The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) no longer uses the terms "substance abuse" and "substance dependence." Rather, it refers to substance use disorders, which are defined as mild, moderate, or severe. The level of severity is determined by the number of diagnostic criteria met by an individual.
Substance use disorders are conditions where people use substances in harmful ways that interfere with their lives. According to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), substance use disorders are patterns of symptoms resulting from the use of a substance that you continue to take, despite experiencing problems as a result.
A substance use disorder (SUD) is a chronic brain disease, and like other chronic diseases it involves:
Periods of recovery
Periods of relapse
Medication and behavior change needed to manage and treat the disease
SUD Symptoms
The DSM-5 identifies 11 criteria (symptoms) in 4 categories as shown below.
Impaired Control |
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Social Impairment |
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Risky Use |
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Tolerance & Withdrawal |
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Food addiction is a term that is used to describe a pattern of eating consumption and behaviors with the same criteria for substance use disorder.
According to the DSM-5-TR, substance use disorder is diagnosed when a person meets at
least two of the following 11 criteria within a 12-month period:
Taking the substance in larger amounts or for longer than you're meant to
Wanting to cut down or stop using the substance but failing to
Spending a lot of time getting, using, or recovering from substances
Intense cravings and urges to use the substance
Failing to carry out important roles at work, home, or school because of substance use
Continuing to use the substance even when it causes problems in relationships
Giving up important social, occupational, or recreational activities because of substance use
Using substances again and again, even when it puts you in danger
Continuing to use the substance even when you know you have a physical or psychological problem that could have been caused or made worse by the substance
Needing more of the substance to get the effect you want (tolerance)
Development of withdrawal symptoms, which can be relieved by taking more of the substanceSeverity of Disorder
The severity of the disorder is determined by the number of criteria met
two or three symptoms indicate a mild disorder,
four or five symptoms indicate a moderate disorder, and
six or more symptoms indicate a severe disorder.
The prevalence of substance use disorders is similar to that of other chronic diseases.
8.1% of the US population aged 12 and over has a substance use disorder.*
9.3% of the US population has diabetes.*
7.7% of the US population has asthma.***
29% of American adults have high blood pressure.****
NIDA. "Preface." National Institute on Drug Abuse, 30 May. 2023, https://nida.nih.gov/research-topics/addiction-science/drugs-brain-behavior-science-of-addiction https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction
* Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf
**2014 National Diabetes Statistics Report. Centers for Disease Control and Prevention Web site. https://www.cdc.gov/diabetes/data/statistics/2014StatisticsReport.html
*** National Current Asthma Prevalence (2015). Centers for Disease Control and Prevention Web site. https://www.cdc.gov/asthma/most_recent_data.htm
****High Blood Pressure Facts. Centers for Disease Control and Prevention Web site. https://www.cdc.gov/bloodpressure/facts.htm. Updated November 30, 2016