There’s tons of misinformation out there about what having a “problem” means. One of my common session discussions deals with trying to educate people about what a drug or alcohol “problem” really looks like. When asked “how do you know someone has a problem?”, the common answers are “they use everyday” or “they use a lot”. Clients are surprised that there’s much more to it than that.
Substance use disorders (SUDs) affect millions of people worldwide. When assessing if someone has an issue or not with substances, all mental health professionals go by the criteria standardized in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). If you’ve ever been to a counselor, doctor, psychiatrist, social worker, etc. for mental health problems, the diagnosis you get comes from the bible of all mental health disorders: the DSM-5.
The DSM-5 outlines the following symptoms or characteristics of substance use disorders:
- Substance is often taken in larger amounts or over a longer period than was intended.
- 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.
- Craving, or a strong desire or urge to use the substance.
- Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home.
- Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance.
- Important social, occupational, or recreational activities are given up or reduced because of substance use.
- Recurrent substance use in situations in which it is physically hazardous.
- 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 the substance.
- Tolerance, as defined by either a need for markedly increased amounts of the 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 or the substance (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.
How bad of a drug or alcohol problem may be estimated by the number of symptoms met within a 12-month time frame: mild (2-3 criteria), moderate (4-5 criteria), and severe (6 or more criteria).
Seeking Help
If you or someone you know is struggling with a substance use disorder, it’s crucial to seek professional help. Treatment options can range from outpatient counseling to residential treatment programs, and the right approach depends on the individual’s needs and circumstances. The best place to start is with an evaluation.