How Are Substance-Related Disorders Diagnosed?

Substance-Related Disorders can be split into two different categories – substance-induced disorders, and substance-use disorders.

Substance-Induced disorder refers to a condition that is directly caused by the use of a substance. Therefore, these disorders – like depression or anxiety, have their own diagnostic criteria, albeit with some added criteria connected to substance use.

Substance-use disorders meanwhile are linked to the abuse of a substance. This distinction is important when considering a diagnosis.

What are Substance-Related Disorders?

Substance-Related Disorders: Substance-Related Disorders are a category of conditions which involve any form of substance abuse, substance dependence, and disorders that specifically arise from drug abuse. There are two distinct types of Substance-Related Disorders – Substance-Induced Disorders and Substance Use Disorders. Substance-Induced Disorders refers to the immediate effects (e.g. intoxication) or discontinuation (e.g. withdrawal) of substance use. Substance Use Disorders meanwhile involve the negative consequences that arise from continued use of substances – typically involving addiction.

Background

The first step is to visit a Doctor. A doctor may ask a series of questions regarding the abuse of the substance. Anything discussed will remain confidential.

The impact too of symptoms will be questioned. Questions on a personal history of substance abuse may also be asked – so that the doctor can get a thorough picture of how the substance abuse is affecting an individual.

It is crucial that in order to receive an accurate diagnosis that the patient answers each question truthfully – despite any fear of embarrassment.

A referral to a specialist may follow, if a Doctor believes the symptoms or circumstances warrant further investigation – such as if they suspect a comorbid mental health condition is present.

By getting a full picture of how the substance abuse affects an individual, a doctor can tailor a treatment plan to fit the specific symptoms.

Substance-Induced Disorder Diagnosis

It can be difficult to diagnose a substance-induced disorder – mainly due to the similarity and overlap between symptoms of psychiatric disorders and those seen with intoxication and withdrawal.

For a Substance-Induced Disorder to be diagnosed, the following criteria will first need to be satisfied:

1. The disorder will have developed either during or within a month of substance intoxication or withdrawal.
2. The symptoms of the disorder persist for at least a month following complete cessation of substance use.
3. The symptoms cause an individual distress in multiple contexts
4. There was no trace or underlying symptoms of the disorder prior to substance use.
5. The disorder in question will be known to be potentially caused by the substance that is linked to the onset of the disorder

If the above criteria have all been satisfied, then the individual will also need to satisfy the diagnostic criteria for the psychiatric disorder that has been caused by substance use.

For instance, someone with suspected Substance-Induced Depressive Disorder will need to meet the diagnosis for Depression. Another example would be if someone developed suspected Substance-Induced Bipolar and Related Disorder, they would need to meet the criteria for the diagnosis of Bipolar Disorder, as well as the above.

By adding the extra criteria above, it is possible to distinguish between substance-induced disorders and disorders that have arisen through a different cause. This has important implications for the treatment phase.

Substance Use Disorder

In terms of the actual symptoms, for a Substance Use Disorder to be diagnosed, a patient will generally show at least two of the following symptoms in any given year:

• There is evidence of the individual developing a tolerance to the substance – meaning they require a higher dose of a substance to obtain its anticipated effects.
• There is evidence of withdrawal symptoms – such as the effects on mood, behaviour and health – when consumption of the substance is stopped abruptly, or slightly reduced
• Person uses more of a substance than they had intended upon
• Person is unable to stop using the substance, despite exhibiting a desire to do so.
• The person continues to use the substance despite knowing the harm it does to them, either/both mentally and physically.
• Person has persistent cravings to use the substance.
• The use of the substance causes an individual impairment in multiple areas of their life e.g. work or socially

These symptoms involve the loss of control associated with substance abuse, impairment in life, as well as pharmacological effects.

The more symptoms that are present, the more severe the Substance Use Disorder is considered to be. They are generally rated as follows:

• 2 Symptoms: Mild Substance Use Disorder
• 3-4 Symptoms: Moderate Substance Use Disorder
• 5+ symptoms: Severe Substance Use Disorder

It is important to note that those who experience some of the symptoms through therapeutic use will not be considered to be suffering from a Substance Use Disorder.

Summary

As seen above, diagnostic criteria across the two different categories of substance-related disorders do vary.

The sooner an individual seeks help for their substance-related issues, the better. Substance-Related Disorders are difficult to live with, and also impair the lives of those around the individual. Getting help is crucial.

See Also

1. Substance-Related Disorders: Everything You Need to Know
2. What Are The Different Types of Substance-Related Disorders?
3. What Are The Symptoms of Substance-Related Disorders?
4. What Are The Causes of Substance-Related Disorders?
5. How are Substance-Related Disorders Diagnosed?
6. How Can Substance-Related Disorders be Treated?
7. What is the Prognosis for Substance-Related Disorders?
8. 10 Tips for Living With Substance-Related Disorders