Substance Use Disorders: A Comprehensive Overview

Discover the impact of substance use disorders and how to get the help you need to achieve recovery in this comprehensive article.

What is a Substance Use Disorder?

A substance use disorder (SUD) is a condition where a person has difficulty controlling their use of drugs or alcohol. It’s a serious health issue that can affect people of all ages and backgrounds. In 2022, more than 48 million people aged 12 or older struggled with a substance use disorder.1

When someone has an SUD, they cannot limit how much or how often they use drugs or alcohol. This can cause many problems in their life, including:
  • Suffering relationships
  • Neglecting responsibilities at work or school
  • Legal issues 
Substance Use Disorders

How are Substance Use Disorders Classified?

Substance use disorders are classified based on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The classification helps in understanding the severity and specific characteristics of different disorders.2

The DSM-5 defines specific criteria for diagnosing substance use disorders. To diagnose a substance use disorder, a person must meet a certain number of these criteria. This can vary depending on the severity of the disorder.
These criteria include:
  • Pharmacological criteria such as tolerance and withdrawal symptoms
  • The presence of impaired control over substance use
  • Social impairment
  • Risky use

Substance Categories

Substances can be categorized into different groups based on their effects on the body. Each category has its own set of characteristics and potential consequences associated with misuse.
Some common categories include:
  • Alcohol
  • Opioids
  • Stimulants
  • Sedatives
  • Tobacco
  • Hallucinogens
  • Cannabis 

Severity Levels

Substance use disorders can vary in severity from mild to severe. The severity level is determined by the number of diagnostic criteria met.
Mild substance use disorder is characterized by the presence of two to three criteria, moderate by four to five criteria, and severe by six or more criteria. The severity level helps in understanding the impact of the disorder on a person’s life.


Substance use disorders often co-occur with other mental health conditions. This is known as comorbidity. Common comorbid conditions include:
  • Mood disorders
  • Anxiety disorders
  • Personality disorders
The presence of these conditions can complicate the diagnosis of substance use disorders. Proper assessment and management of comorbidity are essential for comprehensive care.

Withdrawal Symptoms

Many substances can lead to withdrawal symptoms when their use is abruptly reduced. Withdrawal symptoms can range from mild discomfort to severe physical and psychological distress.

Each substance has its own set of withdrawal symptoms. This can impact a person’s ability to quit or reduce substance use.

Risk Factors for Developing Substance Use Disorders

The knowledge of what contributes to substance use disorders is crucial in promoting prevention. Below is an overview of some of these factors:

Genetics and Family History

Genetic factors can affect a person’s vulnerability to certain substances and their response. Research suggests that genetics plays a role in the development of a SUD. Having a close family member with a history of substance use increases the likelihood of developing a SUD.3

Environmental Factors

The environment in which a person lives can also contribute to SUD development. The following factors can influence a someone’s likelihood of engaging in substance abuse:
  • Peer pressure
  • Exposure to substance use
  • Negative life events

Childhood Adversity

Experiencing adverse childhood experiences increases the risk of SUD. These traumatic experiences can affect brain development and increase vulnerability.
Examples of these events may include:4
  • Neglect
  • Abuse
  • Household dysfunction

How Adverse Childhood Experiences (ACEs) Can Lead to SUD and Mental Health Challenges

Personal Factors

Certain personal characteristics can also contribute to the risk of developing a SUD. These include:
  • A lack of self-control
  • Impulsivity
  • Sensation-seeking behavior
  • A tendency to take risks

Socioeconomic Factors

Socioeconomic factors can contribute to the risk of developing substance use disorders. These factors can create anxiety and may limit access to support systems. This increases the likelihood of turning to substance abuse.
These factors include:
  • Low income
  • Unemployment
  • Limited educational opportunities

Early Substance Use

Initiating substance use at an early age increases the risk of developing a SUD. Adolescent brains are still developing, making them more susceptible to the adverse effects of drugs or alcohol.

Symptoms of Substance Use Disorders

Understanding the symptoms of SUDs is crucial in seeking help for those affected. Here is a brief overview of the most common among them:

Changes in Appearance

People with substance use disorders may experience physical changes. These may include:
  • Bloodshot eyes
  • Dilated or constricted pupils
  • Poor hygiene
  • Skin problems

Changes in Appetite

People may experience changes in appetite, such as increased or decreased hunger. This leads to significant weight fluctuations.

