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Is A Substance Use Disorder The Same As An Addiction?

Dr. Ted Bender, Ph.D., LCDC

Medically reviewed by

Dr. Ted Bender, Ph.D., LCDC

January 24, 2019

Substance abuse affects millions of Americans and their loved ones every year. Learn the differences between a substance abuse disorder and addiction and find out how individuals can help themselves or a loved one get the help that they need.

What Is A Substance Use Disorder?

What society and doctors used to call “addiction” is now known by the clinical term “substance use disorder.” According to the Substance Abuse and Mental Health Services Administration (SAMHSA), a substance use disorder, or a drug use disorder, is characterized by being a mild, moderate, or severe dependence on certain drugs or prescription medications. Substance use disorders occur when the ongoing use of a drug, alcohol, or prescription medication causes a clinical inability to fulfill and experience normal activities and responsibilities, including work, school, and at home.

Although it may seem substance use disorders are more likely to be found in older citizens who may be on one or more medications for health reasons, substance use disorders happen in all walks of life, ages, and social groups. SAMHSA states that according to a 2014 survey, 21.5 million Americans from the age of 12 and up were classified as having a substance use disorder within the past year.

There are a few different types of substance use disorders, and they include Alcohol Use Disorder (AUD), Tobacco Use Disorder, Cannabis Use Disorder, Stimulant Use Disorder, Hallucinogen Use Disorder, Opioid Use Disorder, and others.

When someone is dealing with a substance use disorder, you will often notice changes in their appearance, actions, and habits. The three primary areas to observe are behavioral changes, physical changes, and social changes.

Behavioral Changes:

  • Spotty attendance at school or work, or frequently being late
  • Consistently getting into trouble at school or at work (which includes fights, arguments, and accidents)
  • Using substances at dangerous times, like while driving or operating machinery
  • Behaving in secretive or suspicious ways
  • Changes in appetite and sleep patterns
  • Sudden change in personality or attitude
  • Sudden mood swings, anger, and irritability
  • Unusual bouts of giddiness, agitation, and energy
  • Lack of motivation
  • Unexplainable fear, anxiety, or paranoia

Physical Changes:

  • Bloodshot eyes and abnormally sized pupils
  • Sudden weight loss or gain
  • Deterioration of physical appearance
  • Abnormal smells on body, clothing, or breath
  • Slurred speech and body tremors (shakes)

Social Changes:

  • Sudden change in social circle
  • Change in hobbies and favorite hangout spots
  • Legal issues related to substance use
  • Out-of-character need for money or other financial problems
  • The use of substances even though it causes relationship problems, including with friends, family, and spouse/partner

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Alcohol Use Disorders (AUDs)

Continued drinking despite causing distress or harm to yourself and those around you classifies an AUD. According to the National Institute on Alcohol Abuse and Alcoholism, there were 16.3 million adults aged 18 years and older with an Alcohol Use Disorder (AUD) in 2014. And there were approximately 679,000 adolescents, ages 12-17, with an AUD in 2014. Excessive alcohol use causes about 88,000 deaths every year, according to the Centers for Disease Control and Prevention, making it the fourth leading preventable death in the country. Societal pressure, family usage/history, and a person’s living environment all play a role in someone’s risk for an AUD.

Here are the CDC’s guidelines of what is considered to be a typical drink:

  • 12 ounces of beer at 5 percent alcohol
  • 8 ounces of malt liquor at 7 percent alcohol
  • 5 ounces of wine at 12 percent alcohol
  • 1.5 ounces of 80-proof distilled spirits, such as vodka, gin, rum, and whiskey

What are the differences between normal drinking, excessive drinking, and binge drinking?

The definition of binge drinking:

  • Women—4 or more drinks during a single occasion
  • Men—5 or more drinks during a single occasion

The definition of heavy drinking:

  • Women—8 or more drinks per week
  • Men—15 or more drinks per week

Moderate drinking entails up to one alcoholic drink per day for women, and up to two drinks per day for men.

What Causes Someone To Drink Excessively?

An alcohol use disorder is most likely to start during adolescence, says the National Institute on Drug Abuse. In fact, by the time high school students are seniors, 70 percent of them will have tried alcohol. Stressors in life and work environments are reasons why people maintain or develop an AUD as well. Moderate to heavy alcohol consumption is directly connected to the feeling of euphoria, calm, decreased impulse control, and increased social confidence. When someone continues to drink despite the negative physical effects like fatigue, headaches, and nausea, that is a sign they are suffering from an AUD.

