Substance use disorder (SUD) refers to a pattern of substance use—be it nicotine, cannabis, cocaine, or something else—that causes significant impairment or distress to the user. SUD is prevalent and growing in the United States and around the world. People of any age may be at risk for developing a substance use disorder. But exposure to and experimentation with alcohol and drugs usually begins in early adolescence. Many adolescents experiment with substances and then taper down or stop using them. Others continue to advance their drug use, leading to a diagnosable substance use disorder with negative health and social consequences.

The Diagnostic and Statistical Manual of Mental Disorders (fifth edition; DSM-5) is the widely accepted and respected guide to diagnosing psychiatric disorders in the United States. Substance abuse has been recognized in the DSM-5 as a mental health disorder for many years. The manual no longer describes substance abuse and dependence separately but instead globally uses substance use disorder with specifiers to determine the severity of the use.

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