Substance Abuse

Not exactly. Substance abuse remains a familiar term, but current clinical diagnosis generally uses substance use disorder (SUD). DSM-5 replaced the former separate diagnoses of substance abuse and substance dependence with a single SUD diagnosis based on a pattern of clinically significant problems involving impaired control, social impairment, risky use, and pharmacological features such as tolerance or withdrawal when applicable. Substance use alone does not establish a substance use disorder.

Yes. Substance use can be associated with acute impairment, hazardous behavior, occupational or academic problems, interpersonal difficulties, or medical consequences without by itself establishing addiction or a substance use disorder. The substance involved, amount and pattern of use, timing, clinical findings, toxicology results, and documented consequences can help characterize its effects. An isolated episode of use or impairment should not automatically be interpreted as evidence of a chronic addictive disorder.

Treatment records may document the substances involved, symptom severity, prior treatment episodes, medications for substance use disorders, counseling, periods of reduced use or abstinence, return to use, co-occurring mental or medical conditions, and changes in daily functioning. Reviewing the longitudinal history can show how substance use and related problems changed during and after different periods of treatment. A return to use does not by itself establish that treatment failed.