What Is Substance Use Disorder?

Substance use disorder ( SUD) is a condition distinguished by the inordinate and obsessive use of medicines or alcohol. Despite the negative consequences on a person's health, connections, and social functioning. SUD is considered as a complex brain disorder, which affects multiple aspects of a person's life, including their feelings, and cognitive functioning. According to the Diagnostic and Statistical Manual of Mental diseases(DSM-5), SUD is diagnosed when an individual meets two or further of the 11 criteria for substance use within a 12-month period.

SUD can have severe consequences, including physical and internal health problems, fiscal issues, and legal problems. It can also lead to social insulation, relationship problems, and employment difficulties. Treatment for SUD may involve a combination of pharmacological and behavioural curatives, including support groups. Early intervention and treatment are critical for a successful recovery and precluding relapse.


Substance use disorder (SUD) is a chronic, relapsing condition characterized by compulsive drug-seeking behaviour despite negative consequences. It is a major public health issue that affects 35 million people worldwide.1 and can lead to a range of negative outcomes, including physical and mental health problems, social and economic issues, and legal problems.

The causes of SUD are complex and multifactorial, with genetic, environmental, and behavioural factors all playing a role. Research has shown that genetic factors can increase an individual's risk of developing SUD, while environmental factors such as stress, trauma, and social influences can also contribute to the development of the disorder.2

The symptoms of SUD vary depending on the type of substance being used but commonly include a loss of control over drug use, continued use despite negative consequences, and the development of tolerance and withdrawal symptoms. SUD can also lead to physical and mental health problems, including liver disease, heart disease, anxiety, and depression.

Treatment for SUD typically involves a combination of pharmacological and behavioural interventions. Medications such as methadone, buprenorphine, and naltrexone can help reduce cravings and withdrawal symptoms, while behavioural therapies such as cognitive-behavioural therapy (CBT) and contingency management can help individuals change their patterns of drug use and develop coping skills.3

Research on SUD is ongoing, with new treatments and interventions being developed and tested. However, the stigma associated with SUD remains a significant barrier to treatment and recovery. It is important for individuals struggling with SUD and their families to seek help from trained professionals and to have access to effective, evidence-based treatments. 

Causes of substance use disorder

The causes of substance use disorder can be due to genetics, behavioural or environmental factors.

Genetic factors can increase an individual's risk of developing SUD. Studies have shown that genetic variations can influence an individual's response to drugs, their likelihood of becoming addicted, and their ability to quit using drugs.4

Environmental factors, such as stress, trauma, and social influences, can also contribute to the development of SUD. Stressful life events, such as abuse or neglect, can increase the risk of developing SUD. Additionally, social factors, such as peer pressure or exposure to drug use, can also contribute to the development of  SUD.5

Behavioral factors, such as impulsivity, peer pressure and sensation seeking, can also increase the risk of developing SUD. Individuals who are impulsive or seek out new and exciting experiences may be more likely to try drugs, which can lead to addiction.6

It is important to note that while these factors can increase an individual's risk of developing SUD, not everyone who experiences them will develop the disorder. Additionally, individuals may develop SUD for different reasons, and the factors that contribute to the disorder may vary depending on the individual.

Signs and symptoms of substance use disorder

Symptoms of SUD may include as follows:

  • Obsessive cravings or urges to use medicines or alcohol
  • Difficulty controlling substance use
  • Using larger quantities of medicines/drugs or alcohol over time
  • Demanding larger amounts of the substance to achieve the full effect
  • Withdrawal symptoms when trying to stop using the substance
  • Continued use of the substance despite negative consequences, such  as legal problems, relationship and social issues, or health problems
  • Spending a significant quantum of time carrying, using, or recovering from the goods of the substance
  • Neglecting important daily life responsibilities, such as work, education, or family scores, due to substance use
  • Giving up your feel-good factors such as activities you used to enjoy and replacing this with substances
  • Using substances in  dangerous situations, such as when you are driving

Management and treatment for substance use disorder

The management and treatment of SUD generally involve a combination of approaches, including specific medication, behavioural therapies such as CBT, and focus  groups. The specific treatment approach may vary depending on the existent's requirements, the inflexibility of the complaint, and the type of substance being used.

Medicines can be used to help manage withdrawal symptoms and reduce obsessive wantings associated with SUD. For example, drugs such as methadone and buprenorphine are frequently used to treat opioid dependence, while naltrexone is used to reduce alcohol dependencies.

Behavioural Therapy is also an important element of SUD treatment. These therapies aim to help individuals change their actions and mindset toward substance use, as well as develop healthy coping stratergies to manage stress and other triggers that may lead to medicine/drug or alcohol use. Types of behavioural therapy used to treat SUD include cognitive- behavioural therapy( CBT), motivational interviewing( MI), and contingency management.

Support groups, such  as a 12-step program can also be helpful in managing SUD. These groups provide a supportive community helpful for individuals in recovery, people with lived experience come to motivate the group.


How is substance use disorder diagnosed

Substance use disorder (SUD) is typically diagnosed through a combination of clinical assessment, physical examinations, and psychological evaluations. The diagnosis is based on the presence of certain criteria, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is a manual used by healthcare professionals to diagnose mental health disorders. To diagnose SUD, a healthcare professional may perform a comprehensive assessment of the patient, including their medical history, family history, and substance use patterns. 

Can substance use disorder be prevented

Substance use disorder (SUD) can be prevented or reduced through various approaches, including education, community initiatives, and individual efforts. While not all substance use can be prevented, several strategies can be used to reduce the likelihood of developing SUD.

