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Medically Reviewed

How is Substance Use Disorder Diagnosed?

- 4 sections

Medically Verified: 2/1/24

Medical Reviewer:

Sahil Talwar, PA-C, MBA


All of the information on this page has been reviewed and verified by a certified addiction professional.

While many people use the terms substance use disorder (SUD) and addiction interchangeably, there is a set of criteria that physicians use to diagnose SUDs and other mental health conditions. Although addiction can refer to anything from drugs and alcohol to food and specific behaviors, addiction in itself isn’t technically a medical diagnosis. While addiction describes a range of things, substance use disorder directly describes the symptoms and severity of a person’s drug abuse.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the American Psychiatric Association’s standard on the names, symptoms, and diagnostic features of mental health conditions and addictions. However, previous editions of the DSM broke down addictions into two categories: substance abuse and substance dependence. The latest edition, the DSM-V, combined these categories to diagnose addiction as substance use disorder. It was also the first edition to recognize gambling as an addictive disorder.[1]

How Do Addictions Get Diagnosed?

In most cases, the diagnostic process begins with friends, family members, or the afflicted individual bringing attention to a drug problem. Oftentimes, loved ones are concerned and reach out to addiction professionals or interventionists to help an addicted loved one. Other times, the person who is addicted to drugs reaches a point where they can no longer manage their lifestyle. Once a person has agreed to seek professional help, this person should visit a family doctor, hospital, or rehabilitation specialist.

Today, this process is usually done during intake at a drug rehab facility. However, any practicing physician can diagnose a substance use disorder and refer patients to a treatment center that meets their needs.

While speaking with a physician, he or she will ask the patient a variety of questions regarding the frequency of drug use, consequences in life, and social, occupational, and educational implications. They will also get an idea of whether or not you are physically dependent on a substance and if you are experiencing withdrawal symptoms. This diagnostic process helps the practicing physician determine whether or not a person has a problem with drugs, how severe this problem is, and what type of treatment, if any, is recommended for the individual.[2]

Diagnosing Substance Use Disorder

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or DSM-V, recognizes 10 unique classes of substance-related disorders including cannabis, alcohol, caffeine, hallucinogens, opioids, sedatives, inhalants, stimulants, hypnotics, and tobacco. While it considers the relative addictive qualities of each substance, the DSM-V also recognizes that every individual with a substance-related disorder is different. Some have more severe symptoms than others, while some are pre-disposed to developing addictions.

Diagnostic Criteria for a Substance Use Disorder Diagnosis

Substance use disorders arise from an array of psychological, environmental, and biological factors that promote substance abuse. The 11 criteria, outlined by the DSM-V, to clinically diagnose substance use disorder are:[1]

  • Wanting to cut down or stop using the substance but not being able to.
  • Taking the substance in greater quantities or for longer amounts of time than you intended to.
  • Feeling cravings and desires to use the substance.
  • Spending a lot of time and resources obtaining, using, and recovering from the effects of the substance.
  • Continuing to use the substance despite problems it is causing in your personal relationships.
  • Failing to complete your obligations or responsibilities at home, work, or school due to substance abuse.
  • Giving up activities (social, recreational, or occupational) that you once enjoyed in order to use the substance.
  • Continuing to use even when a physical or psychological problem is being made worse by the substance.
  • Using the substance over and over again even if it is dangerous to you or your health.
  • Developing a tolerance to the substance where you need to take more and more to produce the effect that you want.
  • Experiencing withdrawal symptoms when you don’t take the substance.

To be diagnosed with substance use disorder, you must meet two of the above criteria within a one-year period. Furthermore, the number of criteria that a person meets helps define the severity of that person’s drug addiction. For example, if a person demonstrates 2-3 symptoms, their condition is described as mild. On the other hand, identifying with 4-5 symptoms indicates a moderate substance use disorder, and 6 or more is classified as severe.[2]

While the diagnosing physician should make appropriate treatment recommendations if a diagnosis is made, there are several types of addiction treatment programs that meet the needs of people suffering from substance-related disorders.

Professional Treatment for Substance Use Disorder

Unfortunately, there is no ultimate cure for drug addiction. However, there is an array of treatment options that help people overcome substance use disorder each and every day. Some factors that should be considered when looking for treatment include:[3]

  • How severe your addiction is
  • What substance you are addicted to
  • Whether or not you need medical detox
  • Whether or not you suffer from a related medical or mental health disorders

Depending on your needs, you can speak with an addiction professional and determine if you need a long-term residential program, intensive outpatient therapy, or outpatient treatment. While people with more severe addictions typically attend inpatient treatment, all rehabilitation programs offer different therapies, amenities, and services. For example, the different kinds of treatments for substance use disorder include:

different kinds of treatments for substance use disorder

  • Dual diagnosis rehab
  • Medically-assisted detox and treatment
  • Faith-based treatment
  • Holistic treatment
  • Evidence-based therapy
  • Behavioral therapy
  • Family therapy
  • Relapse prevention
  • Group therapy
  • Individual therapy
  • Alumni programs

All of these aspects of treatment can help people overcome substance use disorder. What’s most important is that you find one that meets your needs. If you’re concerned that you or a loved one needs help with substance abuse, contact our drug rehab in North Carolina today. We will either provide you with individualized care or refer you to the program that fulfills your needs.