Substance Use Disorder (SUD) is an uncontrollable urge to use substances despite knowing it will cause negative consequences. This disorder is challenging and demanding, and successfully overcoming it is incredibly difficult. Diagnosing SUD is a critical step in receiving treatment and learning how to manage addiction. Find out how medical professionals diagnose SUD, including the criteria used, the process involved, and more.
Understanding Substance Use Disorder
SUD encompasses a range of conditions associated with the use of different substances, including alcohol, prescription medications, and illegal drugs. SUD can vary from mild to severe, depending on the number of criteria met. A diagnosis of SUD is not based on a single symptom or behavior but rather a pattern of physical symptoms and behaviors that indicate a problematic relationship with a substance.
Diagnostic Criteria for SUD
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association. identifies the criteria of SUD. The DSM-5 lists 11 criteria to determine whether an individual has SUD:
- Substances are used in larger amounts or for a longer duration.
- A constant desire to quit or unsuccessful efforts to cut down.
- A considerable amount of time is spent obtaining and using a substance or recovering from the effects of the substance.
- An individual has a strong desire or urge to use the substance.
- Substance use results in a failure to meet obligations at work, school, or home.
- Continued use despite social or interpersonal problems.
- Social, work, or recreational activities are abandoned or reduced because of substance use.
- The substance is used in dangerous situations, such as driving or operating machinery while intoxicated.
- The individual continues to use the substance even though they know it is causing or worsening physical or psychological problems.
- Significantly higher quantities of the substance are needed to achieve intoxication, or using the same amount doesn’t provide the same high.
- The individual experiences withdrawal symptoms characteristic of the substance when they reduce or stop using it, or they use the substance to relieve or avoid withdrawal symptoms.
Healthcare professionals evaluate these criteria over 12 months to diagnose substance use disorder. The number of criteria present determines the severity of the disorder:
- Mild SUD: Presence of 2-3 symptoms.
- Moderate SUD: Presence of 4-5 symptoms.
- Severe SUD: Presence of 6 or more symptoms.
The Diagnostic Process
Diagnosing SUD involves several steps, typically performed by a medical professional trained to identify substance use disorder:
Comprehensive Assessment
The first step is a thorough assessment. Healthcare providers need to know more about the substances used, including frequency and quantity. They will also ask about any attempts to quit or reduce use. All of this information is useful to diagnose the condition and fully understand the situation.
Physical Examination
A physical exam assesses health and identifies any medical conditions resulting from substance use. This step is crucial because prolonged substance use can cause other health conditions, including liver disease, cardiovascular issues, or neurological damage.
Screening Tools and Questionnaires
Clinicians often use standardized screening tools and questionnaires to help identify SUD. Some commonly used tools include the Alcohol Use Disorders Identification Test (AUDIT), Drug Abuse Screening Test (DAST), and CAGE-AID Questionnaire. These tools provide a structured way to evaluate the impact on the individual’s life.
Laboratory Tests
Laboratory tests cannot diagnose SUD, but they can provide additional information about the extent of substance use through its impact on the body. Additional testing can detect the presence of substances or assess organ function.
Evaluation of Co-occurring Disorders
Many individuals with SUD also suffer from co-occurring mental health conditions. Depression, anxiety, and bipolar disorder often accompany SUD. A comprehensive evaluation will include assessing these conditions, as they can influence the course of treatment and prognosis.
Role of Healthcare Professionals
Healthcare professionals can identify the signs of SUD, conduct assessments, and create individualized treatment plans. The diagnostic process requires a compassionate and non-judgmental approach, as individuals with SUD often experience stigma.
Diagnosing SUD
Diagnosing SUD is a multi-faceted process. Healthcare professionals utilize a combination of interviews, screenings, and tests to reach an accurate diagnosis. Diagnosis and intervention are challenging but also crucial to treatment and long-term recovery. We are here to help if you or a loved one struggles with SUD.
