Let’s just set the record straight once and for all shall we? Lynn shares the accurate and up to date information you need to hear, learn and know. Alcoholic and alcoholism are highly stigmatized and outdated terms for the overuse of alcohol. Get the researched and accurate information on how you can understand your own drinking patterns in this episode.
Criteria for Substance Use Disorders
Substance use disorders span a wide variety of problems arising from substance use and cover 11 different criteria or areas of your day to day life. The presence of at least 2 of these symptoms occurring within a 12-month period indicates an alcohol use disorder (AUD):
The severity of the AUD is defined as:
- Mild: 2-3 symptoms.
- Moderate: 4-5 symptoms.
- Severe: 6 or more symptoms.
Most heavy drinkers are at-risk drinkers or have a mild AUD. They drink above the low-risk guidelines, but are often able to drink moderately, have not suffered serious social consequences of drinking, and do not go through withdrawal. They often respond to brief advice and reduced drinking strategies, but may require additional treatment for underlying mental health concerns.
People with moderate to severe AUDs often, but not always have withdrawal symptoms, rarely drink moderately, continue to drink despite knowledge of social or physical harm, and spend a great deal of time drinking, neglecting other responsibilities. They generally require abstinence and more intensive treatment to break the cycle and address underlying mental health concerns.
- Taking the substance in larger amounts or for longer than you’re meant to.
- Wanting to cut down or stop using the substance but not managing to.
- Spending a lot of time getting, using, or recovering from use of the substance.
- Cravings and urges to use the substance.
- Not managing to do what you should at work, home, or school because of substance use.
- Continuing to use, even when it causes problems in relationships.
- Giving up important social, occupational, or recreational activities because of substance use.
- Using substances again and again, even when it puts you in danger.
- Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.
- Needing more of the substance to get the effect you want (tolerance).
- Development of withdrawal symptoms, which can be relieved by taking more of the substance.
What Are Substance Use Disorders?
The DSM 5 recognizes substance-related disorders resulting from the use of 10 separate classes of drugs: alcohol; caffeine; cannabis; hallucinogens (phencyclidine or similarly acting arylcyclohexylamines, and other hallucinogens, such as LSD); inhalants; opioids; sedatives, hypnotics, or anxiolytics; stimulants (including amphetamine-type substances, cocaine, and other stimulants); tobacco; and other or unknown substances. Therefore, while some major groupings of psychoactive substances are specifically identified, the use of other or unknown substances can also form the basis of a substance-related or addictive disorder.
The activation of the brain’s reward system is central to problems arising from drug use; the rewarding feeling that people experience as a result of taking drugs may be so profound that they neglect other normal activities in favor of taking the drug. While the pharmacological mechanisms for each class of drug are different, the activation of the reward system is similar across substances in producing feelings of pleasure or euphoria, which is often referred to as a “high.”
The DSM 5 recognizes that people are not all automatically or equally vulnerable to developing substance-related disorders and that some people have lower levels of self-control that predispose them to develop problems if they’re exposed to drugs.
There are two groups of substance-related disorders: substance-use disorders and substance-induced disorders.
Substance-use disorders are patterns of symptoms resulting from the use of a substance that you continue to take, despite experiencing problems as a result.
Substance-induced disorders, including intoxication, withdrawal, and other substance/medication-induced mental disorders, are detailed alongside substance use disorders.
The severity of Substance Use Disorders
The DSM 5 allows clinicians to specify how severe or how much of a problem the substance use disorder is, depending on how many symptoms are identified. Two or three symptoms indicate a mild substance use disorder; four or five symptoms indicate a moderate substance use disorder, and six or more symptoms indicate a severe substance use disorder. Clinicians can also add “in early remission,” “in sustained remission,” “on maintenance therapy,” and “in a controlled environment.”