What is Substance Use Disorder?
The term addiction is no longer commonly used in the diagnosis or treatment of individuals who have severe issues with substance abuse. The term is considered to be limited in its ability to describe the actual behaviors and emotional issues associated with severe substance abuse. Instead, the proper clinical designation for both substance abuse and what people consider to be an addiction is now asubstance use disorder. This term is better suited to describe the continuum of behaviors that occur in individuals who abuse substances and to rate their use or abuse in terms of its severity. Laymen, however, may use these two terms – substance use disorder and addiction – interchangeably.
There are multiple signs to suggest that an individual may have a substance use disorder. The signs can be partitioned in terms of their behavioral, cognitive, and emotional manifestations. This article will list some of the most common signs that suggest that an individual may have a substance use disorder according to these domains.
The information in this article comes from the American Psychiatric Association, the American Psychological Association, the American Society of Addiction Medicine, the Substance Abuse and Healthcare Services Administration, and the National Institute of Drug Abuse.
Behavioral Signs of a Substance Use Disorder
Behavioral signs of a substance use disorder include what the person actually does. These are the types of signs and symptoms that are typically listed in diagnostic manuals. Some of the behavioral signs that an individual has an addiction follow.
- The person has repeated strong desires or cravings to use the substance.
- The person spends significant amounts of time trying to obtain the substance.
- The person has difficulty controlling their use of the substance. Most often, they use more than they had originally intended to or use for longer periods of time than originally intended. In addition, the person may have expressed a desire to cut down on their use or to quit using the substance altogether; however, they are unable to do so except for very short intervals.
- Individuals with substance use disorders often experience negative life events or negative ramifications associated with their substance use. These can often be quite severe and disrupting. However, despite the negative effects associated with their substance use, these individuals continue to engage in it. Negative ramifications from substance use can manifest in a number of different areas in the individual’s life, including their occupation, career goals, education, family responsibilities and relationships, other important personal relationships, financial situation, legal status, living situation, etc.
- Individuals suffering from addiction often use their substance of choice to cope with everyday life stressors. This practice escalates until they are using that substance very frequently to cope with what others might consider to be insignificant stressors.
- As a result of their substance use, individuals with substance use disorders will often neglect to attend to important responsibilities, including personal hygiene, health, work, family obligations, normal maintenance issues, etc.
- The person may withdraw from social contacts or give up activities that were once important to them as a result of their substance use.
- The person secretively uses the substance and tries to hide their use.
- The person becomes very defensive and may even get aggressive when someone tries to discuss their use of that substance with them.
- The person repeatedly uses the substance in situations where it is inappropriate or dangerous, such as at work or while operating a motor vehicle or other machinery.
- The person needs to use increasing amounts of the substance in order to achieve effects that were once achieved at lower amounts (tolerance).
- The person demonstrates withdrawal symptoms when they are not able to use the substance for an extended time period.
Individuals with substance use disorders will typically display two or more of these signs for extended periods of time.
Cognitive Signs of Addiction
Cognitive signs that an individual has a substance use disorder refer to how the person thinks about their actions and situation. These cognitions are often only uncovered when the individual is assessed by a trained mental health professional. Many of these cognitive signs represent cognitive biases that help to drive some of the dysfunctional behaviors listed above. Some of the major cognitive signs that an individual may have a substance use disorder follow.
- Despite fairly obvious evidence that the individual is not exhibiting control over their substance use (as explained above), the person still believes that they are in full control. Individuals often believe that they can stop using their substance of choice at any time despite numerous failed attempts to do so and obvious instances of using the substance in situations where it is totally inappropriate.
- The individual suffering from the addiction will often think that the use of the substance, even though it does result in some negative effects, is a positive behavior that helps them cope with stress and something they “need” for emotional stability.
- Individuals with substance use disorders often believe that their situation is qualitatively different than the situations of other individuals who may have substance use disorders. They often believe that their substance use is “special” or somehow represents a special exception to qualifying as abusive.
- Often, individuals suffering from addiction adopt an approach to the world that is centered on one of two extremes, sometimes referred to as “all or nothing thinking.” For example, individuals with substance use disorders may believe that their substance use always results in benefits for them, such as relieving stress or helping them function, despite evidence to the contrary. All or nothing thinking is often identified by the use of terms such as always or never when applied to situations that are not absolute.
- Individuals with substance use disorders often make generalizations about their behavior and the behavior of others based on very little evidence or even by selectively abstracted bits of evidence. This tendency to overgeneralize about their own situation and the situation of others leads to a number of invalid conclusions.
- Addicted individuals are often quick to attach labels to the behavior of others and blame or personalize the behavior of others for their own situation. This is another instance of overgeneralizing and selectively abstracting information to conform with one’s expectations (often termed a “confirmation bias”). These individuals may magnify perceived benefits of their substance abuse and minimize the detrimental effects.
- Individuals suffering from addiction may have the perception that they should be in control of everything that happens to them. This often results in these individuals setting unrealistic expectations of themselves that results in the development of an unrealistic personal image.
Emotional Signs of a Drug Addiction
The majority of sources discussing the emotional signs of substance use disorders indicate that there is a level of emotional immaturity associated with individuals who develop substance use disorders such that they struggle to understand their own feelings and how their feelings affect their behavior. These individuals often attempt to magnify positive emotional experiences and minimize potentially negative emotional experiences via their use of substances as opposed to directly assessing, confronting, and changing them. These signs often come out during treatment.
- Those with addiction often have a state of learned helplessness, which consists of the feeling that the individual is powerless to directly deal with feelings that they find overwhelming or negative. They turn to other means, such as drugs and alcohol, to deal with such feelings.
- Individuals with substance use disorders often overreact to even typical daily stressors, such as making mistakes (everyone makes mistakes), issues or events that occur that are not under their control, and other normal feelings.
- Many individuals suffering from addictions adhere to a more pessimistic outlook regarding the world, other people, and even themselves.
- Individuals with substance use disorders often exhibit little emotional control over their feelings even though they hold the belief that they should be in control of themselves (see above). Because of their unrealistic expectations of themselves in the world, they are frequently disappointed.
- Addicted individuals often find it impossible to deal with reality as it occurs but instead worry about the past or the future as opposed to simply doing what has to be done in the moment.
- Individuals with substance use disorders often have difficulty developing deep personal relationships with other people and take solace in the impersonal type of relationship they have with their substance of choice or other inanimate objects. They may have very shallow personal relationships with others, including individuals that should be close to them, such as immediate family members, spouses, etc.
- Despite the perception that they should be in control, these individuals may often feel overwhelmed.
- Some individuals with substance use disorders may have significant emotional problems that qualify as separate psychiatric disorders, such as issues with anxiety, depression, trauma-related issues, personality disorders, etc. These conditions need to be fully assessed and treated in conjunction with the substance abuse.
Individuals suffering from addiction will not necessarily display all of these signs and symptoms, but many individuals will display several of the above signs and symptoms from each domain. Like any mental illness, the designation of what constitutes a substance use disorder is achieved by understanding both the quantity and quality of the aspects associated with the individual’s feelings, thoughts, and behavior.
Nearly everyone will express a number of the above signs and symptoms to some degree; however, those that develop psychological disorders express them in a manner that is often global (occurs under many different conditions), rigid (very resistant to change), and enduring (continues over time). Because this is a complicated situation, only professional licensed mental healthcare workers are able to definitively diagnose the presence and severity of a substance use disorder in an individual.