Substance abuse is a maladaptive pattern of substance use. Maladaptive here refers to a behavior that stops an individual from adjusting to situations in a healthy way. Psychiatrists regard substance abuse as a mental health condition that can lead to many issues in an individual’s life and result in significant distress. 

Based on your habits, you may be wondering, am I addicted to drugs? Here we will explore the criteria for abuse and drug dependence to help you answer this question. It’s important to be aware of the signs of addictive behaviors so you can keep a problem from becoming out of control. 

What Is a Substance Use Disorder?female patient talks to a male counselor about the criteria for substance abuse

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is what most psychiatrists use to diagnose a range of mental health conditions. The latest edition of the text—the DSM-5—replaces the substance abuse and dependence categories from the previous edition with a single category: substance use disorder. 

The previous edition made a distinction between substance abuse and addiction based on the notion that the former was milder. In reality, substance abuse can involve severe symptoms. Experts also felt that the term “addiction” was too loaded and lacked precision. Instead, psychiatrists view substance use disorders as having specific symptoms that can be mild or severe in nature. 

The DSM-5 recognizes that substance use disorders can result from ten classes of drugs:

  • Alcohol
  • Caffeine
  • Cannabis
  • Hallucinogens
  • Inhalants
  • Opioids
  • Sedatives
  • Stimulants
  • Tobacco
  • Other or unknown substances

If you abuse an individual substance, mental health professionals regard this as a unique disorder (excluding caffeine). The DSM-5 has different diagnostic criteria on alcohol use disorders, opioid use disorders and so on. Having said that, psychiatrists will diagnose most of these specific disorders based on the same overarching criteria of substance use disorder. 

The Diagnostic Criteria for Addiction

The DSM-5 contains specific diagnostic criteria for substance use disorder. The DSM-5 states that if you meet two or more of the following criteria in a 12-month period, you have a substance use disorder:

  • Taking higher doses of a substance or over longer periods than you intended
  • Trying to cut back or quit using a substance but failing to do so
  • Spending considerable energy obtaining, using or recovering from substance use
  • Experiencing cravings for the substance
  • Failing to fulfill responsibilities at work, school or in the home as a result of substance use
  • Failing to quit even though it’s causing issues in your relationships
  • Giving up social, leisure or work-related activities because of substance use
  • Using substances even when it puts you in danger
  • Continuing to use a substance when you know it’s damaging your physical and/or mental health
  • Requiring a higher dosage to get the desired effect (tolerance)
  • Experiencing withdrawal symptoms when you stop using the substance (physical dependence) 

These 11 criteria are also subdivided into four categories of behavior related to a person’s substance use:

  • Impaired control
  • Social impairment
  • Risky use
  • Withdrawal symptoms or tolerance

The DSM-5 notes that there are two types of substance-related disorders: substance use disorders and substance-induced disorders. 

  • Substance use disorders involve a habit of using a substance despite that behavior resulting in negative outcomes.
  • Substance-induced disorders involve mental health issues that result from drug intoxication or withdrawal. These are psychological issues that were not present before the person started using a substance.

How Substance Abuse Begins

Illegal and prescription drugs can activate the brain’s reward system. This creates a surge of chemicals like dopamine, similar as when you eat food or have sex. The pleasurable feeling from drugs can create a strong desire that is so intense that some people will chase this experience at the expense of their normal activities and duties. When the high or euphoria from the drugs takes priority in a person’s life, many mental health experts would regard this as a substance use disorder. 

Not all people are equally susceptible to developing a drug or alcohol addiction. The DSM-5 highlights that drug abusers generally have lower levels of self-control and are more vulnerable to addictive behaviors. This can predispose them to a substance use disorder if they start using drugs. Many drug abusers also suffer from preexisting mental disorders, which increase the likelihood of alcohol abuse and dependence. 

Substance Use Disorders Differ in Severity

The DSM-5 also gives room for psychiatrists to define the severity of a substance use disorder. This is based on how many symptoms a person has. For example, if someone has two or three symptoms of a substance use disorder, then a psychiatrist would consider this a mild form of the condition. A moderate form of substance use disorder involves four or five of the 11 symptoms. And a severe form of the disorder features six or more criteria. Addiction treatment should be considered if you are experiencing any level of drug dependence. 

Consequences of Substance Use Disorders

You will often know if you meet the criteria for addiction based on how your substance use is affecting your life. Substance abuse and addiction to drugs can result in many negative life situations, including:

  • Legal problems related to substance use, such as DUIs or possession charges
  • Financial problems, such as financial instability or debt
  • Health problems including hospitalization or ER visits as a result of drug or alcohol use; this may be a result of vehicle accidents while using, overdoses, organ damage, hepatitis, seizures, illnesses from impure drugs, fights or AIDS
  • Strained relationships with parents, children, siblings, partners and friends
  • Issues at work, such as losing or quitting a job, changing jobs, arriving to work late, leaving work early or having poor work performance
  • Educational consequences, such as getting poor grades or dropping out
  • Hallucinations, seizures, blackouts or memory loss

If you notice any of these adverse life consequences, you should talk to a mental health professional. A psychiatrist may decide that you have a substance use disorder. As a result, it’s important to seek out addiction treatment based on a psychiatrist’s recommendations. With the right kind of drug rehab, therapy, support and lifestyle changes, you can turn your life around and achieve a greater sense of happiness and stability. 



Choose a better life. Choose recovery.