Every day, millions of people use addictive substances, whether it’s alcohol, an illicit drug, or even a prescription drug. The 2018 National Survey on Drug Use and Health reported that “an estimated 164.8 million people aged 12 or older in the United States, or 60.2 percent, were past-month substance users.” The substances used include tobacco, alcohol, and illicit drugs.

Not everyone who uses drugs and alcohol will develop an SUD or a substance use disorder, but some will. This group also includes people who take prescription medications. Here’s how to tell if someone’s substance use has developed into a severe medical condition.

SUD Signs: How Can You Tell?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association, defines problematic behaviors related to substance use as “substance use disorders [SUDs].”

The guidance in the DSM-5 can help determine when a person’s use of drugs and alcohol, as well as any associated behaviors, have gone too far.

SUDs are categorized as either mild, moderate, or severe.  A severe SUD is also known as an addiction, which is a chronic, progressive disease that physically changes the brain and how it functions. A medical professional must review diagnostic criteria first before determining which category best fits a person’s condition or situation.

Compulsive use of substances is a sign that someone’s SUD has turned severe. Red flags that signal a problem often involve how someone looks, acts, and relates to other people. SUD signs include:

Changes in Appearance

This could be weight loss, weight gain, red or bloodshot eyes, and poor hygiene. Puncture marks on the skin, as well as skin infections, might be noticeable.

Changes in Behavior

Sudden changes in mood or one’s emotional state commonly occur with SUDs. A person may appear to have a lack of energy and could sleep more than usual. On the opposite end, a person could have sudden bursts of energy that are frequent or last longer than usual.

Changes in Interpersonal Relationships

Many substance users isolate themselves and appear more withdrawn than usual. They could show little to no interest in their usual hobbies and avoid hanging out with others. They may limit their social circle to new friends, which are usually people who are unfamiliar to the user’s family and friends.

Use Vs. Abuse

It is important to note that using substances doesn’t mean someone is abusing them or will continue to abuse them long-term. It’s also worth noting that substance abuse is not always a precursor to addiction.

Many factors unique to a person have a major role in whether an addiction develops. Age, weight, family history, metabolism, medical history, substance use history, social environment, and more can influence how often someone uses alcohol and drugs and whether they continue to do so despite the harm they cause themselves and others.

It helps to know the difference between “substance use” and “substance abuse” and whether someone has entered the stage of “substance dependence.”

Substance Use

Substance use involves drugs, legal and illegal, alcohol, and any other substance used to get high. While use doesn’t necessarily lead to substance abuse, it does increase the chances of chemical dependency developing, as the brain can change when the substance is used more often.

Drugs and alcohol flood the brain with the natural neurotransmitter dopamine, a chemical that regulates the brain’s reward center. This increase creates pleasurable feelings that the brain wants to repeat. This is why users find it hard to ignore powerful cravings for substances. The desire to use usually beats out the desire to abstain from drugs and alcohol.

Seeking out drugs and alcohol to feel good can lead to using these substances regularly. The more a substance is used, the higher tolerance to that drug grows. This usually means people have to use it more to get the same feelings they once did. A person at this stage is likely on the road to substance abuse.

Substance Abuse

Overindulging in addictive substances is the difference between substance use and substance abuse. This could mean excessive use of a drug or continuing to use substances in ways that are harmful to one’s overall health and well-being. WebMD advises, “Abused substances produce some form of intoxication that alters judgment, perception, attention, or physical control.”

Such use is usually characterized as excessive or reckless. If someone continues to use, even when it brings about problems and consequences that can jeopardize someone’s life, outside help might be required.

Substance Dependence

If a person uses a substance to the point where they feel changes in mind and body and feel unable to function in their daily lives without it, then that person has reached a stage of substance dependence. A substance use disorder could be the issue at this point. Chemical dependency is considered an addiction to the substance.

What happens when a chemically dependent person cuts back on their use or stops using the drug altogether is a sign of whether substance dependence is an issue. If withdrawal symptoms unfold when either one of these actions is taken, then it’s likely that a severe substance use disorder is the issue.

Signs of SUDs

It can be challenging to know when someone’s drinking or drug use has turned into substance abuse, and when professional addiction treatment should be the next step. Some SUDs can seemingly come out of nowhere, but that likely just means the disorder developed quietly away from others, as the person may have hidden their substance abuse problem. This is just one of the many signs that someone is struggling with an SUD.

These questions can help you recognize if someone’s substance use has become substance use disorder:

  • Does the person continue to use despite the adverse effects on their daily life and relationships?
  • Does the person experience frequent cravings for the substance they are using?
  • Is the person using the substance more often than intended?
  • Is the person using  the substance for longer periods than intended?
  • Has the person’s spending habits changed to support a substance habit, even when the person can’t afford it?
  • Does the person feel unable to stop using the substance despite a desire to do so?
  • Does the user need more of the substance to achieve a high?
  • Is the person combining substances to get high?
  • Is the person attempting to get the drug at any cost, including engaging in illegal activities?
  • Does withdrawal start when substance use is stopped or reduced?

If the answer is “yes” to any of these questions, then a substance use disorder likely has developed. At this point, the person may need to seek professional help to regain control over their physical and mental health and their lives. A recovery-focused treatment program can help a person also understand the mental health aspect of their SUD as they work to overcome it.

As the Substance Abuse and Mental Health Services Administration (SAMHSA) advises, “Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home.”

An inability to function in daily life because of a substance use disorder is serious and usually requires a level of care to treat it. Addiction is treatable. Seek help at a reputable, licensed facility that can meet the medical needs of people in need of recovery from substance abuse.

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