Poor Coordination and Motor Control

Substance misuse can impair motor skills and coordination. This results in unsteady movements, clumsiness, and difficulty maintaining balance.

Mood Swings

Frequent and intense changes in mood can be common in people with substance use disorders. Some common signs include intense:
  • Irritability
  • Anger
  • Sadness
  • Euphoria

Anxiety and Depression

Substance misuse often leads to the development of anxiety and depression symptoms. These may include:

  • Persistent worry
  • Restlessness
  • Feelings of hopelessness
  • Loss of interest in activities once enjoyed

Emotional Instability

Substance use can lead to emotional instability. This manifests in sudden outbursts of anger or emotional outbursts without apparent reason.

Increased Risk of Suicidal Thoughts

22% of suicides in the U.S. involve alcohol intoxication. People with substance use disorders may experience increased thoughts of self-harm. This necessitates immediate intervention and support.5

Neglecting Responsibilities

People struggling with substance use disorders often neglect their responsibilities. This results in poor work or school performance, frequent absences, or strained relationships.

Loss of Interest in Hobbies

Previously enjoyed hobbies and social engagements may be disregarded in favor of substance use. This leads to withdrawal from once pleasurable experiences.

Financial Problems

People with substance use disorders may experience significant financial strain. This is due to excessive spending on substances and neglecting bills or debts.

Social Isolation

The use of substances can lead to isolation from friends and family. Preoccupation with substance use also causes withdrawal from social activities.

What Substances Most Commonly Lead to SUD?

Different substances have varying levels of addictive properties. Below are the most addictive substances that commonly lead to SUD:


More than 75% of drug overdose deaths in 2021 involved opioids. Opioids are among the most addictive drugs that lead to substance use disorders. They work by blocking pain signals in the brain and creating a euphoric feeling. Opioid addiction can be disastrous and affects one’s physical and mental health.6
Examples of commonly misused prescription opioids include:
  • Oxycodone
  • Vicodin
  • Fentanyl


Alcohol is legal and widely used for recreational purposes. However, prolonged use can lead to addiction. This can be harmful and lead to liver damage, risky behavior, and chronic health conditions.


Benzodiazepines are prescribed to treat conditions such as anxiety and insomnia. They are highly addictive and can lead to severe withdrawal symptoms if stopped abruptly. In fact, benzodiazepines caused 12,499 deaths in 2021.7
Common benzodiazepines include:
  • Xanax
  • Valium
  • Ativan


Methamphetamine is a highly addictive stimulant. It can increase energy and mental acuity. However, its long-term use can result in severe physical damage and mental health complications. The withdrawal symptoms of methamphetamine can be extremely intense and difficult to manage.

Marijuana (Cannabis)

The illegal drug with the highest usage in the U.S. is marijuana. While cannabis may not be as physically addictive as other substances, it can still lead to psychological dependence. Frequent use can impact memory, coordination, and motivation.8


Nicotine is a highly addictive substance found in tobacco products. Smoking is the most common way of using nicotine, and it can lead to lung cancer and other respiratory diseases. Nicotine use over time can lead to addiction, and it can be extremely hard to quit without professional help.

Nicotine Addiction and Withdrawal


In 2021, cocaine emerged as the second most prevalent illicit drug used in the United States. Cocaine is a powerful stimulant derived from the coca plant. It produces a short-lived euphoric effect and increases energy levels. Regular use can quickly lead to dependence as individuals chase the initial high.9


Hallucinogenic substances can alter perception, mood, and thoughts. These substances can cause unpredictable effects and have potential risks for mental health. Among them are lysergic acid diethylamide (LSD) and magic mushrooms.

How Common is SUD in the U.S.?

In the U.S., substance use disorders are a significant issue affecting millions of people. Below are some latest statistics concerning SUDs in the United States:10

Alcohol Use Disorder (AUD)

In 2022, over 29.5 million people aged 12 or older in the U.S. had an alcohol use disorder (AUD). This staggering number highlights the widespread nature of AUD in the country.

Drug Use Disorder (DUD)

Similarly, 27.2 million people in the U.S. suffer from a drug use disorder (DUD).

Co-Occurrence of AUD and DUD

8.0 million people in the U.S. had both an alcohol use disorder and a drug use disorder. This indicates the need for approaches that address both alcohol and drug-related issues.

Mental Illness

Mental illness is often interconnected with substance use disorders. Approximately 25% of adults aged 18 or older in the U.S. had any mental illness (AMI) in 2022. This highlights the overlapping nature of these conditions.