Here are the most common symptoms of an AUD:

  • Drinking more or longer than intended
  • Trying to cut down on or stop drinking but can’t
  • Getting into situations more than once that increased risk of bodily harm while drinking, such as driving, swimming, using machinery, walking in an unsafe area, or having unsafe sex
  • Having to drink more to get the same previous effect
  • Continuing to drink despite feeling depressed, anxious, or lending to a pre-existing health problem
  • Spending a lot of time drinking, or being sick from drinking
  • Continuing to drink despite harming relationships with family and friends
  • Realizing that drinking prevented you or a loved one from taking care of your home or family, or caused problems at work
  • Choosing to cut back on activities or hobbies rather than cut back on drinking
  • Getting arrested or having other legal implications due to drinking
  • Experiencing withdrawal when the effects of alcohol wear off

Stimulant Use Disorders

Stimulants are used to increase alertness, energy, attention, and to increase blood pressure, respiration, and heart rate. Stimulants are commonly used to treat obesity, ADHD, and depression. Their use produces feelings of euphoria and confidence. Amphetamines, methamphetamine, and cocaine are the most abused stimulants. These substances are taken orally, intravenously, or by snorting. In 2014, 913,000 people age 12 and older were estimated to be suffering from a stimulant use disorder due to cocaine use, according to SAMHSA. 476,000 people suffered from a stimulant use disorder from using other types of stimulants. Below are some physical and behavioral changes of someone with a stimulant use disorder.

Physical changes include:

  • Pupil dilation
  • Altered body temperature
  • Nausea
  • Weight loss
  • Psychomotor changes
  • Muscular weakness
  • Chest pain
  • Confusion
  • Increased or decreased blood pressure

Behavioral changes include being:

  • Highly paranoid
  • Anxious
  • Irritable
  • Angry
  • Depressed

People may also experience dramatic mood swings. A few key notes of a stimulant use disorder are hypervigilance, hyperactivity, confusion, and talkativeness.

What Are The Common Causes Of A Stimulant Use Disorder?

A person’s genetics, brain chemistry, social group, life stressors, ability to cope with stress, and employment situation all affect their risk for developing a stimulant use disorder. Amphetamines, a common stimulant used for ADHD, give people a false sense of confidence and calmness, alleviating the weight of any current life stressors. Individuals who prefer to feel stimulated, overactive, and have difficulty dealing with delayed gratification, are more likely to turn to stimulants compared to others to achieve a sense of happiness. Amphetamines in the brain are what cause the release of “happy” chemicals, like dopamine. Stimulants are also used to lose weight and have become more and more common due to societal pressure to look a certain way.

Opioid/Opiate Use Disorders

Opioids and opiates are used to relieve pain. They also cause nausea, drowsiness, confusion, euphoria, constipation, and reduced sweating. Heroin is an illegal opiate, and legal opioids, such as oxycodone and hydrocodone, can cause detrimental health effects when abused. Opioids and heroin were responsible for more than 28,000 deaths in 2014. People using opioids and opiates develop a craving for the euphoric feeling they receive, and at least half of all opioid-related deaths are due to prescription opioids.

According to SAMHSA, nearly 1.9 million people had an opioid use disorder related to taking prescription pain medication in 2014. Many of these pain-relieving opioids are prescribed by doctors, including oxycodone, morphine, and codeine. However, according to a study led by the National Survey on Drug Use and Health, a little over 50 percent of opioid users got them from a friend or family member. And only 22.1 percent got them from a doctor. In 2014, it was estimated that 4.3 million Americans used opiates for nonmedical reasons in a one-month period.

Over time, many people need to take more opioids to retain the same effect they had when they first started the drug. As a result, many people turn to less expensive and more readily available opiates, like heroin.

An estimated 586,000 people had a heroin use disorder in 2014. Heroin is a white or brown colored powder and is used by either injecting, smoking, or snorting. Its common symptoms include drowsiness, respiratory depression, constricted pupils, nausea and dry mouth. It can also cause shallow breathing, blue lips and fingernails, cold clammy skin, coma, convulsions, and death.

What are the common symptoms of someone suffering from an opioid use disorder?

If you suspect yourself or a loved one has an opioid or opiate use disorder, look for these common signs and behaviors:

  • A strong craving
  • Not able to control or reduce use
  • Continued use even though it may cause social or relationship problems
  • Increased usage over time
  • Development of tolerance to opioids
  • Withdrawal symptoms: nausea, vomiting, negative mood, muscle pains, fever, diarrhea, and insomnia

Other Substance Use Disorders

In addition to the primary types of substance use disorders, many people also suffer from Tobacco Use Disorders, Cannabis Use Disorders, and Hallucinogen Use Disorders.

How can I help myself or a loved one who has a substance use disorder or addiction?

There are many treatments available for those suffering from a substance use disorder, as well as addiction. For substance use disorders, the Substance Abuse and Mental Health Services Administration explains that standard treatments involve many components, which include:

  • Individual and group counseling
  • Inpatient and residential treatment
  • Intensive outpatient treatment
  • Partial hospital programs
  • Care management
  • Medication
  • Recovery support services
  • 12-step fellowship
  • Peer supports

In order to accurately diagnose someone with a substance use disorder, the person in question will need to work with their doctor or a specialist and complete a screening and assessment. You can read more about what to expect at a substance use disorder evaluation here.

Studies have found that, for both substance use disorders and addiction, combining appropriate medication with behavioral and emotional support programs are the most effective at treating disorders and preventing them from recurring.

Begin Your Journey to Overcome a Substance Use Disorder Today

If you’re concerned that you are suffering from a substance use disorder, or you observe the symptoms in a loved one, contact us today to learn more about how you can overcome an SUD or addiction. Our compassionate team at is here to empower you with the knowledge and tools you need to beat it and take back control over your life.

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