Substance Use Disorder Criteria: What You Need to Know

Explore substance use disorder criteria with Black Horse Health. Dive into treatment approaches and discover the unique value of specialized care.

How Black Horse Health Can Help You Heal From Substance Use Disorder

Substance use disorder (SUD) is a national epidemic. According to CDC, 40.3 million U.S. individuals over the age of 12 experienced SUD in 2023 — a staggering 14.3% of this population. Know that, if you’re part of that statistic, you’re more than a number to us.

Our team of skilled and compassionate specialists have over 100 years of combined experience, and we are committed to helping you or your loved one lead a fulfilling life by providing you with the substance use disorder treatment you deserve.

With comprehensive services including medical detox, dual diagnosis treatment, and cognitive-behavioral therapy, we will create a path to recovery that best meets your unique set of symptoms.

Steps Toward SUD Recovery

Learn more about our substance use disorder programs, other treatment opportunities, and how our Black Horse Health team of specialists can help you find sustainable health and sobriety in this comprehensive article.

Don’t hesitate to reach out to our team for more information or to begin your path to recovery today. We’re here to help you harness the power of wellness.

substance use disorder criteria

The Evolution of Substance Use Disorder Criteria

Over time, our understanding and diagnosis of substance use disorders has changed significantly. In the past,the criteria for SUD were often not well-understood and associated with stigma.

However, over the years with advancements in medical research and societal awareness, the criteria for diagnosing these disorders has evolved significantly.

At Black Horse Health, we’ve closely followed these changes, ensuring our approaches are always up-to-date. This evolution has paved the way for more accurate diagnoses and effective treatments. These all ultimately benefit those with substance use disorders and their loved ones.1

What Is the DSM-5?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is one of the main tools in the field of mental health. It’s a detailed map for identifying various mental health and substance use issues.

When healthcare experts want to figure out the severity and type of substance use disorder someone has, they turn to the DSM-5. This helps make sure the assessments are fair, consistent, and accurate for everyone who needs help with substance use problems.

Mild, Moderate, and Severe Substance Use Disorders

Understanding the severity of a substance use disorder is important to choose the right treatment approach.

The DSM-5 classifies substance use disorders into three categories:2
  1. Mild: Characterized by a limited number of symptoms. People with a mild disorder can often get better with early help and treatments that don’t require staying in a hospital.
  2. Moderate: A middle-ground severity, where the number of symptoms is more pronounced. Treatment at this stage might involve more intensive therapies and possibly inpatient care.
  3. Severe: This is the most acute form, with a high number of symptoms. Comprehensive treatment, often involving inpatient care and long-term therapy, is crucial. 

The Triad of Assessment: Behavioral, Physiological, and Cognitive Factors

There are various substance use disorder criteria that individuals may present with or exhibit. These most often include behavioral, physiological, and cognitive factors.

Behavioral Symptoms in Substance Use Disorders

Individuals grappling with substance use disorders often exhibit noticeable behavioral changes over time.
These might include:
  • Increased aggression
  • Social withdrawal
  • A neglect of personal and professional responsibilities
Being aware of these changes can be the first step in recognizing a potential issue.3

Shifts in Social Circles

Another behavioral sign can be when someone starts hanging out with a different crowd that uses drugs or alcohol. They might also start being secretive and hiding things from loved ones.

Performance Decline

Substance use disorders may also lead to a decline in academic or work performance. This is because so much time and energy is spent on finding and using the substance of choice.
Tasks at work, school, or home that were once easy might become challenging, and there might be a noticeable lack of interest in pursuing goals.

Physiological Indicators of Substance Use

One notable physiological indicator of substance use disorder criteria is that over time, individuals may develop a tolerance. This means that they need more of the substance to achieve the same effect. This increase in tolerance is often a clear sign of a developing substance use disorder.
Experiencing physical or psychological symptoms in the absence of the substance indicates dependence.
Withdrawal symptoms may include:
  • Anxiety
  • Irritability
  • Headaches 
  • Nausea

Cognitive Impacts of Substance Use

Cognitive impacts of substance use disorder criteria may take time to manifest but often become severe.
Some of the most common cognitive symptoms of substance use disorder include:
  • Obsessive Desires: An overwhelming desire or compulsion to use the substance, often to the detriment of other areas of life, is a significant cognitive indicator of a substance use disorder.
  • Neglected Activities: Individuals might abandon hobbies or activities they once enjoyed as the substance takes up more of their time and focus.
  • Time Allocation: A substantial amount of time might be dedicated to obtaining, using, or recovering from the substance, leaving little time for other activities. This also creates a cycle of continuous use.

