The DSM-5 is a diagnostic manual used by medical and mental health professionals. It lays out specific criteria for identifying Substance Use Disorders, helping replace shame and guesswork with clarity and direction. Having language for what you are experiencing can be grounding. It turns something that feels overwhelming into something that can be named, understood, and treated.
The DSM-5 helps provide clarity. It offers a clear, research-backed way to understand when substance use becomes a disorder, how severe it has become, and what kind of support may be most helpful.
If you or someone you love has been wondering where they stand, understanding the DSM-5 framework can be an important step toward change.
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What Is a Substance Use Disorder?
A Substance Use Disorder (SUD) is a medical condition that affects the brain and behavior, making it difficult to control substance use even when it causes harm. This can involve alcohol, opioids, stimulants, benzodiazepines, cannabis, or any other substance that alters mood or functioning.
SUD is not a character flaw or moral failure. It is not a sign that someone is weak or broken. It is a condition rooted in changes in brain chemistry, stress response, emotional coping, and physical dependency. With the right support, it is treatable.
How the DSM-5 Defines Substance Use Disorder
The DSM-5 outlines 11 criteria to determine whether someone meets the diagnosis of a Substance Use Disorder. These criteria look at patterns of use, emotional dependence, physical dependence, and functioning in daily life.
A person must meet at least two of these criteria within a 12-month period to be diagnosed. The more criteria present, the more severe the disorder is considered.
This framework is not meant to label someone. It is meant to understand the level of support that will be most effective. Even mild symptoms deserve care and attention. Early intervention can prevent the disorder from becoming more severe.
The 11 DSM-5 Criteria for Substance Use Disorder
Below are the 11 indicators clinicians look for when diagnosing a Substance Use Disorder. They are grouped into clusters so the concepts are easier to understand.
1. Using More Than Intended
This is when someone sets limits but repeatedly goes past them, almost without realizing it. They may say, “I’ll only use a little” or “Just for tonight,” only to find themselves continuing longer than planned. It reflects changes in impulse control and reward pathways in the brain.
2. Unsuccessful Attempts to Cut Down
A person may genuinely want to quit or reduce use and may have tried several times. The desire is real, but the brain and body have adapted to the substance, making change extremely difficult without proper support.
3. Spending Significant Time on Substance Use
This includes obtaining the substance, using it, recovering from effects, or planning around use. The substance gradually takes up space in a person’s schedule and mental energy, often without them realizing how much.
4. Cravings
Cravings are intense urges that feel physical and emotional. They are not simply “wants.” They can interrupt concentration, mood, and decision-making, and they often feel like the only way to get relief is to use.
5. Problems Fulfilling Responsibilities
This can show up at work, school, caregiving, or home life. Deadlines slip. Classes get skipped. Motivation drops. Tasks pile up. Someone may feel frustrated with themselves, not understanding why they can’t “just get it together.” It’s because the brain is prioritizing the substance.
6. Continued Use Despite Relationship Conflict
Conflicts with partners, friends, coworkers, or family members may become more frequent. Loved ones might express worry, frustration, or concern. Even when relationships feel strained or painful, the pull of the substance can still feel stronger. This is not about not caring; it reflects how dependency overrides emotional priorities.
7. Loss of Interest in Activities Once Enjoyed
Things that used to bring joy, creativity, social connection, or fulfillment may start to fade into the background. Someone may begin to withdraw from hobbies, sports, passions, or community. The substance gradually replaces those sources of meaning and becomes the main way to cope, relax, or escape.
8. Using in Physically Hazardous Situations
This includes drinking and driving, mixing substances, using alone in unsafe environments, or operating machinery or vehicles while impaired. Even smart, thoughtful, responsible people fall into this when dependence develops. The need to use becomes urgent, overshadowing safe decision-making in the moment.
9. Continued Use Despite Physical or Mental Health Issues
Someone may notice anxiety worsening, depression deepening, sleep getting disrupted, or medical symptoms increasing. They may even receive medical advice to stop using but feel unable to do so. The substance has become tied to emotional regulation, so stopping feels overwhelming even when harm is clear.
10. Tolerance
Over time, the body adjusts to the substance, requiring higher amounts to achieve the same effect. This isn’t about chasing a high—it’s the brain recalibrating around the substance’s presence. Tolerance is one of the clearest signs that physical dependence is forming.
11. Withdrawal
When someone reduces or stops use, the body reacts. Withdrawal symptoms vary depending on the substance, but may include anxiety, irritability, shaking, nausea, sweating, muscle aches, insomnia, depression, or even dangerous medical complications.
Withdrawal is a major reason many people continue using, not because they want to, but because they’re trying to avoid feeling sick.
Levels of Severity Based on DSM-5
Once the criteria have been reviewed, clinicians determine severity:
- Mild: 2–3 symptoms
- Moderate: 4–5 symptoms
- Severe: 6 or more symptoms
Severity is not about how “bad” someone is struggling. It simply helps determine what level of care will offer the most support. Someone with mild symptoms may benefit from therapy and peer support.
Someone with moderate or severe symptoms may need structured treatment such as detox, residential care, or intensive outpatient programming.
Why Understanding the DSM-5 Matters
Understanding the DSM-5 framework helps shift the conversation from blame to care. It allows individuals and families to recognize patterns sooner and seek support before hitting a crisis point.
It also provides something equally important: evidence that recovery is possible. People recover from Substance Use Disorders every single day. The brain can heal.
Coping skills can grow. Life can become fuller and steadier again. Getting help is not admitting defeat. It is choosing to step into the rest of your life.
How Peachtree Recovery Solutions Can Help
Peachtree Recovery Solutions offers compassionate, evidence-based treatment for individuals in Atlanta and throughout Georgia who are seeking support with substance use and mental health. Our programs are designed to meet people where they are, offering:
- Medical detox
- Residential Treatment
- Partial Hospitalization Programs (PHP)
- Intensive Outpatient Programs (IOP)
- Evening IOP
- Dedicated Programs for Women and Men
- Dual Diagnosis treatment
- Individual and group therapy
- Family support and family support groups
- Aftercare and Sober Living
Our approach is rooted in respect. Recovery looks different for every person. Some people need structure and accountability. Others need trauma-informed care and emotional support. Many need both. We take the time to understand the whole person, not just the symptoms.
Substance Use Disorder Treatment in Atlanta, Georgia
If any of the DSM-5 criteria resonated with you, it may be time to talk with someone who understands. You do not have to have everything figured out before reaching out. You do not have to know how to explain everything. You do not have to be “ready” in a perfect way.
You just have to be willing to take the next step. Healing is possible. And you deserve it.
Call us now at 678-325-7250 or verify your insurance now.