Substance use disorder is a health condition involving compulsive substance use. It can occur with prescription or nonprescription drugs. It can also range from mild to severe.

Substance use disorder, formerly known as “drug abuse,” develops when substance use interferes with the ability to function day to day.

Substance use disorder can range from mild to severe, depending on how it affects different areas of your life.

Keep reading to learn more about substance use disorder, including types, risk factors, and how to treat it.

What is substance use disorder?

A substance use disorder is a mental health condition in which a person experiences a pattern of symptoms surrounding substance use that negatively affects their health and quality of life.

Substance use disorder exists on a spectrum from mild to severe, depending on the number of criteria a person meets. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR):

One symptom could indicate a person is at risk of a substance use disorder.
Two or three criteria point to a mild substance use disorder.
Four or five symptoms show someone has a moderate substance use disorder.
Six or more criteria indicate a severe substance use disorder, which signals an addiction to that substance.

The DSM-5-TR criteria for substance use disorder include:

Using more of a substance than intended or using it for longer than you’re meant to.
Trying to cut down or stop using the substance but being unable to.
Experiencing intense cravings or urges to use the substance.
Needing more of the substance to get the desired effect, also called tolerance.
Developing withdrawal symptoms when not using the substance.
Spending more time getting and using the substance and recovering from use.
Neglecting responsibilities at home, work, or school because of substance use.
Continuing to use even when it causes relationship problems.
Giving up important or desirable social and recreational activities due to substance use.
Using substances in risky settings that put you in danger.
Continuing to use despite the substance causing problems to your physical and mental health.

How do you develop substance use disorder?

People typically develop substance use disorder over time. This may look like:

Experimental or prescription use: A person may try a substance once or take a prescription drug as directed by a doctor.
Occasional use: A person may use the substance in social situations or use a prescription drug in a way not directed by a doctor.
Regular or heavy use: A person may take a substance routinely.
Substance use disorder: A person may take the substance daily or multiple times per day. They may rarely not be using the substance.

Who gets substance use disorder?

Anyone can develop substance use disorder. However, some factors may increase the chance of developing a substance use disorder.

Researchers are learning that specific genetics play a role in developing substance use disorder. However, genes are not the only factor. Genetics may combine with other factors in a person’s environment to increase their risk.

Other risk factors for developing substance use disorder include:

family member or peer use
current or past physical, sexual, or emotional abuse or neglect
trauma
access to these substances
mental health disorders, such as:
- depression
- anxiety
- eating disorders
- personality disorders
substance use at an early age
attention deficit hyperactivity disorder (ADHD)

What are the different types of substance use disorders?

People may categorize some forms of substance use disorder based on the type of substance.

Common types include:

alcohol use disorder
opioid use disorder
cocaine use disorder
meth use disorder

The following section categorizes common substances and their associated symptoms.

Depressants

Substances classified as depressants (or central nervous system depressants) reduce activity in your central nervous system (CNS). They typically make you feel relaxed and drowsy.

Their effects vary depending on the amount consumed and an individual’s specific reaction to the substance.

For example, low doses of depressants can actually have a stimulant effect and cause a euphoric feeling. Larger doses can cause depressant effects, such as cognitive impairment or loss of coordination.

Alcohol use disorder

Alcohol use disorder occurs when your use of alcohol affects your daily life, like your ability to work or maintain relationships. Heavy alcohol misuse can harm your health in the long term.

Alcohol is the most commonly used recreational substance in the United States. The 2022 National Survey on Drug Use and Health found that, over a 30-day period, approximately 137.4 million people 12 years old and older (48.7%) used alcohol at least once, and 16.1 million reported heavy alcohol use.

Heroin use disorder

Heroin is an opioid made from the seed of the poppy plant. Heroin is also referred to as:

smack
H
ska
junk

Heroin use can lead to:

heart problems
miscarriage
overdose
death

Because regular heroin use leads to increased tolerance over time, you may need to take more of the substance to experience its desired effects. If abruptly stopped, withdrawal symptoms typically occur. Because of this, many people who use heroin may continue using it to avoid feeling sick.

