When Does “Problematic” Substance Use Become a Substance Use Disorder?

Most people around the world who use substances like alcohol or marijuana don’t have what is considered a problem with these substances. Others begin to exhibit habitual patterns that interfere with daily life and can lead to a substance use disorder (SUD). For loved ones and even the user themselves, it may be hard to recognize the gradual onset of an SUD. What is problematic use, and when does it become a disorder?

Understanding Substance Misuse

Before examining problematic use, it’s important to understand why people use substances. Anyone can use drugs or alcohol, but some groups are more likely to use substances. Teenagers and young adults often experiment with substances, especially alcohol and marijuana. Younger people usually experiment out of curiosity or peer pressure. Adults tend to use substances as a way of coping with stress, anxiety, pain, or trauma. They may use alcohol, for example, to “relax” after a stressful day at work. Often, people may use substances to self-medicate in response to symptoms of mental health issues like PTSD, anxiety, or depression. 

People from all walks of life use alcohol and drugs. People in marginalized communities may turn to substances to manage economic hardship or discrimination. Genetic predisposition can make some people more susceptible to developing substance use disorders. People in high- stress careers also more likely to use substances or struggle with their mental health. 

Regardless of the reasons for substance use, addressing it requires understanding, honesty, and compassion.

Recognizing Problematic Substance Use

Problematic substance use doesn’t necessarily mean addiction. A person who may be using problematically should undergo an honest assessment of why they are using the substance, as well as the impact it has on their life.  For example, a person who only gets high when they’re upset about something likely needs better coping mechanisms. 

When drugs or alcohol exceed occasional or social use or become a pattern that disrupts daily functioning and well-being, it might be time to seek help to reduce the substance use.

It’s well-known that substance use can lead to issues like neglecting responsibilities at work, school, or home. Problematic drinking or drug use can cause strained relationships, financial troubles, and other issues that make life difficult. Physical and mental health can also decline.

People struggling with problematic use may continue despite knowing the harm it causes. They may be in denial or early in their addiction. The good news is that you can get help at any stage of problematic use.

At What Point Does Substance Use Become a Disorder?

Problematic drug or alcohol use becomes a substance use disorder when it meets specific diagnostic criteria. Typically, a clinician will evaluate factors such as loss of control, compulsive use, and continued use despite negative consequences. SUD is recognized by NIH as a medical condition that affects the brain and behavior. Professional treatment, support, and medication (if needed) are recommended for the treatment of SUD.

Substance use crosses into disorder territory when it significantly interferes with daily life, responsibilities, and health. The key factor is not just how much or how often substances are used but how that use impacts functioning and well-being.

If using drugs or alcohol makes you feel bad, yet you do it anyway, it may be time to seek out help through therapy or a treatment program.

Symptoms of Substance Use Disorder

Substance use disorders are usually diagnosed based on criteria from various books, including the Diagnostic and Statistical Manual of Mental Disorders (DSM). There are also other scales and tools available to clinicians. Here is a summary of the aspects of life that professionals use to diagnose SUD:

• Loss of Control: Difficulty cutting down or controlling substance use, even when trying.
• Cravings: Strong urges or intense desire to use the substance.
• Tolerance: Needing more of the drug or drink to achieve the same effect.
• Withdrawal Symptoms: Physical or psychological symptoms when not using the substance.
• Shirking Responsibilities: Problems fulfilling obligations at work, school, or home.
• Social Problems: Relationship issues caused or worsened by substance use.
• Risky Use: Using substances in physically dangerous situations, such as drinking and driving.
• Continued Use Despite Harm: Continued substance use despite struggling with physical, psychological, or social problems.
• Time Spent: A significant amount of time spent obtaining, using, or recovering from substance use.
• Giving Up Activities: Reducing or giving up friends, hobbies, or work activities due to substance use.

If you think you may have a substance use disorder, you’re probably right. You know yourself best when you’re being honest with yourself. An addiction recovery professional, however, can clinically diagnose that you are struggling with SUD. This can help you find appropriate treatment and you may be able to use your health insurance to cover some of the expenses.

Recovery is Available to All

Substance use disorder does not discriminate by age, gender, culture, or background. While the struggles of addiction can feel isolating, millions of people globally have found recovery. Healing is possible no matter the circumstances.

Recovery looks different for everyone. Some find support through professional treatment programs, therapy, or medication-assisted treatment, while others rely on peer support groups like Alcoholics Anonymous, SMART Recovery, or community-based programs. 

Cultural and spiritual practices also play a role in many people’s recovery journeys, helping them reconnect with themselves and their communities.

With access to treatment, support groups, and compassionate care, people can rebuild their lives. They can work to make themselves whole again, restore relationships, and regain their sense of purpose, substance-free.