What is a Substance Use Disorder (SUD)?

What is a Substance Use Disorder (SUD)?

A Substance Use Disorder (SUD) is a medical condition that is defined by the inability to control the use of a particular substance (or substances), despite harmful consequences.1 

In other words, SUDs occur when an individual compulsively misuses drugs or alcohol and continues using the substance despite knowing the negative impact it has on their life.2,3 

SUDs can range from mild to severe, and severity is determined by how many Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria are met: mild (2–3 symptoms), moderate (4–5), and severe (6 or more).²

Diagnostic Criteria for SUD

The American Psychiatric Association (APA) has developed 11 criteria for SUD diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).2

The DSM-5 Criteria for Substance Use Disorders includes:2

• Taking the substance for long periods of time or in larger amounts than intended.
• Being unable to cut down or stop substance use.
• Spending a lot of time obtaining, using, and recovering from the effects of the substance.
• Experiencing cravings, or intense desires or urges for the substance.
• Failing to fulfill obligations at home, work, or school due to substance use.
• Continuing substance use despite having interpersonal or social problems that are caused or worsened by substance use.
• Giving up social, recreational, or occupational activities due to substance use.
• Using the substance in risky or dangerous situations.
• Continuing substance use despite having a physical or mental problem likely caused by substance use.
• Tolerance, or needing more of the substance to achieve previous effects.
• Withdrawal, meaning that unpleasant symptoms occur when you stop using your substance of choice.

Substance Use Disorder Statistics

The National Survey on Drug Use and Health (NSDUH) provides statistics on substance use and substance use disorders across the US. The most recent NSDUH (2019) results show the prevalence of SUDs in general and specific types of the following: SUDs in the US in people aged 12 and older over the previous year.

• 4 million people had an SUD.⁴ 
• 5 million had an alcohol use disorder.⁴
• 6 million had a marijuana use disorder.⁴
• 1 million had a cocaine use disorder.⁴
• 438,000 had a heroin use disorder.⁴
• 1 million had a methamphetamine use disorder.⁴
• 558,000 had a prescription stimulant use disorder.⁴
• 681,000 had a prescription tranquilizer or sedative use disorder.⁴
• 4 million had a prescription pain reliever disorder.⁴
• 6 million had an opioid use disorder.⁴

The NSDUH also collects data about receipt of and need for substance use treatment.⁴

• 1 million people aged 12 and older with a SUD received treatment in the past year.
• 9 million aged 12 or older had a past year SUD but did not receive treatment at a specialty facility.
• 1 million of these people felt they didn’t need treatment.
• 236,000 felt they needed treatment and made an effort to get it.
• 577,00 felt they needed treatment but didn’t make an effort to get it.

Symptoms of Substance Use Disorders

The visible signs or symptoms of a SUD can vary by specific substance, but can include physical, behavioral, and social changes such as:9

• Skipping school or missing work.
• Having frequent fights, accidents, or legal trouble.
• Secretive or suspicious behavior.
• Appetite or sleep changes.
• Personality or attitude changes.
• Mood swings or irritability.
• Unusual hyperactivity or energy.
• Lack of motivation.
• Bloodshot eyes or small pupils.
• Sudden weight changes.
• Poor physical appearance.
• Smelly breath or clothing.
• Tremors, slurred speech, or impaired coordination.
• Changes in social circle.
• Repeatedly asking for money.

Substance Use Disorder vs. Substance Use

The terms substance use disorder and substance use are often used interchangeably; however, they hold very different meanings.

SUD, also known as addiction, is a diagnosable medical condition that requires a person to meet at least 2 of the 11 DSM criteria.2 For example, someone with an alcohol use disorder may drink more than they intended; experience strong cravings; struggle to cut down despite wanting to;  or continue drinking even when it causes health or relationship problems.

On the other hand, substance use, or substance misuse, are terms that are used when a person uses a substance inappropriately or in ways that cause harm to themselves and the people around them.5 Unlike SUDs, substance use isn’t a diagnosable disorder. However, chronic substance use can potentially lead to the development of an SUD.5

Types of Substance Use Disorders

The DSM provides diagnostic criteria for 10 classes of SUD, which (excluding caffeine and tobacco) include:2

• Alcohol use disorder, commonly called alcoholism.
• Cannabis use disorder, also known as marijuana use disorder.
• Opioid use disorder.
• Sedative, Hypnotic, or Anxiolytic use disorder ( includes substances like benzodiazepines, benzodiazepine-like drugs such as zolpidem (Ambien), carbamates, and barbiturates)
• Stimulant use disorder, (includes substances like cocaine or methamphetamine).
• Phencyclidine (PCP) use disorder.
• Hallucinogen-use related disorders.
• Inhalant use disorder.

Take Our Substance Use Self Assessment

Risk Factors for Substance Use Disorders

Your vulnerability to substance misuse involves a complex interplay of different factors. Risk factors include:5

• Genetics, such as a family history of substance use.
• Starting substance use at an early age.
• Easy access to drugs or alcohol, especially at a young age.
• Exposure to heavy advertising of substances (like alcohol).
• A current mental health diagnosis.
• Low parental monitoring.
• A high amount of family conflict.
• A history of abuse or neglect.
• Family conflict or violence.

How Are SUDs Diagnosed?

