How do professionals diagnose a substance use disorder?

A substance use disorder (SUD) is a mental health condition. There are many diseases that fall under the umbrella term SUD, including Nicotine Use Disorder, Stimulant Use Disorder, and Opioid Use Disorder. What these conditions share is an individual’s inability to control their use of the substance due to how the said substance affects their brain and how they act. The use of drugs or alcohol becomes harmful to their physical and mental health. Before seeking treatment for a SUD, though, how do professionals diagnose a substance use disorder?

Firstly, who are the ‘professionals’?

If you worry that a loved one might be struggling with SUD, it can be difficult to know how to help them. One of the first steps is understanding how professionals diagnose a SUD properly. This blog post provides insights.

Please note that an in-depth evaluation is crucial to an accurate diagnosis. While you may see signs suggesting a SUD, this is not a replacement for a medical conclusion. Psychologists, psychiatrists, licensed drug counselors, and licensed alcohol counselors are examples of professionals who can identify the disease.

To diagnose a SUD, a professional utilizes:

You’ve likely heard of the DSM, but what exactly is it? This text is an important part of the diagnosis, as is the observation and assessment beforehand.

1. Observation and assessment

The first step in diagnosing a substance use disorder is observation and assessment. This step involves gathering information about the person’s substance use history, including when they began using, any previous attempts at quitting, and any patterns that have developed in their use over time.

It is also important to assess the person’s family history, as SUD often runs in families. Additionally, if the person is experiencing any mental health issues or other co-occurring disorders, such as depression or anxiety, these should also be noted to include in the future treatment plan.

2. DSM-5 diagnostic criteria

Once enough information is gathered through observation and assessment, the next step is determining if the person meets the criteria for a diagnosis of a SUD, as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). To diagnose a substance use disorder, the professional focuses on 11 different criteria to assess the individual; these criteria are essentially symptoms that indicate the severity of the issue. The patterns of symptoms that arise from the substance use help the expert to diagnose the individual.

The criteria cover four categories: risky use, social issues, distortion in control, and physical dependence. In terms of severity, meeting two or three of the criteria indicates a mild SUD, four or five is moderate, and meeting six or more criteria is severe.

The criteria include things like the inability to control drug use despite efforts to do so; continued use, regardless of the social or relational problems caused by drug use; cravings for drugs; withdrawal symptoms when not using; tolerance; spending large amounts of time obtaining drugs or recovering from their effects; neglecting responsibilities due to drug use; continuing drug use despite physical or psychological harm; increased risk-taking behaviors due to drug use; and more.

Three common treatment options after SUD diagnosis

Several treatments are available for a SUD, depending on its type and severity. Generally speaking, these treatments can be divided into three main categories:

1. Inpatient rehabilitation

One of the most effective treatment options for a substance use disorder is inpatient rehabilitation. This treatment involves a short-term stay in a residential setting where individuals receive 24/7 care from trained professionals. Inpatient rehabilitation typically involves detoxification, individual counseling sessions, group therapy, and other activities designed to help individuals learn how to cope with their cravings and triggers once they leave the facility.

2. Outpatient treatment

Outpatient treatment is another option for those dealing with a substance use disorder. These outpatient programs are often less intensive than inpatient ones and allow individuals more freedom and flexibility as they manage their addiction. Outpatient programs typically involve weekly visits with counselors or therapists who provide structure and support while individuals continue living at home or in a sober living environment.

3. Medication-assisted therapy (MAT)

Medication-assisted therapy is another form of treatment effective in helping some individuals manage their addiction. MAT reduces cravings and withdrawal symptoms associated with certain drugs, such as alcohol, opioids, and stimulants. It involves taking medications, such as Buprenorphine, Methadone, Naltrexone, or Suboxone, on an ongoing basis under a healthcare provider’s supervision.

MAT has been shown to be particularly effective when combined with behavioral therapies, such as cognitive behavioral or contingency management therapy. Effective means that certain individuals are able to sustain recovery.

Takeaway on substance use disorder diagnosis and treatment

Making sure you or a loved one receives proper diagnosis and treatment for a substance use disorder is crucial to getting on a track towards recovery. Observing behavior patterns related to substance abuse and assessing family history and mental health conditions makes it possible for a professional to make an accurate diagnosis for a SUD under the DSM-5 criteria.

Once a formal diagnosis is made, treatment options, such as therapy sessions with a professional counselor or psychologist, medications management programs, detoxification programs, support groups (such as AA), and residential treatment centers are all ones to explore. Receiving personalized care tailored specifically toward individual needs is key to maintaining long-term recovery.