What is Substance Use Disorder?

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What is substance use disorder” is a question commonly asked by the families of those with addictions.

SUD (substance use disorder) is recognized as a chronic and relapsing brain condition that involves the ongoing consumption of addictive substances regardless of adverse outcomes. SUD is sometimes incorrectly labeled as substance abuse disorder, SUDs illness, or SUDs disease.

Those with substance use disorders abuse alcohol, prescription medications, or illicit drugs to the extent that it triggers a decline in their daily functioning. Persistent consumption continues even when individuals are aware of the potential or actual complications.

Substance use disorder is a clinical term for the informal expression “severe addiction”. Substance use disorder criteria are outlined in DSM-5-TR (the fifth and revised edition of APA’s Diagnostic and Statistical Manual of Mental Disorders).

If you are concerned about substance abuse in yourself or a loved one, read on to discover:

  • What is SUD? – a definition of SUD.
  • Substance use versus substance abuse: is there a difference?
  • Substance abuse disorder vs substance abuse: what’s the difference?
  • Substance use disorder vs addiction: how do these terms differ?
  • What is polysubstance use disorder?

Addiction vs. Substance Use Disorder

The concept of addiction may not be explicitly mentioned in DSM-5-TR, but it is widely acknowledged that addiction is a severe form of substance use disorder. Addiction represents the most extreme manifestation on the spectrum of substance use disorders, arising from the repetitive misuse of substances and diagnosed as mild, moderate, or severe.

NIDA (National Institute of Drug Abuse) defines addiction as a chronic condition characterized by an irresistible compulsion to seek drugs in the face of obviously negative repercussions, and often leading to enduring alterations in brain function. Addiction, then, is a multifaceted phenomenon.

The term dependence is a term used to describe a physical reliance on a substance. This condition is characterized by two key symptoms: withdrawal and tolerance – both diagnostic criteria for substance use disorder. It is possible to become physically dependent on a substance without being addicted, although addiction often follows closely behind.

Unlike physiological dependence, addiction is associated with changes in behavior stemming from biochemical alterations in the brain caused by prolonged substance abuse. For those with addictions, use of the substance becomes the primary focus, regardless of the potential harm to themselves or others. Irrational actions may arise when the person with an addiction is deprived of the substance upon which they are now reliant.

Addiction encompasses both a mental and physical attachment to the substance. It involves the compulsive need for the substance, coupled with an altered mindset that drives the person to prioritize substance use over other aspects of life.

Distinguishing between physical dependence and addiction is vital. Physical dependence refers to the body’s adaptation to a substance, leading to withdrawal symptoms upon discontinuation. Addiction, by contrast, involves behavioral changes driven by biochemical alterations in the brain, with substance use becoming a driving force.

Diagnostic and Statistical Manual of Mental Disorders has evolved its terminology over time and different editions, moving toward the inclusive term substance use disorder to encompass a spectrum of addictive behaviors and substances from alcohol and marijuana to prescription opioids or benzos, and illicit drugs like meth, heroin, cocaine, and fentanyl. These substances can trap people in a cycle of compulsive consumption, marked by the brain’s pleasurable response that reinforces their continued use. DSM-5-TR recognizes ten sub-types of substance use disorders.

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Substance Use Disorder Assessment

There are effective treatments available for substance use disorders. The first step involves acknowledging the issue, as the recovery process can be hindered when a person lacks awareness of their problematic substance use. While interventions by concerned friends and family often trigger treatment-seeking, self-referrals can be just as effective.

Formal assessment of symptoms by a medical professional is essential when determining the presence of a substance use disorder. Treatment can be beneficial for everyone, irrespective of the severity of the disorder. Regrettably, a substantial number of people meeting the criteria for a substance use disorder and who could gain from treatment do not receive the support they need – 2021 data from SAMHSA (Substance Abuse and Mental Health Services Administration) indicate that fewer than 10% of those who required addiction treatment in 2021 engaged with any form of therapy.

Since SUDs impact various facets of a person’s life, a combination of treatments is frequently required. For many, a blend of medication and individual or group therapy proves most effective. Tailoring evidence-based treatment strategies to an individual’s unique circumstances, including co-occurring medical, psychiatric, and social issues, is key to achieving sustained recovery.

Medications play a role in managing drug cravings, alleviating withdrawal symptoms, and preventing relapses. The FDA (U.S. Food and Drug Administration) approves three medications to treat alcohol use disorder and three medications to treat opioid use disorder. MAT (medication-assisted treatment) is always more beneficial when delivered alongside behavioral interventions.