SUDs can only be diagnosed by medical professionals.10 

They will conduct a formal assessment that takes into account a person’s symptoms and needs (such as medical, social, or psychiatric concerns), to determine whether you have a SUD based on DSM-5 criteria.10

Getting Treatment for SUD with AAC

Unfortunately, many people with SUDs don’t seek help. But even someone with a mild SUD can significantly benefit from a medically supervised, evidence-based treatment plan.10 

If substance use is affecting your life and you think you may have a SUD, then it’s time to seek help. You can call a drug addiction helpline to find treatment facilities near you, or use the Substance Abuse and Mental Health Services Administration’s FindTreatment.gov website.

Treatment types can include:10,11

• Drug detox: This is often the first step in recovery. Medically-supervised detox helps you safely and comfortably withdraw from the substance so you can become stable and enter treatment. During detox, you may receive medications (depending on the substance used) to help minimize withdrawal symptoms and prevent relapse.
• Inpatient rehabilitation: You live at a treatment facility and receive round-the-clock care and monitoring, as well as different forms of therapy and medication if appropriate. Inpatient rehab can take place in different settings, such as hospitals or residential facilities.
• Outpatient rehab: You live at home but travel to a facility for treatment. Intensive forms of outpatient rehab include partial hospitalization or intensive outpatient programs, which require treatment for several hours per day, most days a week, or less intense settings where you may only attend treatment once a week.
• Co-occurring mental health disorder: Co-occurring mental health and substance use disorder treatment means addressing both the mental health condition and the SUD at the same time through a single, coordinated plan. Because each condition can influence the other, integrated care can improve overall outcomes and support lasting recovery.

Behavioral Health Treatment for SUDs

Behavioral therapies are often used to address SUDs. This includes:12

• Cognitive-behavioral therapy (CBT) to help change thoughts and behavioral patterns that contribute to substance use.
• Motivational interviewing to help increase your motivation to stop substance use and make positive changes.
• Contingency management to help you remain abstinent using positive reinforcement.

The Cost of Substance Use Treatment

The cost of rehab for substance use disorders can vary by the treatment center, the level of care needed, and whether your insurance will cover the cost of rehab.

Find out if your insurance provider covers rehab and verify your insurance by filling out the confidential online form below.

Are You Covered For Treatment?

American Addiction Centers is in-network with many private insurance companies. We’ll help you verify your insurance coverage for treatment quickly and easily.

Substance Use Disorder Treatment at American Addiction Centers (AAC)

American Addiction Centers (AAC) is a nationwide network of accredited inpatient and outpatient rehab centers. Our teams of physicians, nurses, therapists, counselors, and admissions navigators understand that reaching out can feel overwhelming. If you’re scared or unsure where to start, you won’t have to do this alone. We’ll meet you where you are and help you map a path forward.

Same-Day Admissions & 24/7 Support

Same-day admission may be available (based on clinical need and bed availability). Call any time to speak confidentially with an admissions navigator, ask questions, and check your insurance.

Our Approach: Whole-Person, Integrated Care

Addiction touches health, relationships, and daily life, so treatment should address each of those areas. We personalize your plan to your goals, medical and mental health history, family needs, and support system to help you build stability that lasts.

Co-occurring Mental Health and Addiction  treatment (Dual Diagnosis)

We provide integrated care for co-occurring conditions—treating mental health and substance use together in one coordinated plan. Addressing both can reduce relapse risk and support long-term recovery.

Your Care Pathway: Levels of Care

• Medical Detox: 24/7 monitoring and withdrawal management to begin safely and more comfortably.
• Residential Rehab: A structured, supportive setting with individual therapy, groups, skills practice, wellness activities, and discharge planning.
• Partial Hospitalization Program (PHP): Day treatment (typically 5 days/week) while living at home or in sober housing.
• Intensive Outpatient Program (IOP): Flexible therapy (often 3+ days/week) that fits around work, school, and family.

We’ll help you enter at the right level and step up or down as your needs change.

Evidence-Based Therapies & Psychiatric Services

You may receive CBT, DBT, Motivational Interviewing/MET, REBT, EMDR, Seeking Safety, Brainspotting, solution-focused and trauma-informed therapies. Psychiatric services include comprehensive evaluation and medication management when appropriate. (Offerings vary by facility.)

Specialized Tracks, Family Involvement & Aftercare

We offer specialized groups and tracks (e.g., Veterans programs , first responders, LGBTQI+ support, grief/trauma, coping skills, 12-Step and secular options).

Families are invited into education and counseling, and aftercare planning begins early to support life after treatment.

Wellness & Holistic Supports

Many AAC centers offer holistic rehab treatment, including nutrition guidance (often with registered dietitians), fitness and movement (e.g., yoga, gym), stress management, mindfulness, and creative/experiential activities to support whole-person healing. (Offerings vary by facility.)

What Happens When You Call

• Initial evaluation: An admissions navigator listens to what’s going on, reviews safety concerns, and gathers history.
• Insurance & logistics: We can verify benefits, discuss payment options, and plan travel or timing.
• Next steps: If clinically appropriate—and space allows—we coordinate same-day admission or schedule the soonest date and share exactly what to bring and expect.

Our 90-Day Brand Promise

If you successfully complete 90 consecutive days of AAC treatment and later experience a relapse, you may return for up to 30 days of additional treatment at no cost. 

Terms and conditions apply.. Ask our team for details.

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