If you have a friend or loved one with an alcohol or drug use problem – or you have an alcohol or drug use problem yourself – then over the past few years, you’ve probably noticed a change in the way we talk about drug use, and addiction treatment. We’ve also changed the way we talk about addiction and addiction symptoms.
That’s because – over the past few decades – we’ve learned that the words we use to talk about these subjects matters. The words matter in real, practical ways that may not be readily apparent.
First, we’re moving away from the word addiction.
There’s nothing inherently wrong with the word itself. However, when mental health experts revised the Diagnostic and Statistical Manual of Behavioral Disorders (DSM) and replaced the fourth edition (DSM-IV) with the new, fifth edition (DSM-V), they removed it – along with several other outdated phrases – and replaced it with a phrase that aligns with our new, 21st century concept of alcohol and drug use and misuse.
This new concept is known as the medical model, and it’s characterized by two things: viewing the misuse of alcohol and drugs as a chronic medical condition, and using person-first language to describe people who meet the diagnostic criteria for this medical condition.
Here’s what we mean.
With regards to alcohol, we no longer say alcoholic or alcohol abuser or drunk to talk about a person whose alcohol use meets clinical criteria for the medical condition designated by the DSM-V as alcohol use disorder (AUD).
We say a person with an alcohol use disorder.
With regards to illicit drugs and substances of misuse, we now follow a similar pattern. We’ve abandoned words like addict or druggie or junkie to describe a person whose alcohol or substance use meets clinical criteria for the medical condition designated by the DSM-V for alcohol or substance use disorder (SUD).
We say a person with a substance use disorder.
We mention above that the words we use to talk about people with AUD and/or SUD matter in real and practical ways.
We’ll explain what we mean by that now.
Alcohol Use Disorder, Substance Use Disorder: Why These Words Matter
How we talk about things reflects how we think about things. And how we talk about people reflects how we think about people. The old language – addiction, addict, drunk, alcoholic, drug abuser, and others – belong to a time when the disordered use of substances was misunderstood by virtually everyone, including treatment professionals and the people who engaged in the disorder use of substances.
That was a time – not long ago at all – when a majority of people believed addiction symptoms or alcoholism were the result of a character flaw, a moral deficit, poor decision-making, or a simple lack of willpower. People who’d never experienced these conditions thought people with them could simply suck it up and decide to quit. And if they couldn’t, then it was because they lacked something – moral character, strength of will, or the determination to stop using alcohol or drugs.
The prevalence of those beliefs led to stigmatizing people who misused alcohol or drugs or showed symptoms of addiction. This stigmatization caused harm on a level it’s difficult to quantify. Individuals with AUD or SUD feared judgment and ostracization. They feared the judgment of their family and friends, which caused them to keep their AUD or SUD private and prevented them from seeking treatment. If they entered rehab, or treatment of any kind, or even went to community support meetings like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), they often kept it a secret not only from family and friends, but from coworkers and bosses, for fear of losing status, losing respect, and – in real, practical terms – losing their jobs.
In some cases, people who decided against seeking any type of treatment or support experienced an escalation in their disordered use of substances. We can assume some experienced the worst possible consequences: permanent disability or death.
That’s why words matter.
Defining Alcohol and Substance Use Disorder
A quick disclaimer.
You’ll see the word addiction in various places on our website. We still use this word – begrudgingly – because we know that not everyone will use the internet to search for “treatment for SUD.” Despite the progress we’ve made around the relationship between language and stigma, we understand most people are more likely to search for things like “drug addiction treatment” or “rehab for alcoholism” than they are for “SUD treatment.”
When they get here, however, they’ll learn by reading our primary website content and our blogs that we put people first, starting with the language we use, exactly as we describe above.
Now let’s get to that definition.
Here’s how the Substance Abuse and Mental Health Services Administration (SAMHSA) defines substance use disorder:
“Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home.”
