Substance Use Disorder

What Is Substance Use Disorder (SUD)?

Substance Use Disorder (SUD), commonly referred to as addiction, is a chronic yet treatable mental health condition that affects the brain’s reward system and decision-making abilities. It causes individuals to repeatedly misuse substances despite serious negative effects on health, relationships, and responsibilities. In 2022, nearly 50 million people aged 12 and older were reported to be living with SUD. Its impact often reaches every aspect of daily life, from emotional well-being to job performance and social stability.

According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), there are ten primary categories of substances that can lead to addiction:

• Caffeine
• Marijuana and cannabis-related products
• Hallucinogens (e.g., PCP, DXM, MDMA)
• Inhalants (e.g., spray cans, solvents, nitrates)
• Opioids such as heroin, fentanyl, and prescription painkillers
• Tranquilizers and sedatives (e.g., benzodiazepines, barbiturates)
• Stimulants (e.g., cocaine, methamphetamine, certain ADHD medications)
• Tobacco products (cigarettes, cigars, chewing tobacco)
• Emerging or synthetic drugs (e.g., kratom, lab-engineered cannabinoids)

Polysubstance use—misusing more than one substance—is common and may result in overlapping SUD diagnoses.

What Causes Substance Use Disorder?

Substance use disorders often develop from a mix of emotional, physical, and psychological factors. Common contributors include:

• Using drugs or alcohol to escape trauma, anxiety, depression, or chronic physical pain
• Social or peer pressure, particularly during adolescence
• Unintentional dependence from overusing prescribed medication
• Perceived enhancement in performance, energy, or appearance through unsupervised substance use

Signs of Substance Use Disorder

In Yourself:

• Persistent cravings for the substance
• Spending significant time and energy acquiring or using it
• Needing higher doses to get the same effect
• Struggling to cut back or quit
• Using daily or multiple times a day
• Withdrawal symptoms when not using

In a Loved One:

• Noticeable mood changes or irritability
• Pulling away from family or friends
• Money issues or borrowing without explanation
• Visible physical changes, like shaking, weight loss, or bloodshot eyes
• Neglecting important responsibilities or obligations

How Substance Use Disorder Is Diagnosed

At Sapphire Psychiatric Medical Group, licensed clinicians conduct a full assessment that includes:

• A review of the individual’s substance history, overall health, and mental health profile
• Diagnostic screening based on DSM-5 criteria, looking at:
  • Excessive use and inability to stop
  • Social issues like missed duties or strained relationships
  • Continued use despite known harm
  • Physical dependency through tolerance and withdrawal
• Lab testing to confirm substance presence
• Evaluation for co-occurring psychiatric disorders

Why Some People Are More at Risk

There’s no single reason why SUD develops, but several risk factors may increase vulnerability:

• Underlying mental health conditions like PTSD, anxiety, or depression
• Family history or genetic predisposition
• Exposure to stressful or unsafe environments
• Chronic pain or other long-term physical issues
• Pressure from peers or social circles

However, having one or more risk factors does not guarantee the development of SUD—and some affected individuals may show no obvious warning signs.

Substance Use and Co-Occurring Mental Health Conditions

Many people with SUD also battle other mental health concerns. Addressing both conditions simultaneously—called dual diagnosis—is essential for lasting recovery. Common co-occurring disorders include:

• Anxiety and PTSD
• Bipolar disorder
• Schizophrenia
• Borderline or antisocial personality disorders
• Attention-deficit/hyperactivity disorder (ADHD)

Living with SUD: Steps Toward Recovery

If you or someone close to you is struggling with substance use, know that you’re not alone. At Sapphire Psychiatric Medical Group, our experienced mental health team delivers supportive and personalized treatment. Having open conversations and building a support system are powerful first steps in regaining control.

Recovery often involves re-establishing healthy daily habits. Many individuals thrive by pursuing hobbies, engaging in creative outlets, joining recovery groups, and building positive social connections. Exercise and wellness practices also support physical and emotional healing.

When to Seek Immediate Help

• Signs of overdose, such as unconsciousness, chest pain, or difficulty breathing
• Suicidal thoughts or behavior—call 911 or the 988 Suicide & Crisis Lifeline
• Severe confusion, hallucinations, or agitation
• Seizures or extreme physical symptoms after drug use
• Behavior that poses harm to oneself or others