What is Substance Use Disorder, and What to Do if You’re Struggling
Substance Use Disorder (SUD) is a medical condition that affects one’s brain chemistry and behavior. It involves ongoing substance use despite negative consequences to your health, relationships, career, and/or other aspects of daily life.
Having a SUD is not a lack of willpower or a moral failure. Repeated substance use changes how the brain processes reward, stress, and decision-making, while also impacting areas of the brain involved in memory, judgement, and learning. Drugs and alcohol flood the brain with dopamine, a “feel-good” chemical that reinforces use over time. Dopamine also reinforces healthy behaviors, such as eating and socializing, but substance use hijacks the system by flooding the brain with higher levels of dopamine, and therefore intense reinforcement for continued use. Over time, the brain adapts, leading to tolerance and an increase in usage to chase that same ‘high,’ also resulting in decreased pleasure from everyday activities. This cycle leads to severe dependence over time.
SUD exists on a spectrum. Some people experience mild symptoms, while others face severe dependence. You don’t have to “hit rock bottom” to reach out for support.
Symptoms of Substance Use Disorder
SUD is identified by patterns of behavior and impact on daily life, not by how much or how often someone uses.
Common symptoms include:
Using more than intended or for longer than planned
Difficulty cutting back or stopping use
Strong cravings to use
Spending significant time obtaining, using, or recovering from substances
Neglecting responsibilities at work, school, or home
Relationship problems that are caused or worsened by use
Giving up other activities that once mattered, such as social and recreational activities
Recurrent use in physically hazardous situations (ex. drinking and driving)
Continuing use despite physical or mental health issues (ex. drinking with a liver condition)
Increased tolerance (needing more to feel the same effect)
Withdrawal symptoms when not using
SUD, as defined by the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders from the American Psychiatric Association), is categorized based on the number of symptoms present within a 12-month period–mild (2-3 of the above criteria), moderate (4-5 of the above criteria), or severe (6+ of the above criteria). Regardless of severity, all levels are treatable. And the earlier you seek support, the easier it will be to overcome.
Why Do Some People Develop a SUD and Others Do Not?
SUD doesn’t affect everyone the same way. Several factors influence risk:
Genetics account approximately 50% of risk, along with co-occurring mental health conditions and individual brain chemistry.
Environment, such as family dynamics, peer influence, trauma, and economic stress can all play a role.
Development: Early exposure to substances, especially during adolescence, increases risk, as the brain is still developing in areas related to decision-making and control.
Understanding these factors can help reduce shame and reinforce that Substance Use Disorder is a complex, but treatable, condition.
Can Substance Use Disorder Be Treated?
Absolutely! SUD, no matter the severity, is treatable. The most effective approaches often combine:
Medical support (including Medication-Assisted Treatment when appropriate for initial withdrawal management and Post-Acute Withdrawal Syndrome)
Behavioral therapy (counseling, therapy, equine-assisted learning)
Ongoing peer and community support (meetings, sober peer events)
Treatment plans should be individualized and adjusted over time to meet each individual's changing needs.
What To Do If You’re Struggling
Questioning your relationship with substances is the first step to making positive changes, and the earlier you recognize signs that your substance use is affecting your life negatively, the sooner you can get the support you need to get back on track.
1) Talk to Someone You Trust
This might be a trusted friend, family member, counselor, or healthcare provider, who can help you identify your next steps and offer accountability and support throughout your recovery journey.
We offer free personalized treatment planning as well as a brief online quiz to help you identify next steps, if you don’t have a trusted individual to turn to or if you need additional guidance.
2) Learn Your Options
Recovery is not one-size-fits-all. Support may include:
Withdrawal management (detox), especially if you’ve been using regularly
Outpatient or inpatient treatment
Meetings
Peer support groups
Case management or recovery planning
We offer free one-on-one treatment planning to help you navigate your next steps and connect you with local resources throughout your journey.
3) Get Outside Support Early
The sooner you reach out for outside help, the easier it will be to start your recovery journey and begin thriving in a life of sobriety. The longer you use, the more your brain chemistry will change and the stronger your dependence on substances will be. While recovery is possible at every level of dependence, you will have fewer challenges the earlier you start. Even if you have 1-2 SUD symptoms, getting guidance and accountability from one or more of the options in number 2 above can change your trajectory from slipping into addiction to living life to the fullest.
4) Don’t Detox Alone
If you’ve been using substances regularly, stopping suddenly can be physically and mentally challenging, or even dangerous. Withdrawal management, including Medication-Assisted Treatment (MAT) and 24/7 monitoring by trained clinicians, will help you detox safely and successfully, as many people who try to detox on their own are unsuccessful due to the severity of symptoms.
We offer withdrawal management, including MAT, to those in Pitkin and surrounding counties, regardless of ability to pay.
4) Be Kind to Yourself
Struggling with a SUD doesn’t mean you’ve failed. It means your brain and body have been affected by substance use. While it is understandable to want to hide your substance use from others out of shame and guilt, this only allows your SUD to take a stronger hold. Admitting that you are struggling and seeking outside help is the best way to cut the cycle of addiction. Isolation and tackling your SUD alone almost always results in continued use.
Related: Why Shame and Guilt are Toxic
The Takeaway:
Millions of people struggle with substance use, and many go on to build healthy, fulfilling lives in recovery.
If you’re struggling and aren’t sure where to start, please reach out to us for one-on-one support or, if you’re not ready to speak to someone directly, take our 5-minute quiz to help determine your next steps and related resources for where you are in your recovery journey.
Written by Liz Haas, Recovery Resources Digital Marketing & Outreach Specialist
