Substance abuse is the excessive use of a substance such as alcohol or a drug. While substance abuse is unhealthy and risky, it is not a mental illness in and of itself.

The Link Between Substance Abuse and Mental Illness

However, when a person’s ongoing abuse of alcohol, drugs or tobacco causes health problems, disability or inability to successfully manage obligations at home, work or school, they may have a substance use disorder, which is a mental health condition that can be mild, moderate or severe. People who have a substance use disorder also exhibit impaired judgment, lack of self-control, risky behavior and difficulty with social interaction.

Diagnosing Substance Use Disorder

To be diagnosed with a substance use disorder, a person must demonstrate a problematic pattern of substance abuse that leads to what is known as “clinically significant impairment or distress,” which is characterized by at least two of the symptoms below occurring within one year:

• Uses the substance in larger amounts or over a longer period than was intended
• Craves the substance
• Expresses a persistent desire or exhibits unsuccessful efforts to stop using the substance
• Spends a significant amount of time on obtaining the substance, using it or recovering after use
• Struggles to meet requirements at home, work or school due to substance use
• Continues to use the substance despite social or interpersonal problems caused or exacerbated by its effects
• Forgoes important social, occupational or recreational activities because of substance use
• Uses the substance in situations in which it is physically hazardous
• Continues to use the substance despite knowing the physical or psychological problems it causes
• Exhibits tolerance as defined by either a need for significantly increased amounts of the substance to achieve the desired effect or a markedly diminished effect with continued use of the same amount of the substance
• Goes through withdrawal with the characteristic withdrawal syndrome for the substance or uses the substance to relieve or avoid withdrawal symptoms

Diagnosing substance use disorder also requires a thorough physical and psychological evaluation.

Treating Substance Use Disorder

Substance use disorder treatment programs vary in setting and intensity. They include:

• Assessment
• Individualized treatment plans
• Stabilization
• Withdrawal management
• Continuing care

The goal of these programs is to help patients regain their sobriety in a manner that emphasizes that they are struggling with a mental illness and that treats them and their loved ones with dignity and respect. With determination and focus, abstinence is achievable.