substancedependent

Substancedependent is a term used to describe a state in which an individual shows signs of dependence on a psychoactive substance. It denotes a pattern of chronic, compulsive use accompanied by tolerance, withdrawal, and a persistent desire or inability to cut down, despite adverse consequences.

In modern diagnostic frameworks such as the DSM-5, these patterns are captured under Substance Use Disorder (SUD). SUD is defined by a set of 11 criteria across impaired control, social impairment, risky use, and pharmacological indicators like tolerance and withdrawal. The number of criteria met determines severity: mild (2–3), moderate (4–5), or severe (6 or more). The older separate diagnoses of “substance dependence” and “substance abuse” have been consolidated into the single SUD category, with the emphasis on dependence now understood within that broader spectrum.

Common substances that can lead to substancedependent patterns include alcohol, opioids, cannabis, cocaine, methamphetamine, sedatives, and nicotine. Dependence can occur with a single substance or multiple substances (polysubstance dependence). The course and prognosis vary, and co-occurring mental health disorders are common, necessitating integrated treatment.

Treatment typically involves a combination of pharmacological and psychosocial approaches. Medications may include methadone or buprenorphine for opioid use disorder, naltrexone or acamprosate for alcohol use disorder, and nicotine replacement or varenicline for tobacco. Psychosocial therapies such as cognitive-behavioral therapy, motivational interviewing, and contingency management, along with structured rehabilitation and ongoing recovery support, are central components. Effective care is usually individualized and may require long-term management to address withdrawal, cravings, and social determinants.