Another disclaimer: you may have noticed the word abuse in the name SAMHSA. This is an example of how we, as a society, perpetuated stigma from the top down. However, this will change soon. The new National Drug Control Strategy released in 2022 by the Office of National Drug Control Policy (ONDCP) includes the following changes for 2023:
- The Substance Abuse and Mental Health Services Administration will become the Substance Use and Mental Health Services Administration
- The National Institute on Alcohol Abuse and Alcoholism will become the National Institute on Alcohol Effects and Alcohol-Associated Disorders
- The National Institute on Drug Abuse will become the National Institute on Drugs and Addiction
That’s important, because it demonstrates the revolution in AUD/SUD treatment – which began at the ground level, in treatment centers like ours – made an impact. These changes will guide the way we think, talk, and treat people with SUD.
Now let’s learn more about how we define AUD and SUD.
Diagnosing Substance Use Disorder and Alcohol Use Disorder
While the basic definition of SUD describes the need to acquire and use certain drugs, despite negative outcomes, clinicians use additional criteria to identify the presence of SUD. These criteria include the following.
Diagnosing AUD and SUD: Clinical Criteria
(Addiction and Addiction Symptoms)
- Inability to discontinue substance use when attempting to discontinue use
- Using more alcohol/substances for longer periods of time than planned
- Using more of the same substance or alcohol to achieve the same effect
- Experiencing intense cravings for alcohol/substances
- Using significant energy and time to obtain and use alcohol/substances
- Continued alcohol/substance use despite negative consequences on family, romantic, and peer relationships
- Continued alcohol/substance use despite negative consequences that impair work or academic achievement
- Use of alcohol/substances to prevent experiencing the symptoms of withdrawal
- Continued use of alcohol/substances despite risky and dangerous behavior associated with alcohol/substance use
Those are the diagnostic criteria clinicians use to arrive at a diagnosis of AUD or SUD, while this next list includes the most common signs and symptoms of AUD or SUD.
AUD and SUD: Common Signs and Addiction Symptoms
- Sudden decline in work or academic performance
- Unexplained financial problems
- Lying or covering up alcohol or drug use
- Withdrawing from family and friends
- Declining or completely ceasing participation in favorite activities
- Sudden loss or gain of weight with no medical explanation
- Changes in sleep: far more or less than usual
- Decrease or increase in appetite
- Extreme personality changes
- Uncharacteristic risky behavior
If you recognize the signs and symptoms above in yourself, a friend, a family member, or someone you love, we encourage you or them to seek a full biological, psychological, and social evaluation – called a biopsychosocial assessment – administered by a licensed and experienced mental health professional. Only a trained professional can offer a diagnosis and make a recommendation for treatment. The information we offer here is to help you understand AUD/SUD, and encourage you to seek professional help if what we share leads to the realization that you, a friend, or a loved one may need to arrange an assessment.
Common Drugs of Misuse and/or Disordered Use
If you meet the clinical criteria for AUD/SUD, you’re not alone – and neither are your friends, family members, or other loved ones if they meet the clinical criteria for SUD. When we say you’re not alone, it’s not an empty platitude. It’s a statement of fact based on data collected, analyzed, and published by research scientists and mental health professionals.
We’ll list the common drugs of misuse and disordered use in a moment, after we take a moment to share the facts and figures on AUD and SUD in the U.S.
The 2020 National Survey on Drug Use and Health (2020 NSDUH) – published each year by the National Institutes of Health, based on a nationwide survey of around 70,000 people – shows the following data:
- 28,000,000 adults 18 + met clinical criteria for AUD
- 7% received treatment
- 3% received treatment specifically designed for AUD
- 17,000,000 adults 18 + met clinical criteria for SUD
- 14% received treatment for SUD
- 2% received treatment specifically designed for SUD
The difference between the number of people who need treatment for AUD or SUD and the number of people who receive treatment for AUD or SUD is called the treatment gap. The fact that the treatment gap is so large – 93 and 97 percent for AUD, and 86 and 98 percent for SUD – is a significant public health issue. This issue, or problem, takes on greater meaning when we consider this fact: in 2021, over 107,000 people died of drug overdose.
Untreated AUD and SUD is not only associated with increased risk of health problems, family problems, school problems, and work problems, but they’re also associated with increased risk of mortality, i.e. death.
That’s why understanding misuse and disordered use is important. It’s also important to know which drugs or substances may be misused.