How Substance Use Disorder Criteria Affects Co-Occurring Disorders

Substance use disorders rarely exist in isolation. They often coexist with other mental health conditions such as depression, anxiety, or PTSD. For instance, an individual might turn to substances as a way to cope with the overwhelming symptoms of anxiety or traumatic memories.

Symptom Overlap

The symptoms of mental health conditions can intertwine with signs of substance use, creating a complex web of challenges. Recognizing this overlap is crucial, as it ensures that the treatment addresses all facets of the individual’s health.4

Integrated Treatment Approach

Addressing both the substance use disorder and the co-occurring mental health condition is essential for a comprehensive recovery. An integrated approach ensures that the treatment of one condition doesn’t inadvertently worsen the other.
By treating both conditions simultaneously, individuals often experience improved overall well-being, reduced chances of relapse, and a more sustainable path to recovery.

SUD Criteria

While the criteria for diagnosing a substance use disorder doesn’t require that the individual also present with a co-occurring condition, many individuals often do. This is important to keep in mind for holistic treatment.

Embracing Cultural Sensitivity in Substance Use Disorder Criteria and Diagnosis

Different cultures have varied perceptions of substance use, addiction, and recovery. These cultural views can influence how individuals perceive their own substance use, how willing they are to seek help, and what kind of treatments they might be open to.

Stigma and Substance Use

Across many cultures, there’s a stigma associated with addiction. This societal pressure can deter individuals from seeking the help they need or grasping what substance use disorder criteria for treatment may be. Understanding and addressing this stigma is crucial for effective diagnosis and treatment.

Acknowledging Differences

Every individual’s experience with substance use is unique, influenced by their cultural background, beliefs, and values. Recognizing these differences ensures a more accurate diagnosis and fosters trust between healthcare professionals and patients.

Building Trust

A culturally sensitive approach in diagnosis and treatment can bridge gaps. This helps make sure that individuals from all backgrounds feel acknowledged, respected, and understood in their recovery journey.

Navigating the Challenges in Substance Use Disorder Diagnosis

Substance use disorder criteria can manifest differently in various individuals, making a one-size-fits-all diagnostic approach ineffective. Recognizing the unique nuances of each case is crucial.
Due to symptom overlaps with other conditions, there’s a risk of misdiagnosis. Ensuring a comprehensive assessment is vital to avoid this pitfall.

How Does the Severity of Substance Use Disorder Criteria Affect Treatment Planning?

As mentioned, healthcare professionals assess the severity of substance use disorders based on specific criteria outlined in diagnostic manuals such as the DSM-5.
Understanding the severity of an individual’s substance use disorder criteria can help in multiple ways during treatment, such as:

Treatment Planning

Severity assessment of substance use disorder criteria helps healthcare professionals determine the appropriate level of care and treatment intensity required for an individual. Not all cases are the same, and treatment should be tailored to the severity of the condition.


Assessing severity can provide insight into the potential course of the disorder. More severe cases may have a different prognosis and require more extended or intensive treatment to achieve and maintain recovery.
Substance use disorder criteria and symptoms should get better throughout the course of treatment. If this is not the case, however, the prognosis and treatment methods can be re-assessed.

Risk Assessment

The severity of a substance use disorder can indicate the level of risk an individual poses to themselves and others. High-severity cases may be associated with greater risks, such as overdose, accidents, or criminal behavior.

For those with more severe substance use disorder criteria, healthcare professionals may recommend more intensive care, such as inpatient or residential treatment.