Stimulants

Stimulants increase CNS activity and can temporarily make someone feel more alert, energized, or confident.

Cocaine use disorder

Cocaine typically produces a short high. People typically use it by injecting it into veins, snorting it, or smoking it. Cocaine produces energetic and euphoric feelings. It’s also called:

coke
C
crack
snow
flake
blow

Cocaine use increases:

body temperature
blood pressure
heart rate

Heavy and prolonged cocaine use can lead to:

heart attack
respiratory failure
stroke
seizures
death

Read more about how long cocaine stays in the body and how to manage symptoms after stopping use.

Methamphetamine use disorder

Methamphetamine is closely related to amphetamine. Other names for methamphetamine include:

chalk
meth
ice
crystal
glad
speed
crank

Methamphetamine stays in your body for several days and can produce long-term wakefulness. It may also increase physical activity, which can result in increased:

heart rate
body temperature
blood pressure

If used for a long time, methamphetamine can lead to:

mood problems
violent behavior
anxiety
confusion
insomnia
severe dental problems

Learn signs that someone is using meth and how to respond.

Cannabis use disorder

Cannabis is a dried mix of parts of the cannabis plant. It can produce feelings of euphoria, distorted perceptions, and trouble solving problems. Cannabis is also called:

weed
pot
marijuana, though this term has racist connotations
ganja
grass
420
trees

Cannabis use disorder can increase your risk of:

cardiovascular disease
cognitive impairment
mental health disorders
insomnia

Learn more about cannabis use disorder.

‘Club’ drugs

This category refers to a wide variety of substances people often use at dance parties, clubs, and bars.

They include:

Gamma hydroxybutyrate (GHB): It’s also known as grievous bodily harm, G, and liquid ecstasy.
Ketamine: Ketamine is also known as K, special K, vitamin K, and cat valium.
Methylenedioxymethamphetamine (MDMA): MDMA is also known as ecstasy, X, XTC, adam, clarity, and molly.
Lysergic acid diethylamide (LSD): LSD is also known as acid.
Flunitrazepam (Rohypnol): Flunitrazepam is also known as R2 or as a roofie, rophie, roche, or forget-me pill.

Club drugs can lead to feelings of euphoria, detachment, or sedation. Due to their sedative qualities, roofies, in particular, have been used to commit sexual assaults, or “date rape,” on unsuspecting people.

Club drugs can cause:

serious short-term mental health problems, such as delirium
physical health issues, such as rapid heart rate, seizures, and dehydration
death

Risks of these side effects increase when they’re mixed with alcohol.

Other compounds

Other commonly used substances do not fall into the above categories.

Anabolic steroids

Anabolic steroids are also commonly known as:

juice
gym candy
pumpers
stackers

Steroids are lab-made substances. They mimic testosterone, the male sex hormone, and people typically take them orally or inject them.

In the United States, they’re legal with a prescription for certain medical uses, including to treat muscle wasting diseases. However, some people may use them to enhance athletic performance and build strength. Anabolic steroids are banned by many sports institutions, including the National Collegiate Athletic Association (NCAA) and the Olympics.

Steroid use, especially over a long period, can cause serious and chronic health problems, including:

aggressive behavior
liver damage
high blood pressure
high cholesterol
fertility issues

Females who use anabolic steroids face additional symptoms, such as:

facial hair growth
menstrual cycle changes
baldness
a deepened voice

Teens who use steroids may experience:

impaired growth
accelerated puberty
severe acne

Inhalants

The act of using inhalants is sometimes known as huffing. Inhalants are also known as:

whip-its
poppers
snappers

Inhalants are chemical vapors that people breathe to experience mind-altering effects. They include common products, such as:

glue
hair spray
paint
lighter fluid

The short-term effects cause a feeling similar to alcohol use.

