Addiction is an umbrella term that reflects qualities of substance use disorder, characterized by an inability to stop using a substance despite harmful consequences. However, addiction is not a diagnosis.
Substance use disorder can range from mild to severe, depending on the number of symptoms a person has.
Addiction is sometimes used as a synonym for substance use disorder, though it is not a specific diagnosis.
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) outlines criteria for substance use disorder.
If you (or a loved one) are living with substance use disorder or addiction, know that help is available. All forms of substance use disorder are treatable.
Keep reading to learn what distinguishes addiction from substance use disorder, how to get help, and what treatment usually involves.
The DSM-5-TR outlines criteria for having substance use disorder. There aren’t specific criteria for addiction.
Substance use disorder can range from mild to severe, depending on the number of criteria a person meets.
- Mild substance use disorder: Two or three criteria
- Moderate substance use disorder: Four or five criteria
- Severe substance use disorder: Six or more criteria signal addiction to that substance
The DSM-5-TR criteria for substance use disorder include:
- Substance is taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control substance use.
- A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
- Important social, occupational, or recreational activities are given up or reduced because of substance use.
- Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by substance use.
- Tolerance, as defined by either:
- a need for markedly increased amounts of substance to achieve intoxication or desired effect or
- a markedly diminished effect with continued use of the same amount of the substance
- Withdrawal, as manifested by either:
- the characteristic withdrawal syndrome for the substance (excludes Phencyclidine, Other Hallucinogens, and Inhalants)
- the substance (or a closely related substance) is taken to relieve or avoid withdrawal symptoms
- Note: This criterion is not considered met for those taking opioids, sedatives, hypnotics, or anxiolytics, or stimulant medications solely under appropriate medical supervision.
Can you have an addiction to more than one substance?
It’s also possible to have mild to severe substance use disorder while using more than one substance.
Though the DSM-5-TR does not classify this as a separate disorder, it may be known as polysubstance use disorder.
Help is available for substance use disorder, regardless of the severity.
One way to get help involves talking with your primary care doctor. They may talk with you about your symptoms and recommend different treatment options based on the severity of substance use disorder.
They may use a screening test or order blood or urine tests to better understand your usage pattern and health.
You can also access care through a treatment center for substance use disorder.
The Substance Abuse and Mental Health Services Administration (SAMHSA) offers free resources and referrals to treatment. If you have questions or need help, call the 24/7 helpline at 800-662-HELP (4357).
Doctors may recommend treating mild to moderate substance use disorder with outpatient treatment, which can involve medications to reduce substance use and supportive care to manage withdrawal symptoms. It may also include long-term treatment options like counseling.
Depending on the type of substance, severe substance use disorder may require inpatient care and monitoring during the detoxification stage to manage withdrawal symptoms. Abruptly stopping use of certain substances can cause severe withdrawal symptoms and be life threatening.
If you’re considering reducing or stopping use of a substance you’ve been using heavily or habitually, it’s best to talk with a healthcare professional about the type of care you may need.
Some of the options below may be covered by insurance, but it’s best to ask a representative to check your coverage before deciding on a specific program.
Treatment center options
There are many types of treatment centers available, including:
- Inpatient care: This involves care you receive while admitted to a hospital or clinic overnight. You may need this care for a few days or weeks. Then, you would switch to a residential or outpatient program.
- Residential care: Residential care programs usually last from a few weeks to a few months and provide individual and group counseling to support recovery. They can also provide medications for substance use disorder, support groups, and referrals to care that you can access after discharge.
- Outpatient care: You are not admitted to a facility for this type of care. It may include office or telehealth appointments that you attend while staying at home. You can also receive support with medications for managing substance use disorder and group or individual counseling.
- Intensive outpatient care: Intensive outpatient care is a form of outpatient care that provides additional support and generally involves additional appointments and therapy sessions, lasting hours per week.
- Opioid treatment programs: If you use opioids, you may need specialized care in a residential or outpatient facility that’s certified for this purpose. These programs can provide medications and behavioral therapy for opioid use disorder.
Depending on the type of substance use disorder you have, the first stage of treatment may be medically assisted detoxification. Healthcare professionals provide supportive care during this process as the substance clears your bloodstream.
Supportive care may include:
- medications
- fluids
- sedation
- monitoring
The detoxification process can vary by the substance and your usage pattern:
Withdrawal symptoms
Stopping substance use after habitual or heavy use can cause withdrawal symptoms. These symptoms may begin shortly after the substance wears off or within 24 hours of your last use. They vary by substance and can include:
- headache
- irritability
- hallucinations and delusions
- fast heartbeat
- nausea and digestive issues
- vomiting
- vivid dreams
- sweating
- depersonalization
Withdrawal symptoms range from uncomfortable to life threatening. That’s why it’s best to get medical attention during detoxification if a doctor recommends it.
For instance, withdrawal from alcohol or benzodiazepines can cause life threatening symptoms and require medical attention.
Detoxification is followed by other treatments to help you abstain from the substance long term. This can include:
- talk therapy, like cognitive behavioral therapy for addiction, that helps you reframe thinking patterns and behaviors that may contribute to substance use
- group counseling
- medications to ease your recovery and cope with withdrawal symptoms
- recovery coaches
- peer support
You may access these treatments in an inpatient, outpatient, or residential program.
Recovery is possible. No matter where you are on your recovery journey, treatment and support can help you recover from substance use disorder and addiction.
Resources are available to support your recovery from substance use disorder. Some helpful resources include:
- The Substance Abuse and Mental Health Services Administration (SAMHSA) offers free resources and referrals to treatment. If you have questions or need help, call the 24/7 helpline at 800-662-HELP (4357).
- Above the Influence provides information targeted at youth and young adults regarding substance use, peer pressure, and treatment options.
The National Institute on Drug Abuse provides information and research for teenagers and young adults about substance use disorders.- The National Association for Children of Alcoholics provides information and resources for children of parents with alcohol use disorder.
- Al-Anon provides confidential groups and meetings across the United States for adult friends and family members of people who misuse alcohol. Call 888-4AL-ANON (888-425-2666) for more meeting information.
- Alateen provides confidential groups and meetings across the United States to help teenagers and young adults cope with a friend or family member’s alcohol use. Try Alateen chat.
- Alcoholics Anonymous (AA) offers in-person and virtual meetings and support groups for people in recovery from alcohol addiction or misuse.
- Narcotics Anonymous (NA) offers in-person and virtual meetings and support groups for people in recovery from narcotic addiction or misuse.
If you aren’t ready to get treatment for substance use disorder, you can still take steps to reduce harm from substance use, like:
- keeping an overdose reversal medication like naloxone (Narcan) with you in case of emergencies for you or others
- using fentanyl test strips to detect fentanyl on substances you may use
- keeping the phone number of a trusted loved one with you in the case of an emergency
- going to therapy for any co-existing mental health conditions
- if you inject substances, taking steps to prevent infectious diseases, such as hepatitis C, by using sterile supplies or syringe services
Addiction is often used as a synonym for substance use disorder. It is often characterized by an inability to stop using a substance, despite an adverse effect on your daily life. However, addiction is not a medical diagnosis.
Substance use disorder exists on a spectrum from mild to severe, depending on the number of criteria from the DSM-5-TR you meet.
Recovery is possible with treatment, regardless of the severity of substance use disorder.
You can talk with a healthcare professional, such as a primary care doctor, or contact the Substance Abuse and Mental Health Services Administration (SAMHSA) 24/7 helpline at 800-662-HELP (4357).