Substance use does not always begin as a crisis. For many, it starts as a way to cope with anxiety, pain, trauma, or simply the daily weight of life. But over time, what might have seemed manageable can spiral into dependence. Substance use disorders (SUDs) are medical conditions. They affect brain chemistry, disrupt mental health, and interfere with nearly every aspect of daily life. If you or someone you care about is struggling, understanding how professionals diagnose and treat SUDs can be the first step toward real help.
What Is a Substance Use Disorder?
Substance Use Disorder is a medical and psychiatric condition where a person repeatedly uses drugs or alcohol despite serious consequences. It is not just about how much someone uses — it is about what that use does to their life. To be diagnosed with SUD, a person must meet specific criteria laid out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). These criteria focus on patterns like:
- Loss of control: Wanting to cut down but being unable to
- Social impairment: Work, school, or relationships suffering due to use
- Risky use: Using substances even when it’s physically dangerous
- Pharmacological criteria: Developing tolerance and experiencing withdrawal
SUD can range from mild to severe, and the severity often determines the kind of treatment someone might need. What makes this condition particularly complex is how deeply it is tied to both the brain’s reward system and the person’s environment, genetics, and mental health.
How is a Substance Use Disorder Diagnosed?
A psychiatric evaluation looks deep into the why and how often a person uses drugs. Here is how psychiatric diagnosis typically works:
Clinical Interview
A mental health provider will ask about patterns of use, personal history, co-occurring disorders (like depression, PTSD, or anxiety), family background, and even sleep and appetite changes.
Screening Tools & Criteria
Standardized tools like the AUDIT (for alcohol) or DAST (for drugs) help providers assess severity. Then the DSM-5 criteria are applied to determine whether someone meets the threshold for SUD, and how severe it is.
Identifying Co-Occurring Conditions
Many people with SUD also struggle with conditions like bipolar disorder, ADHD, or trauma. Treating only the substance use, without addressing these underlying factors, often leads to relapse.
That’s why, at Renew Health Center, we always prioritize psychiatric evaluations. They give a full picture of the behavior, the brain, and the emotional history behind it.
Also Read: 6 Signs You Need a Same-Day Psychiatry Appointment
What are the Substance Use Disorder Treatment Options?
Once a diagnosis is made, treatment may include medication-assisted treatment (MAT). This is not “swapping one drug for another,” as some people fear. Instead, these are carefully managed, FDA-approved medications designed to stabilize brain chemistry and reduce cravings. Common options include:
- Buprenorphine is used to treat opioid dependence; helps reduce withdrawal and cravings.
- Naltrexone blocks the euphoric effects of alcohol and opioids. Also, it helps prevent relapse.
- Disulfiram (Antabuse) causes unpleasant effects if alcohol is consumed.
- Acamprosate helps maintain abstinence in people recovering from alcohol use.
These medications are often paired with therapy and lifestyle changes. Medication is not a “cure,” but it can give people a level playing field during the early stages of recovery. However, you must understand that not everyone needs medication. Consulting an expert is crucial before taking any medication.
Why Psychotherapy and Behavioral Support are Used for Substance Use Disorders?
Many people with SUD benefit from evidence-based therapy approaches that address both the root causes and the behaviors that keep addiction going. For example:
- Cognitive Behavioral Therapy (CBT) helps reframe negative thought patterns and prevent relapse.
- Motivational Interviewing strengthens internal motivation to change.
- Contingency Management uses tangible rewards to reinforce sobriety.
- Trauma-informed care is critical for those with PTSD or childhood trauma
Always remember that therapy is designed according to a person’s individual history and needs. Someone using substances to self-medicate undiagnosed ADHD will need a very different plan than someone using due to unresolved grief. Therapy often continues long after detox or medical stabilization ends. It is what helps people stay in recovery.
When Do Mental Health and Substance Use Collide?
A dual diagnosis of mental health and substance use is necessary when a person has a substance use disorder and another mental health condition. This is incredibly common, but often misunderstood. For instance, a person with untreated anxiety drinks to calm their nerves, eventually needing alcohol to get through the day. Or, someone with depression uses stimulants to feel “normal” or energetic.
Unfortunately, some people are misdiagnosed, or only one condition is treated while the other is ignored. That is why dual diagnosis requires integrated treatment.
What is the Process of Substance Use Recovery?
There’s no straight line to recovery. Setbacks happen. Progress can be slow. What matters most is building a system of support that keeps someone moving forward. This includes:
- Medication, when appropriate
- Therapy
- Primary care to track physical health in recovery
- Support systems, like family, peer groups, or structured programs
- Relapse planning
This is about having tools, support, and a treatment plan that evolves as you do.
Contact Renew Health Center for Substance Use Disorder Treatments
Substance use disorders can be associated with pain, stress, and imbalance in the brain and body. Treatment works best when it addresses the whole person. If you or a loved one needs help, the first step may be an honest conversation. At Renew Health Center, we offer psychiatric evaluations and primary care to assist patients with substance use disorder. Want to book a psychiatric appointment? Call 210-761-9001 for our San Antonio clinic or 830-346-9001 for our Seguin clinic. Additionally, you can book an appointment online.
Disclaimer: The information provided in our blogs is for informational purposes only and should not be considered medical advice. Always consult with a healthcare professional at Renew Health Center.
Medically Reviewed by Victor Labrado
Psychiatric Nurse Practitioner
MSN, APRN, FNP-C, PMHNP-BC