Using inhalants comes with risks. They can lead to:

a loss of sensation
a loss of consciousness
a loss of hearing
spasms
brain damage
heart failure

Prescription drugs

Doctors prescribe medication to help manage pain and other conditions. But some people may take a medication that’s not prescribed to them, or take it for reasons other than those prescribed by their doctor.

Some people who take these medications can develop a substance use disorder, even when they’re using the medication exactly as prescribed.

These drugs may include:

opioids for pain management, such as:
- fentanyl (Duragesic, Subsys)
- oxycodone (OxyContin, Xtampza ER)
- acetaminophen/hydrocodone
anxiety or sleep medications, such as alprazolam (Xanax) or diazepam (Valium)
stimulants, such as methylphenidate (Ritalin) or amphetamine/dextroamphetamine (Adderall)

Their effects differ depending on the medication, but misusing prescription drugs can lead to:

drowsiness
depressed breathing
slowed brain function
anxiety
paranoia
seizures

Complications of substance use disorder

Substance use and substance use disorder can potentially lead to other problems, such as:

drunk and impaired driving
violence
familial stress
child abuse and neglect, in some situations
legal problems
negative health effects, including cancer and chronic health conditions
mental health conditions

How do you treat substance use disorder?

Medical treatment is available for substance use disorders. The specific treatment may vary depending on the substance and personal factors.

Treatment typically includes:

detoxification (“detox”)
medications to reduce withdrawal symptoms
therapy to support your recovery
monitoring to prevent relapses

Depending on the type of substance use disorder, the first stage of treatment may be medically assisted detoxification. During this process, healthcare professionals provide supportive care as the substance is cleared from your bloodstream.

Learn about the detox process for cocaine, cannabis, alcohol, and tramadol.

Detoxification is followed by other treatments to support long-term abstinence. Many treatments involve both individual therapy, such as cognitive behavioral therapy, and group counseling. These are provided in outpatient facilities or inpatient residential recovery programs.

Medications can also reduce withdrawal symptoms and encourage recovery. In heroin use disorder, for example, your doctor may prescribe a medication called methadone or buprenorphine/naloxone (Suboxone). These medications can ease your recovery and help you cope with the intense withdrawal stage.

How to prevent substance use disorder

The best way to avoid a substance use disorder is to prevent use in the first place.

However, while abstaining from substances is the safest approach, it may not be the most realistic. Because of this, education and safety practices are helpful tools to reduce harm and avoid addiction. These can include:

mental health care, including therapy
community programs
reducing stigma
developing healthy coping mechanisms for times of stress and change

Harm reduction programs can also reduce complications of substance use and connect people to treatment.

If a doctor prescribes a prescription drug that has a risk of addiction, it’s best to follow all directions from the doctor and pharmacist while taking the medication. Never give your prescription medications to another person. If you have extra doses you no longer need, return them through a pharmacy or community take-back program.

Resources and support groups for substance use disorder

Consider using the following resources for support and treatment referral:

Above the Influence provides information targeted at youth and young adults regarding substance use, peer pressure, and treatment options.
The Substance Abuse and Mental Health Services Administration (SAMHSA) offers free resources and referrals to treatment. If you have questions or need help, call the 24/7 helpline at 800-662-HELP (4357).
The National Institute on Drug Abuse provides information and research for teenagers and young adults about substance use disorders.
The National Association for Children of Alcoholics provides information and resources for children of parents with alcohol use disorder.
Al-Anon provides confidential groups and meetings across the United States for adult friends and family members of people who misuse alcohol. Call 888-4AL-ANON (888-425-2666) for more meeting information.
Alateen provides confidential groups and meetings across the United States to help teenagers and young adults cope with a friend or family member’s alcohol use. Try Alateen chat.
Alcoholics Anonymous (AA) offers in-person and virtual meetings and support groups for people in recovery from alcohol addiction or misuse.
Narcotics Anonymous (NA) offers in-person and virtual meetings and support groups for people in recovery from narcotic addiction or misuse.

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