Identifying Co-Occurring Disorders

Severity assessment can help healthcare professionals identify co-occurring mental health disorders, which are common among individuals with substance use disorders. Accurate diagnosis and treatment of these co-occurring disorders are critical for successful recovery.

Outcome Measurement

By assessing severity at the beginning of treatment and periodically throughout the recovery journey, professionals can measure progress and adjust treatment plans as needed. This allows for a more personalized and effective approach to care.
Frequent check-ins with treatment providers are imperative for reassessing substance use disorder criteria.

Resource Allocation

Healthcare organizations and systems can use data on the severity of substance use disorders to allocate resources effectively. For example, regions with a higher prevalence of severe cases may require more specialized treatment facilities or support services.

How Assessment Takes Place

Assessing the severity of substance use disorder criteria is a crucial step in the diagnostic process because it informs treatment planning, risk assessment, and the overall approach to helping individuals with substance use disorders achieve lasting recovery.
It ensures that individuals receive the level of care and support they need to address their unique challenges and circumstances.

Choosing Black Horse Health For Recovery

At Black Horse Health, our team of experts is adept at addressing a wide range of substance use disorders. This ensures that we can provide specialized care for each.
Here’s a snapshot of the substances we address:
  • Alcoholism & Recreational Drugs: This includes widely consumed substances like alcohol and marijuana, each with its unique challenges.
  • Prescription Medications: We can treat substances from benzodiazepines like Xanax and Ativan to opioids like Vicodin and Oxycontin.
  • Stimulants & Depressants: This category encompasses drugs like amphetamines and barbiturates, which can have severe health impacts when misused.
  • Potent Opioids: Fentanyl, heroin, and morphine are among the powerful opioids that require specialized care due to their high risk.
  • Other Substances: We also address substances like PCP and tramadol, ensuring a holistic approach to treatment.

Treatment Services and Therapies Offered at Black Horse Health

At Black Horse Health, we understand that recovery is a multifaceted journey. Each individual’s path is unique, and as such, a diverse range of therapies is essential to cater to these varied needs.
Our offerings are designed to provide holistic care, addressing both the physical and psychological dimensions of substance use disorders.
Some of the services and therapies we offer include:
  • 12-Step Model: This is a structured path emphasizing personal growth and community support.
  • Cognitive-Behavioral Therapy (CBT): CBT offers techniques to manage and reframe negative thought patterns.
  • Dialectical Behavioral Therapy (DBT): DBT utilizes strategies for emotional regulation and interpersonal effectiveness.
  • Eye Movement Desensitization and Reprocessing (EMDR): This helps individuals process and cope with traumatic memories.
  • SMART Recovery: This is a self-empowering approach to addiction recovery.
  • Art Therapy: Art therapy helps individuals express and understand emotions through art.
  • Drama Therapy: Drama therapy utilizes role-playing and performance as therapeutic tools.
  • Equine Therapy: This leverages the human-horse bond for healing, conducted at our off-site stables.
  • Experiential Therapy: Experiential therapy is hands-on activities for personal insights and emotional growth.
  • Meditation & Yoga: This promotes relaxation, mindfulness, and overall well-being.
  • Dual Diagnosis Treatment: This addresses co-occurring substance use and mental health disorders.
  • Medication Assisted Treatment (MAT) with Vivitrol: We can use medications like Vivitrol to support recovery and detox.
  • Trauma-Focused Therapies: This addresses any traumas intertwined with substance use.
substance use disorder criteria

Why Choose Black Horse Health?

At Black Horse Health, we’re not your usual treatment center. We focus on meeting people where they are in the recovery process to provide holistic care.

We also specialize in helping individuals with mental health disorders, chronic pain, and trauma. Our main values are to provide quality care to help people heal for the long term. We will work with you to create an individualized treatment plan that addresses your needs and symptoms.

Reach Out and Begin Healing

Substance use disorders are complex, but with the right knowledge and approach, they can be effectively addressed. Recognizing the signs, understanding substance use disorder criteria, and seeking timely intervention can make all the difference.

If you or someone you know is grappling with such challenges, don’t hesitate to reach out to Black Horse Health to seek help. We will be with you every step of the way to heal.