Serious Thoughts of Suicide

5% of adults in the U.S. reported having serious thoughts of suicide in 2022. This emphasizes the severity of the mental health challenges faced by those struggling with SUD.

How Common is SUD in Texas?

In Texas, many people struggle with substance use disorders. From 2011 to 2016, the number of drug overdose deaths rose by 60%. In 2021 alone, 2,770 people lost their lives to opioid overdoses in Texas.
Additionally, a staggering 36.8% of Texans reported experiencing symptoms of depression in the first half of February 2023. This shows that SUD and mental health issues are prevalent in the state.11

Why are Substance Use Disorders so Common?

Various factors contribute to the prevalence of substance use disorders. Some of the most common among them include:

Cultural Influences

Cultural factors contribute to the widespread presence of substance use disorders. Cultural acceptance of substance use and its glorification normalize addiction behaviors.

Lack of Education and Awareness

Lack of knowledge about the risks of substance use can contribute to its commonality. Insufficient education may lead people to unknowingly engage in risky behaviors.

Availability and Accessibility

Easy access to substances increases the risk of experimentation and subsequent addiction. The widespread availability of drugs can make them more appealing. This makes it difficult to resist for people already susceptible to substance use disorders.

Use of Prescription Drugs

The use of prescription drugs has also contributed to the rise of substance use disorders. Prescription drugs are often meant to reduce pain, but a person can become dependent on them, leading to addiction.

Marketing and Advertising

Influence from marketing and advertising contributes to substance use disorders. The promotion of drug use in various forms can create a positive image of substance consumption. Children and adolescents, in particular, can be affected by this.

Treatment Programs for Substance Use Disorders

Continuum Outpatient Center offers several treatment programs for SUDs. Our aim is to help people overcome addiction and achieve long-term recovery.
Below is a brief description of these programs:

Partial Hospitalization Program (PHP)

The PHP at Continuum Outpatient Center is a highly structured treatment program. It combines intensive therapy and support with the flexibility of returning home in the evenings. This program is designed for people who may not need 24/7 supervision but still need a high level of care.

Participants attend therapy sessions and group activities during the day. They often stay for six to eight hours, then return home at night. The PHP provides a structured environment for them to address their substance use disorders. In addition, they can maintain their personal responsibilities and relationships.

Intensive Outpatient Program (IOP)

The IOP offered at Continuum Outpatient Center is a step-down program from the PHP. This program provides a comprehensive treatment experience while allowing participants to continue with their daily routines and responsibilities.

The IOP offers a combination of individual therapy, group counseling, and educational sessions. The aim is to focus on relapse prevention, coping skills, and addiction recovery. Those attending the IOP often attend sessions for 3-4 hours multiple times a week.

This provides ongoing support and guidance throughout their recovery journey.

Drug Rehab Aftercare

Continuum Outpatient Center understands the importance of continued support. Our drug rehab aftercare program aims to provide ongoing support and guidance to alumni.
This program includes weekly meetings, relapse prevention strategies, and ongoing education. The goal is to help people establish healthy coping mechanisms to maintain long-term recovery.

Therapeutic Interventions Used to Treat Substance Use Disorders

Therapeutic interventions are an essential part of the substance use disorder treatment process. Some of the most common among them include:

Cognitive Behavioral Therapy (CBT)

CBT is a helpful approach for substance use disorders. It focuses on changing negative thoughts and behaviors related to addiction. People work with a therapist to identify and challenge irrational beliefs. They learn healthier coping strategies for managing stress and solving problems.

Dialectical Behavioral Therapy (DBT)

DBT combines CBT with mindfulness techniques to address substance use disorders. It emphasizes:
  • Emotional regulation
  • Effective communication
  • Distress tolerance
  • Mindfulness
By understanding their emotions, people can manage cravings and reduce impulsive behavior.

What is DBT?: A Closer Look

Experiential Therapy

Experiential therapy uses hands-on techniques to address substance use disorders. Activities like art therapy, music therapy, or outdoor recreation are involved.
This therapy helps people explore their emotions and express themselves in healthier ways. Experiential therapy promotes self-discovery, personal growth, and general well-being.

Medication Assisted Treatment (MAT)

MAT combines medications with therapy to treat substance use disorders. Medications like methadone, buprenorphine, or naltrexone are used in MAT. The aim is to ease withdrawal symptoms, reduce cravings, and restore brain function.

