Substance Use Disorder

Substance use disorder (SUD) is a chronic, treatable medical condition that affects the brain's reward, motivation, and decision-making systems. Modern care views SUD as a health issue, not a moral failing.

Table of Contents

Quick Facts

  • Type: Chronic medical condition
  • ICD-10: F10–F19
  • Treatment: Highly effective
  • Recovery possible: At every stage

Overview

SUD develops when repeated use of a substance changes brain circuits involved in pleasure, motivation, and self-control. It is diagnosed based on patterns of use, control over use, social and work consequences, tolerance, and withdrawal.

Common substances include alcohol, opioids, stimulants (cocaine, methamphetamine), cannabis, sedatives, and nicotine.

Signs and Symptoms

  • Using more or for longer than intended
  • Repeated unsuccessful attempts to cut down
  • A lot of time spent obtaining, using, or recovering
  • Craving
  • Use that interferes with work, school, or relationships
  • Continuing use despite knowing harms
  • Giving up other activities
  • Using in physically dangerous situations
  • Tolerance (needing more for the same effect)
  • Withdrawal symptoms when use stops

Treatment

Medications

  • Alcohol use disorder — naltrexone, acamprosate, disulfiram
  • Opioid use disorder — buprenorphine, methadone, naltrexone (highly effective)
  • Tobacco use disorder — nicotine replacement, varenicline, bupropion

Behavioral therapies

  • Cognitive behavioral therapy
  • Motivational interviewing
  • Contingency management
  • Mutual support groups (AA, NA, SMART Recovery)

Comprehensive care

Treatment of co-occurring mental health conditions, social support, vocational help, and harm reduction (e.g., naloxone for opioid overdose reversal) are critical.

Withdrawal Warning

Alcohol and benzodiazepine withdrawal can be life-threatening. Anyone with daily heavy use should consult a clinician before stopping. Opioid withdrawal is rarely life-threatening but is severe and best managed with medication.

Getting Help

Effective treatment exists. Contact a primary care provider, an addiction specialist, or call/text the SAMHSA National Helpline at 1-800-662-HELP (4357) in the US for free, confidential, 24/7 referral.

Related Conditions

Alcohol Use Disorder

Alcohol-specific SUD

 Anxiety

Often co-occurs with SUD

 Depression

Often co-occurs

 Opioid Overdose

Reverse with naloxone

Frequently Asked Questions

Is addiction a disease or a choice?

Modern medicine views addiction as a chronic medical condition with biological, psychological, and social components. Like other chronic diseases, it responds to treatment.

Do you have to hit 'rock bottom' to recover?

No. Earlier engagement in treatment is associated with better outcomes. Waiting for a crisis can be deadly.

Can someone use medication and still be in recovery?

Yes. FDA-approved medications for opioid and alcohol use disorders are evidence-based treatments. People taking them are in active recovery, not 'still using.'

Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.

References

  • American Society of Addiction Medicine. Definition of Addiction.
  • National Institute on Drug Abuse. Principles of Drug Addiction Treatment.