from substance use.
  4. Experiencing intense cravings and irresistible urges to indulge in the substance.
  5. Inability to fulfill responsibilities at work, home, or school due to substance use.
  6. Persisting with substance use despite detrimental impact on relationships.
  7. Sacrificing significant social, professional, or recreational engagements due to substance use.
  8. Engaging in substance use despite clear risks to personal safety and well-being.
  9. Persisting with substance use despite awareness of physical or psychological ailments caused or inflamed by use of the substance.
  10. Developing tolerance and requiring larger amounts of the substance to achieve desired effects.
  11. Experiencing withdrawal symptoms that can be alleviated by consuming more of the substance.

Substance use disorder is diagnosed according to the number of criteria that present as mild (2 to 3), moderate (4 to 5), or severe (6 or more).

How is Substance Use Disorder Diagnosed?

What is a substance use disorder diagnosis, then? The diagnosis of SUD involves a comprehensive assessment conducted by qualified healthcare professionals, typically psychiatrists, psychologists, or addiction specialists. The diagnostic process follows the guidelines outlined in DSM-5-TR.

To determine if an individual meets the criteria for SUD, the healthcare professional will consider the following factors.

  • Assessment of symptoms: Healthcare professionals evaluate the presence and severity of symptoms associated with substance use and addictive disorders using DSM-5-TR criteria.
  • Duration: The duration of symptoms is assessed to determine if they have persisted for a specific timeframe. For a diagnosis of SUD, symptoms typically endure for one year or more. That said, a diagnosis of substance use disorder can be made if the symptoms are severe and meet APA’s diagnostic criteria within a shorter duration.
  • Severity: Healthcare professionals evaluate the severity of SUD based on the number of symptoms present. The severity can range from mild to severe.
  • Functional impairment: The impact of substance use on the individual’s functioning in various areas of life, such as work, relationships, and social activities, is assessed. Impairments in these domains help determine the severity and impact of SUD on overall well-being.
  • Other considerations: Physical and mental health and substance use disorders are closely intertwined. Healthcare professionals also consider additional factors like the presence of co-occurring mental health disorders, medical conditions, and the individual’s social and environmental circumstances. These factors can influence the diagnosis and treatment approach.

A diagnosis of SUD requires a thorough evaluation by a qualified healthcare professional. Conducting a self-diagnosis or relying on online assessments is not recommended. If you suspect that you or someone you know may have substance use disorder, seeking professional help for an accurate diagnosis and appropriate treatment planning is the most effective approach to recovery.

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Substance Use Disorder Statistics

The following substance use disorder statistics are sourced from the most current National Survey on Drug Use and Health published each year by SAMHSA (Substance Abuse and Mental Health Services Administration).

The total number of people diagnosed with substance use disorders has been rising sharply since 2019 in the United States. The latest data for U.S. over-12s shows that:

  • 7.3 million had substance use disorders involving both drugs and alcohol.
  • 16.7 million had substance use disorder involving drugs but not alcohol.
  • 22.3 million had substance use disorder involving alcohol but not drugs.

This is a more specific breakdown of the different types of substance use disorders drawn from the same data:

  1. Heroin use disorder affected 1 million U.S. over-12s.
  2. Opioid use disorder triggered by prescription painkillers affected 6.8 million U.S. over-12s. 
  3. Meth use disorder affected 1.6 million U.S. over-12s.
  4. Benzodiazepine disorder affected 2 million U.S. over-12s.
  5. Prescription stimulant use disorder affected 1.2 million U.S. over-12s.
  6. Cocaine use disorder affected 1.4 million U.S. over-12s.
  7. Marijuana use disorder affected 15 million U.S. over-12s.
  8. Alcohol use disorder affected 29.5 million U.S. over-12s.
  9. Inhalant use disorder affected 251,000 U.S. over-12.
  10. Hallucinogen use disorder affected 445,000 U.S. over-12s.

Among these, only 2.5 million over-12s engaged with drug addiction treatment and just 2.5 million engaged with alcohol addiction treatment, illustrating a significant treatment gap.

Substance Use Disorder Examples

APA recognizes ten different types of substance use disorder encompassing a wide range of substances that can trigger addiction and harmful consequences. Here are some examples of substances commonly associated with SUD:

  • Alcohol: Almost 30 million U.S. adults were diagnosed with alcohol use disorder in 2021. Alcohol use disorder – the clinical descriptor for alcoholism – involves the excessive and problematic consumption of alcoholic beverages, leading to physical and psychological dependence.
  • Opioids: Opioid use disorder involves the misuse or abuse of opioids, including prescription pain medications like oxycodone and hydrocodone, as well as illicit substances like heroin or fentanyl (the synthetic opioid associated with 80,000 overdose deaths last year in the United States). Opioids can cause a powerful euphoric effect, contributing to their highly addictive potential.
  • Stimulants: Stimulant use disorder involves the misuse of substances that stimulate the CNS (central nervous system), such as cocaine, amphetamines like meth, and prescription medications like Adderall or Ritalin. CNS stimulant drugs can produce heightened energy, increased focus, and intense feelings of pleasure, leading to addiction.
  • Marijuana: Although marijuana is increasingly legalized for medical and recreational use in various jurisdictions, the drug is nevertheless associated with addiction in the form of marijuana use disorder, also known as cannabis use disorder. Excessive and compulsive use of marijuana or related products can result in dependence and negative effects on daily functioning.
  • Hallucinogens: Hallucinogen use disorder is characterized by the misuse or abuse of substances that alter perception and cognition – LSD (acid), psilocybin mushrooms, and MDMA (Molly), for instance. These substances can induce hallucinations, intense sensory experiences, and changes in mood.
  • Sedatives and benzodiazepines: Misuse of sedatives and benzodiazepines, including medications like Xanax and Valium, can lead to the development of sedative, hypnotic, or anxiolytic use disorder. These substances are often prescribed to treat anxiety, panic disorders, and insomnia, but can be highly addictive when used inappropriately.
  • Tobacco: Nicotine dependence, commonly associated with cigarette smoking, is a form of substance use disorder. Tobacco use disorder can provoke severe health consequences, including increased risks of respiratory diseases, cardiovascular conditions, and cancer.
  • Other substances: SUD may also involve other substances, such as inhalants (paint thinners and solvents), hallucinogenic plants (peyote or ayahuasca), anabolic steroids, and designer drugs (synthetic cannabinoids and bath salts).

Seeking professional help and support can help anyone conquer substance use disorder. Shortcut the process by reaching out to Renaissance Recovery in Southern California.

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Get Treatment for Substance Use Disorder at Renaissance Recovery

At Renaissance Recovery substance abuse treatment center in Southern California, we specialize in treating all types of substance use disorder in an outpatient setting.

Choose the appropriate level of support and structure from the following programs:

All treatment programs at our Orange County facility deliver individualized treatment for substance use disorders that combines holistic and science-backed interventions. These include:

For immediate assistance, call 866.330.9449 today and move beyond substance use disorder.



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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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