Psychotherapy aids those with SUD in comprehending their behavior and motivations, promoting improved self-esteem, helping manage stress, and addressing concurrent psychiatric challenges. CBT (cognitive behavioral therapy) is the most commonly utilized form of psychotherapy to treat addictions and mental health conditions.

A person’s recovery plan is customized to their specific needs and may encompass strategies such as:

  • Supervised medical detoxification: Provides a controlled environment for managing withdrawal symptoms.
  • Sober living communities: Controlled, substance-free settings for rehabilitation.
  • Outpatient rehab: Offers flexibility while maintaining structured treatment.
  • Intensive outpatient treatment: Comprehensive treatment without the need for residential care in the form of IOPs (intensive outpatient programs) and PHPs (partial hospitalization programs).
  • Residential rehab (inpatient rehab): In-depth treatment in a residential setting over 30 to 90 days or more.
  • Peer support groups: Peer support from groups like AA (Alcoholics Anonymous), NA (Narcotics Anonymous), and SMART Recovery.
  • Family-inclusive self-help groups: Support for family members through groups like Al-Anon or Nar-Anon family groups.

Incorporating these strategies into an individualized plan can greatly enhance the prospects of successful recovery from substance use disorders.


What are the examples of substance use disorder?

Substance use disorders can encompass a range of substances, including alcohol, opioids, benzodiazepines, stimulants, marijuana, and heroin. Substance use disorders involve compulsive substance use despite negative consequences.

What are 3 signs of a substance use disorder?

3 common signs of a substance use disorder include increased tolerance, withdrawal symptoms when not using the substance, and an inability to cut down or control substance use despite wanting to do so.

How do you identify substance use disorder?

Substance use disorders are identified through a comprehensive assessment conducted by a medical professional. This assessment examines criteria such as impaired control over substance use, social impairment, risky use, and pharmacological indicators.

Cognitive Behavioral Therapy for Substance Use Disorders

CBT (cognitive behavioral therapy) is a widely recognized and effective psychotherapy approach for treating a variety of mental health conditions, including substance use disorders. It has demonstrated efficacy as both a standalone treatment and as part of combination treatment strategies. CBT focuses on changing negative thought patterns and behaviors while also helping individuals develop healthy coping skills.

CBT for substance use disorders involves addressing cognitive and behavioral processes that underpin and drive substance use. It aims to increase awareness of triggers, antecedents, and consequences related to substance use, as well as to leverage behavior change principles to reduce or eliminate substance use through environmental and social reinforcement. By helping people understand the thoughts and behaviors linked to substance use, CBT equips them to identify and cope with triggers, manage high-risk situations, reinforce behaviors aligned with recovery goals, and challenge thoughts that contribute to substance use.

Research evidence supports the effectiveness of CBT for substance use disorders. Various studies and reviews have shown that CBT can lead to significant improvements in symptoms and functional outcomes for individuals with substance use disorders. CBT’s goal-oriented nature and its emphasis on changing thought patterns and behaviors make it especially effective for addressing the cognitive components that contribute to substance abuse.

CBT sessions for substance use disorders are tailored to the individual’s needs, and treatment length can vary. Standard approaches often consist of 6 to 14 sessions, during which clients work on understanding and modifying dysfunctional thought patterns and behaviors. Therapists may employ various techniques, including role-playing, skills training, and cognitive restructuring, to help individuals develop healthier ways of thinking and coping.

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Get Treatment for Substance Use Disorder at Ohio Recovery Centers

At Ohio Recovery Centers in Cincinnati, we treat all types of substance use disorders, including addictions to alcohol, prescription medications, and illicit substances.

Research shows that both mild and moderate substance use disorders can be treated equally effectively with intensive outpatient treatment as residential rehab. We offer both traditional outpatient programs and intensive outpatient programs to help you or a loved one fight back against substance use disorder.

Every program at Ohio Recovery Centers integrates a comprehensive approach, blending pharmacological, behavioral, and holistic therapies for a whole-body approach to healing. All programs include a robust aftercare component with relapse prevention strategies, effective coping mechanisms, and access to ongoing therapeutic support if required.

Take the first step towards your transformation today by reaching out to our admissions team at 877-679-2132. Your journey to healing can begin.

Table of Contents

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Joseph Gilmore

Joseph Gilmore has been working in the addiction industry for half a decade and has been writing about addiction and substance abuse treatment during that time. He has experience working for facilities all across the country. Connect with Joe on LinkedIn.
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Christopher Glover CDCA

My name is Christopher Glover, and I am from Cincinnati, Ohio. I am currently in school and working to grow in competence to better support our community. As a recovering individual I know the struggles that you or a loved one can go through and that there is help for anything you may be struggling with.