Here are some ways SUD can be prevented:

  1. Education about the risks associated with substance use is an important way to prevent SUD. This can include information on the effects of specific substances, how they impact the human body and the risks associated with their use
  2. Community-based programs, such as youth centres etc. can provide opportunities for individuals to engage in healthy activities and develop positive relationships with others
  3. Family and social support systems can play an important role in preventing SUD. Strong support systems can provide individuals with the emotional support needed to overcome challenges and avoid turning to substances
  4. Mental health issues, such as depression and anxiety, can increase the likelihood of developing SUD. Therefore, seeking treatment for mental health issues can be an important way to prevent SUD
  5. Responsible prescribing: Healthcare professionals can prevent SUD by being responsible when prescribing medications, such as opioids. This includes prescribing the lowest effective dose for the shortest possible time and monitoring patients for signs of misuse or abuse
  6. Limiting access: Limiting access to substances, such as alcohol and tobacco, can also prevent SUD. This can be achieved through policies, such as increasing taxes on alcohol and tobacco products and restricting access to these products to minors

What are the risks factors for substance use disorder

Substance use disorder (SUD) can affect anyone, regardless of their age, gender, ethnicity, or socioeconomic status. However, several risk factors may increase the likelihood of developing SUD. Some of these risk factors include:

  1. Genetics: Genetics can play a role in the development of SUD. Individuals with a family history of SUD may be more likely to develop the disorder themselves
  2. Mental health: Mental health disorders, such as depression, anxiety, and post-traumatic stress disorder (PTSD), can increase the risk of developing SUD
  3. Trauma: Traumatic events, such as physical or sexual abuse, can increase the likelihood of developing SUD. Trauma can lead individuals to turn to substances as a way of coping with emotional pain
  4. Environmental factors: Environmental factors, such as exposure to drugs or alcohol at a young age, peer pressure, and availability of substances, can increase the risk of developing SUD
  5. Age of first use: The earlier an individual starts using substances, the greater the risk of developing SUD
  6. Chronic pain: Chronic pain can increase the likelihood of developing SUD, as individuals may turn to prescription painkillers as a way of managing their pain
  7. Lack of social support: A lack of social support and a lack of positive relationships with family, friends, or peers can increase the risk of developing SUD

It's important to note that having one or more of these risk factors does not necessarily mean that an individual will develop SUD. However, individuals with one or more risk factors should be aware of their increased risk and take steps to reduce their likelihood of developing SUD. This can include seeking help for mental health issues, avoiding substance use, and developing positive social relationships

How common is substance use disorder

It is common world-wide

When should I see a doctor

It is important to note that SUD is a chronic condition, and recovery often involves ongoing management and support. In some cases, individuals may require long-term or even lifelong treatment to manage their addiction and prevent relapse.

It's important to note that preventing SUD requires a comprehensive approach that includes multiple strategies. If you or someone you know is struggling with substance use, it's important to seek help from a healthcare professional or a substance use disorder treatment program


Substance use disorder (SUD) is a condition in which an individual develops a pattern of harmful use of a substance, such as alcohol, drugs, or prescription medications. SUD can range from mild to severe and can have serious consequences for an individual's health, relationships, and overall functioning. The disorder is typically characterized by a strong desire or compulsion to use the substance, difficulty controlling use, continued use despite negative consequences, and withdrawal symptoms when use is stopped. SUD is a common condition worldwide, affecting millions of people, and can be caused by a variety of genetic, environmental, and psychological factors. Effective prevention and treatment strategies are available to help individuals manage and overcome SUD.


  1. World Drug Report 2019: 35 million people worldwide suffer from drug use disorders while only 1 in 7 people receive treatment [Internet]. United Nations : Office on Drugs and Crime. [cited 2023 Feb 26]. Available from: http://www.unodc.org/unodc/en/frontpage/2019/June/world-drug-report-2019_-35-million-people-worldwide-suffer-from-drug-use-disorders-while-only-1-in-7-people-receive-treatment.html
  2. Volkow ND, Koob GF, McLellan AT. Neurobiologic advances from the brain disease model of addiction. Longo DL, editor. N Engl J Med [Internet]. 2016 Jan 28 [cited 2023 Feb 26];374(4):363–71. Available from: http://www.nejm.org/doi/10.1056/NEJMra1511480
  3. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55). Retrieved from https://www.samhsa.gov/data/sites/default/files/reports/rpt29393/2019NSDUHFFRPDFWHTML/2019NSDUHFFR1PDFW090120.pdf
  4. Genes and addiction [Internet]. [cited 2023 Feb 26]. Available from: https://learn.genetics.utah.edu/content/addiction/genes#:~:text=Like%20most%20other%20diseases%2C%20substance,have%20different%20underlying%20genetic%20causes.
  5. Environmental risk factors & their role in drug addiction [Internet]. Turning Point of Tampa. [cited 2023 Feb 26]. Available from: https://www.tpoftampa.com/environmental-factors-and-their-role-in-addiction/
  6. Drug addiction (Substance use disorder) - Symptoms and causes [Internet]. Mayo Clinic. [cited 2023 Feb 26]. Available from: https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Jolanda Roberts

Masters of Science- MSc Psychological Therapies in Mental Health, Queen Mary University of London
Bachelor of Science- BSc Psychology with Neuroscience

Jolanda is currently an Assistant Psychologist within the Berkshire Healthcare NHS Foundation Trust. She has built a plethora of skills within research, hospitals and community settings. She is dedicated to spreading Mental Health Awareness among people from all backgrounds and is knowledgeable in applying theoretical concepts to real-life scenarios. In the future, Jolanda aspires to qualify as a Clinical Psychologist and provide the best holistic care to meet individual needs in a compassion-driven way.

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