What is the Most Common Type of Substance Use Disorder?

Alcohol use disorder is the most common form of substance use disorder in the United States, driven by widespread legal access and social approval of moderate alcohol consumption. Substance abuse is the medical term used to describe a pattern of using a substance (drug) that causes significant problems or distress. This can include missing work or school, using the substance in hazardous situations, such as driving a car, or causing legal problems related to substances. It can also include continued substance use that interferes with friendships, family relationships, or both.

Substance abuse, as a recognized medical brain disorder, refers to the abuse of illegal substances, such as marijuana, heroin, cocaine, or methamphetamine. It can also refer to the abuse of legal substances, such as alcohol, nicotine, or prescription drugs. Alcohol is the most common legal drug of abuse. Cultural and social factors determine what are acceptable or permitted forms of drug or alcohol use, while public laws determine what type of drug use is legal or illegal.

The question of what type of substance use can be considered normal or acceptable remains controversial. Substance abuse and dependence are caused by multiple factors, including genetic vulnerability, environmental stressors, social pressures, individual personality characteristics, and psychiatric problems. However, it is not always possible to determine which factor has the greatest influence on a person. Signs of substance use disorder include continuously desiring or attempting to reduce or control drug or alcohol use without success; spending a lot of time using, using, or recovering from drug or alcohol use; desiring or having a strong desire to use drugs or alcohol; ongoing drug or alcohol use that interferes with work, school, or home tasks; using drugs or alcohol even with ongoing relationship problems caused by consumption; quitting or reducing activities due to drug or alcohol use; consuming drugs or alcohol on an ongoing basis even if it is causing physical or psychological problems; developing tolerance for drugs or alcohol; and having withdrawal symptoms if you don't use drugs or alcohol. Substance abuse often starts with experimentation. But what begins as occasional drug or alcohol use in social situations can quickly turn into an uncontrollable and dangerous addiction.

The more you drink or use drugs, the more your body adapts to them, leading to greater tolerance and in some cases physical and psychological dependence. Because alcohol is so tightly woven into the fabric of our culture, the line between moderate and heavy drinking can often be blurred. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), moderate consumption is defined as one drink a day for women and two drinks a day for men. Drinking beyond that puts you at risk of developing an alcohol use disorder (AUD), which can lead to significant health complications such as liver disease and wreak havoc on your personal and professional lives. Patients are diagnosed with a specific type of disorder based on the major substance of which they misuse - such as alcohol use disorder, opioid use disorder, stimulant use disorder, marijuana use disorder, sedative use disorder - but many patients diagnosed with SUD misuse more than one type of substance (polysubstance use disorder). Tobacco use disorder is addiction to nicotine in products such as cigarettes, loose-leaf tobacco such as dipping sauces, hookah, and snus bags - this is the most common substance use disorder in the United States. When using medications in the treatment of substance use disorders (SUDs), healthcare providers should not place arbitrary limits on the duration of treatment.

Prevention and treatment specialists can focus their efforts on increasing access to substance use treatment by understanding the number of adults with SUDs and monitoring trends in SUDs. Receiving treatment for substance use provides public health providers with an opportunity to assess the extent of the problem in the United States and plan for substance abuse prevention and treatment scheduling.