Common Drugs of Misuse and Disordered Use
- Opioids, including but not limited to:
- Prescription medications such as oxycodone
- Illegally produced prescription opioids
- Benzodiazepines, including but not limited to:
- Hallucinogens, including but not limited to:
- Mushrooms containing psilocybin
- Nitrous oxide (laughing gas)
- Model airplane/industrial glue
- Amyl nitrate (poppers)
- Other drugs, often called party drugs:
- MDMA, a.k.a. ecstasy
We’ll repeat a statistic we shared above:
In 2021, these drugs and others contributed to almost 110,000 drug overdose deaths in the U.S.
That’s why it’s important to know the facts. And that’s why it’s important to know this additional fact: evidence-based treatment for AUD and SUD can work. By work, we mean when someone with AUD and/or SUD enters treatment, they decrease their risk of the negative consequences of AUD/SUD, and increase their chances of living a life on their own terms, without the use of alcohol or substances.
Evidence-Based Treatment for AUD/SUD: What Works?
Research shows that the most effective treatment for AUD and/or SUD follows an integrated, holistic model that promotes not only abstinence and sobriety, but promotes recovery and reduces the harm associated with AUD and SUD. Integrated treatment helps people diagnosed with AUD or SUD manage addiction and addiction symptoms.
You probably know that abstinence means not using and sobriety means that absence of intoxication of any sort. Here’s what we mean by recovery:
“Recovery is an individualized, intentional, dynamic, and relational process involving sustained efforts to improve wellness.”
This broad, inclusive definition of recovery helps us reach everyone working to reduce or eliminate their alcohol or drug use and build a healthy lifestyle. To participate in the process of recovery, one of the most effective approaches is finding a treatment center that specializes in an integrated, whole-person approach to AUD/SUD treatment. This approach includes:
- If indicated by a professional biopsychosocial assessment, people with opioid use disorder (OUD) can benefit from medication-assisted treatment (MAT) with methadone, buprenorphine, or naltrexone. MAT can help reduce withdrawal and addiction symptoms for people with OUD.
- The science of AUD/SUD
- The science of recovery
- Skill building
- Relationship repair
- Lifestyle changes:
- Healthy eating
- Mindfulness practices:
- Community and peer support:
- Alcoholics Anonymous (AA)
- Narcotics Anonymous (NA)
- Case management and practical support:
- Connecting people in treatment to resources related to housing and employment
- Addressing housing and food instability, i.e. hunger and homelessness
If you think you or someone you love needs integrated, holistic treatment for an alcohol or substance use disorder, you can visit the SAMSHA website and use their treatment locators here, and here. SAMHSA is an excellent resource, and offers user-friendly information on addiction, addiction symptoms, and addiction treatment – and they’re working towards eliminating the word addiction from common use.
You can visit the SAMHSA website, or you can keep reading, and learn about the treatment centers we operate in nine states.
SUD, AUD, and OUD Treatment at Pinnacle Treatment Centers
At Pinnacle Treatment Centers, we offer compassionate care at any level you need. We offer detoxification services, residential treatment programs, partial hospitalization programs, intensive outpatient programs, and outpatient programs. We offer medication-assisted treatment for people with OUD in our Office-Based Opioid Treatment Programs (OBOTS) and certified Opioid Treatment Programs (OTP). Our primary goal is to help people recover from addiction and manage addiction and its symptoms.
In all cases, and at whatever level of treatment you need, we live by this motto:
Any door is the right door.
What that means is that we meet you where you are and offer the level of treatment you’re willing to accept, when and how you’re willing to accept it.
About Pinnacle Treatment Centers
Headquartered in New Jersey, Pinnacle Treatment Centers is a recognized leader in AUD and SUD treatment serving more than 29,000 patients daily in California, Georgia, Indiana, Kentucky, New Jersey, North Carolina, Ohio, Pennsylvania, and Virginia. With more than 120 community-based locations, Pinnacle provides a full continuum of quality care for adult men and women which includes medically-monitored detoxification/withdrawal management, inpatient/residential treatment, partial hospitalization/care, sober living, intensive and general outpatient programming, and medication-assisted treatment (MAT) for opioid use disorder.
Chillicothe Treatment Services
606 Central Center
Chillicothe, OH 45601