Diagnosis and Treatment of Substance Use Disorders

Substance use disorders (SUDs) are complex conditions characterized by the harmful or hazardous use of substances, leading to significant impairment or distress. Diagnosis and treatment of SUDs involve a multi-faceted approach aimed at addressing both the physical and psychological aspects of addiction.


Clinical Assessment:

  • Mental health professionals conduct thorough assessments, considering the individual’s medical history, substance use patterns, and the impact on daily functioning.

Screening Tools:

  • Validated screening tools, such as the Substance Abuse Subtle Screening Inventory (SASSI) or the Alcohol Use Disorders Identification Test (AUDIT), aid in identifying and evaluating the severity of substance use.

Diagnostic Criteria:

  • Diagnosis is based on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Key factors include impaired control, social impairment, risky use, tolerance, and withdrawal symptoms.

Biopsychosocial Approach:

  • Recognizing the interplay of biological, psychological, and social factors helps in understanding the complexity of substance use disorders.

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  • The first step is often medically supervised detoxification, where the body is safely cleared of substances. Medications may be used to manage withdrawal symptoms.


  • Individual or group therapy, including Cognitive-Behavioral Therapy (CBT) and Motivational Enhancement Therapy (MET), helps individuals understand and modify the thoughts, behaviors, and motivations contributing to substance use.

Continued Care:

  • After initial treatment, ongoing care is crucial for relapse prevention. This may involve outpatient counseling, maintenance medications, or participation in support groups.

Medication-Assisted Treatment (MAT):

  • MAT involves the use of FDA-approved medications, such as methadone, buprenorphine, or naltrexone, combined with counseling and behavioral therapies to treat opioid or alcohol dependence.

Inpatient or Outpatient Rehabilitation*:

  • Depending on the severity of the substance use disorder, individuals may undergo residential or outpatient rehabilitation programs offering a structured environment and therapeutic interventions.

Support Groups:

  • Participation in support groups, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), provides a sense of community, shared experiences, and ongoing encouragement.

Holistic Approaches:

  • Addressing co-occurring mental health issues, providing education on lifestyle changes, and involving family in the treatment process contribute to a more comprehensive and effective approach.

Diagnosing and treating substance use disorders requires a tailored and comprehensive strategy. Integrating medical, psychological, and social interventions is essential for addressing the complexities of addiction. Early detection, evidence-based treatments, ongoing support, and a focus on the individual’s unique needs are vital elements in achieving successful outcomes and promoting long-term recovery from substance use disorders.

*For those services not directly offered by clinicians at psychiatric associates of North Carolina, if deemed clinically necessary, providers may choose to provide a referral to trusted local organizations in the area.