When you’re looking for help for yourself or a loved one, it can be difficult to navigate terminology and information when you’ve never been exposed to the recovery or treatment world. The purpose of this article is to break down some of those barriers. The term “substance use disorder”, or SUD, is a term related to drug addiction and substance use that you may hear and/or read often on this journey. We want to provide you with definitions for the terms you will hear and see, as well as give you some insight into recovery terminology.
What does the term SUD mean?
SUD is a commonly used acronym in the treatment field that stands for Substance Use Disorder. Prior to 2013, providers would use the 4th edition of the American Psychiatric Association Diagnostic and Statical Manual (DSM-IV) to diagnose an individual with either substance abuse or substance dependence, but not both. The manual gave a list of symptoms, such as tolerance, withdrawal, the presence of legal consequences, etc. Substance abuse was defined by the presence of 1 or 2 symptoms, whereas substance dependence was defined as 3 or more.
In 2013, a new edition of the manual was released. In the updated DSM-5, SUDs are not characterized by abuse vs. dependence. Without this distinction, an individual would receive a “use disorder” label with a reference to a specific drug class (i.e. “cannabis use disorder” or “cocaine use disorder”).
This new classification and symptom criteria for SUDs came on the heels of professionals recognizing that many different synergistic factors contribute to addiction tendencies involving alcohol and other drugs. This means that it is usually not just one thing (i.e. trauma, strained family relationships, negative peer groups) that causes addiction.
What this means for treatment of Substance Use Disorder
The new classification recognizes that not all substance use disorders are driven by a single cause, and not all of them can be labeled as “drug addiction”, “drug abuse”, etc. Use of drugs, alcohol, nicotine, whether legal or illegal, is a multi-factorial issue.
This is especially true of young people. Not everyone that that meets the criteria for a substance use disorder identifies as an addict or an alcoholic; however, we believe that the treatment for an individual should be consistent regardless of their personal admission of being and addict or alcoholic. This means assessing each person individually to determine the severity of their substance use disorder and to uncover underlying issues that may also be at play.
Signs and symptoms of Substance Use Disorder
The diagnosis of substance use disorder is done in an assessment with a drug and alcohol treatment professional. We take a look at the various signs, symptoms, and consequences of an individual’s consumption of drugs, alcohol, or other substances over the course of the last 12 months. Using information from the assessment, we determine things such as:
- Did the individual’s consumption increase over the 12 month period (tolerance)?
- Did the individual experience cravings for the drug or substance?
- Did the person desire to cut down or quit and find they were unable to?
- Did the individual miss out on school, work, or family obligations as a result of their substance use?
- Many more factors
What Substances Qualify for the Diagnosis of Substance Use Disorder?
Substance abuse disorder is a diagnosis that can be applied to any substances or drugs that are causing a problem or issue in the patient’s life. We are often asked if this applies to legal substances like nicotine, alcohol, or prescription drugs. The answer is YES. The legality of the substance is not a deciding factor in the diagnosis – the main factors are the ones described in the section above. Namely, we want to assess what the effects of the substance have been on the user’s life. Substances that could qualify someone for the diagnosis of substance disorder include:
- Commonly Abused Illegal Drugs such as heroin (or other opiates), methamphetamine, cocaine, or ecstasy.
- Prescription drugs – whether legally prescribed or not.
- Alcohol
- Nicotine
- Marijuana in all of its various forms
- Other drugs such as inhalants or over the counter drugs
Other important definitions for treatment of substance use disorder:
- MAT- Medicated Assisted Therapy: involves the use of medications (such as Buprenorphine) to assist in the detox and treatment of a patient.
- Co-occurring disorders: condition in which an individual has a co-existing mental illness and SUD.
- Intervention: A process by which family and friends confront an individual about their addiction in order to seek help for the individual. Interventions are usually facilitated by a trained personnel. Contacting a trained interventionist is the best place to start when seeking help for a loved one, as the interventionist will help with the process by providing assessments for appropriate levels of care along with referrals to treatment centers.
- Residential Treatment Center (RTC): Intensive treatment for individuals outside of their home in which individuals participate in a live-in health care facility under trained staff supervision. Not everyone is appropriate for RTC, so be sure to have yourself or a loved one participate in an assessment to determine the appropriate level of care.
- Intensive Outpatient (IOP): Usually 10-20 hours of group and individual therapy each week. IOP is a step down from residential treatment, and is usually recommended as follow-up care after successful completion of an RTC; however, completing a residential program is not always necessary prior to participating in an IOP program. Refer to a professional to determine which level of care is an appropriate starting point.
Visit https://www.psychologytoday.com/us/blog/the-high-functioning-alcoholic/201106/understanding-addiction-treatment-levels-care for more information regarding levels care for SUD treatment.