The hardest part is asking for help and we are here as a team to best support you and your decision to start your journey towards a better future. Connect with Chris on LinkedIn

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Amanda Kuchenberg PRS CDCA

I recently joined Ohio Community Health Recovery Centers as a Clinical Case Manager. I am originally from Wisconsin but settled in the Cincinnati area in my early 20s.  My career started in the fashion industry but quickly changed as I searched to find my drive and passion through helping others who struggle with addiction. 

As someone who is also in recovery, I wanted to provide hope, share lived experience, and support others on their journey.  I currently have my Peer Recovery Support Supervision Certification along with my CDCA and plan to continue my education with University of Cincinnati so I can continue to aid in the battle against substance addiction. Connect with Amanda on LinkedIn.

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Patrick McCamley LCDC III

 Patrick McCamley (Clinical Therapist) is a Cincinnati native who has worked in substance use disorder/co-occurring mental health disorder treatment since 2019. Patrick received his bachelors degree in psychology from University of Cincinnati in 2021 and received his LCDC III (Licensed Chemical Dependency Counselor) license from the Ohio Chemical Dependency Professionals Board in 2022. Patrick has worked in Clinical Operations, Clinical Case Management, and Clinical Therapy throughout his career.

Patrick has tremendous empathy and compassion for the recovery community, being in recovery himself since 2018. Patrick is uniquely qualified to be helpful because of the specific combination of his academic background and his own experience in recovery.

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Bill Zimmerman CDCA

Bill Zimmerman is a Greater Cincinnati Area native who has worked in substance use disorder/co-occurring mental health disorder treatment since 2018. Bill received his (Chemical Dependency Counselor Assistant) license from the Ohio Chemical Dependency Professionals Board in 2020.

Bill has worked in Clinical Operations in both support and supervision, and Program facilitating and 12 step recovery support during his career. Bill has a passion for the recovery community, having been in recovery himself since 1982. Connect with Bill on LinkedIn

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Taylor Lilley CDCA, PRS

Growing up in Louisiana with addiction running rampant on both sides of my family. A life away from drugs and alcohol seemed impossible for someone like me. I remember what it was like sitting across from someone thinking there is no way they could ever understand what I was going through.

Sharing my experience offers a credibility and a certain type of trust with clients that only someone who has walked down this road can illustrate. To immerse myself further into the field of addiction, I am currently studying at Cincinnati State for Human and Social Services.  I hope I never forget where I came from, if I can do it, so can you!

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Thomas Hunter LSW

Hello my name is Thomas Hunter. I was born and raised in Cincinnati, Ohio. I am a licensed social worker.In my scope of practice I have worked in the areas of mental health and recovery for thirty years. The clients I have worked with in my career have ranged in age from seven to seventy.

I strive each day to serve my purpose of helping those in need and I believe I do so by utilizing all of my experiences to accomplish my goal of supporting those who desire to establish their sobriety and maintain it in their recovery. Connect with Thomas on LinkedIn.

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Mary D.Porter,LICDC

 My name is Mary D. Porter. I received my Masters of Social Work in 2008 from The University of Cincinnati. I received My Licensed Independent Chemical Dependency Counselor Licensure in 2001. I retired from The Department of Veteran Affairs Medical Center on April 14, 2014. Currently, I am the Associate Clinical Director for The Ohio Community Health Recovery Centers in Cincinnati.. Due to the fourth wave of the Opioid Epidemic in 2019,  I decided to enter back into the workforce to assist the addicted population.

The overdoses were astounding and I wanted to help.  I consider myself  to be an advocate for the addicted population. My compassion, resilience, empathy, wisdom, knowledge, experience and  love I have for this forgotten population goes beyond words. I consider what I do for the addicted population as a calling versus a “career,” because I too was once an “addict and alcoholic.” Today I am 45.5 years alcohol and substance free.

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Ben Lemmon LCDC III

Hello, my name is Ben Lemmon, and I’m the Vice President and Clinical Director at Ohio Community Health Recovery Centers. I’ve been working in the addiction and mental health field since 2013 and decided to enter the field after overcoming my own challenges with addiction.

When I first meet a client, I always explain to them that the reason we are meeting is because they are not capable of obtaining or maintaining sobriety, and my goal is to create a person that can maintain sobriety. I believe a person’s personality is made up of their thoughts, feelings and actions and my job is to help clients identify the thoughts, feelings and actions that have them disconnected from recovery and provide them with the tools to live a healthy and happy life. Connect with Ben on LinkedIn