Dual Diagnosis Treatment

Dual diagnosis treatment acknowledges substance use disorders and mental health conditions like depression or anxiety occurring together. This approach treats both conditions at the same time. By doing so, people can recover long-term and improve their mental well-being.


Meditation, a mindfulness practice, benefits those with substance use disorders. By focusing and staying present, they can build resilience and enhance emotional well-being. Meditation helps manage cravings, improve control, and promote mental clarity. Regular meditation also supports recovery.

Post-Traumatic Stress Disorder (PTSD) Therapy

Many people with substance use disorders also have symptoms of PTSD. Specialized therapy for PTSD can help them heal from traumatic experiences.

These therapies address the underlying trauma that often contributes to substance use. They provide people with the tools to process and manage their traumatic memories, thus mitigating the need for substance misuse as an unhealthy coping mechanism.

What to Expect From SUD Treatment

Recovering from SUD can be a challenging journey. However, with the right support and commitment, people can find hope and transform their lives.
Here is a detailed overview of what to expect during the process of SUD treatment:

Assessment and Evaluation

At the beginning of SUD recovery, doctors will carefully evaluate the patient. They’ll check the seriousness of substance use and any mental health issues. The team will ask questions about history, substance use habits, and support from friends and family.

Individualized Treatment Plan

Depending on the assessment, a personalized treatment plan will be made. This plan considers specific needs and goals.
It may include:
  • Detoxification
  • MAT
  • Counseling
  • Other assistance 


For severe addiction, detoxification might be needed to handle withdrawal safely. Medical professionals will supervise and give support during this process. They may also provide medicine to ease withdrawal symptoms and make patients more comfortable.

Therapy and Counseling

Therapy and counseling are important for recovering from substance use disorders. During therapy, people will participate in different types of sessions, such as:
  • Individual counseling
  • Group therapy
  • Family therapy

Education and Skill Building

Learning about addiction is crucial for SUD recovery. People in recovery will receive educational resources and take part in workshops or classes.
These resources provide information about:
  • Addiction
  • How to prevent relapse
  • Developing important life skills

Supportive Services

Recovering from SUD often requires more than just therapy. Support groups, like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), offer a sense of community.
These meetings bring together people who are facing similar challenges. This allows them to share their experiences and support each other. Peer support is an important part of SUD recovery.

Continued Care and Aftercare

SUD recovery is a lifelong journey, and ongoing care and support are important. Aftercare services may include:
  • Outpatient therapy
  • Programs to help prevent relapse 
  • Weekly alumni meetings
Substance Use Disorders

How Can Continuum Outpatient Center Help?

Continuum Outpatient Center in San Antonio, Texas, provides invaluable help for those struggling with substance use disorders and/or mental health challenges. With a team of dedicated professionals, we are committed to helping people in their journey towards recovery.
Here’s how:

Tailored Treatment Plans

We create personalized treatment plans based on each person’s unique needs. Our team of experts assesses the challenges and goals of each person in detail. By tailoring the treatment plan for every client, we can provide targeted care to increase the chances of successful recovery.

Relapse Prevention Strategies

Preventing relapse is crucial in the recovery journey. At Continuum Outpatient Center, we equip people with skills to maintain sobriety. Through educational sessions, coping mechanisms, and relapse prevention planning, they learn how to handle triggers and challenges in their daily lives.

Holistic Approach

We understand that substance use disorders affect various aspects of a person’s life. Therefore, we take a holistic approach to treatment at our center.

We address physical, mental, and emotional well-being through integrated care. We also offer complementary therapies like yoga and mindfulness practices to support overall healing and well-being.

Family Involvement and Support

We believe involving families and loved ones is vital in the recovery process. That’s why our center offers family therapy sessions. We help families understand addiction, develop healthy communication patterns, and provide a strong support system for their loved ones.

Begin Your Recovery from Substance Use Disorders With Continuum Outpatient Center

Take the first step toward healing from substance use disorders today. Our dedicated team and tailored programs are here to support your journey to a healthier, addiction-free life.
Reach out to Continuum and embrace a brighter, substance-free future. We’re here to help you heal.

Questions About Treatment?

Reach out to our knowledgeable and compassionate Continuum Outpatient Center team for the guidance and support you need for sustainable recovery. We’re here to help you build a foundation for long-term happiness, wellness, and healing.