What is a “Substance Use Disorder”?

The Recovery Review blog has recently re-published a fascinating article titled “Substance Use Disorder as a category.” The article explains the significant changes to the diagnostic category of “Substance use disorder” which came about with the publication of the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5).

The previous edition of the DSM included a diagnosis of “Substance Abuse” - a category that describes someone who’s substance use is causing them harm, however without the extreme tolerance and withdrawal associated with a diagnosis of “Substance Dependence.” A person diagnosed with “substance abuse” would generally find it relatively easy to make changes, which often includes moderation rather than abstinence as the goal.

“Substance Dependence” on the other hand, was the diagnosis that was used for people who had lost all control over their substance use - often featuring more severe withdrawal symptoms, and often requiring longer term, more intensive treatment approaches. These two diagnoses indicated a difference in type of disorder. The DSM-5 has done away with these terms, and instead now uses the catch all
Substance Use Disorder” with different degrees of severity - mild, moderate or severe. Essentially, the DSM-5 sees one disorder with different severity, whereas the older classifications describe two different kinds of disorder. This has big implications for treatment, as these two different types of presentation do require different treatment approaches.

Go to “Substance use disorders as a category”