Substance use disorder

Substance use disorder (SUD) is the persistent use of <a href="/facts/Drugs/FFFUI9n4">drugs</a> despite substantial harm and adverse consequences to self and others. Related terms include substance use problems and problematic drug or alcohol use. 
Substance use disorders vary with regard to the average age of onset. It is not uncommon for those who have SUD to also have other mental health disorders. Substance use disorders are characterized by an array of mental, emotional, physical, and behavioral problems such as chronic <a href="/facts/Guilt_(emotion)/k59guS0M">guilt</a>; an inability to reduce or stop consuming the substance(s) despite repeated attempts; <a href="/facts/Drug%25E2%2580%2593impaired_driving/5qqd8JuQ">operating vehicles while intoxicated</a>; and physiological <a href="/facts/Drug_withdrawal/lGr6VEBU">withdrawal</a> symptoms. Drug classes that are commonly involved in SUD include: alcohol (alcoholism); <a href="/facts/Cannabis_(drug)/241fYAGD">cannabis</a>; <a href="/facts/Opioid/EGnE2x99">opioids</a>; <a href="/facts/Stimulant/nmBdAXM5">stimulants</a> such as <a href="/facts/Nicotine/VQ6HcIrY">nicotine</a> (including tobacco), <a href="/facts/Cocaine/rdQP4zwF">cocaine</a> and <a href="/facts/Substituted_amphetamine/KlmrodPb">amphetamines</a>; <a href="/facts/Benzodiazepine/IgbJr4jy">benzodiazepines</a>; <a href="/facts/Barbiturate/d3PhtK8b">barbiturates</a>; and other substances.
In the <a href="/facts/Diagnostic_and_Statistical_Manual_of_Mental_Disorders/pJ29wFmm">Diagnostic and Statistical Manual of Mental Disorders</a>, 5th edition (2013), also known as <a href="/facts/DSM-5/kwhcSJcg">DSM-5</a>, the DSM-IV diagnoses of <a href="/facts/Substance_abuse/e3jLXFsF">substance abuse</a> and <a href="/facts/Substance_dependence/x9qrReh4">substance dependence</a> were merged into the category of substance use disorders. The severity of substance use disorders can vary widely; in the DSM-5 diagnosis of a SUD, the severity of an individual's SUD is qualified as mild, moderate, or severe on the basis of how many of the 11 diagnostic criteria are met. The <a href="/facts/International_Classification_of_Diseases/mxID6rJp">International Classification of Diseases</a> 11th revision (<a href="/facts/ICD-11/AAItcoCH">ICD-11</a>) divides substance use disorders into two categories: (1) harmful pattern of substance use; and (2) substance dependence.
In 2017, globally 271 million people (5.5% of adults) were estimated to have used one or more illicit drugs. Of these, 35 million had a substance use disorder. An additional 237 million men and 46 million women have <a href="/facts/Alcohol_use_disorder/KGPzpChp">alcohol use disorder</a> as of 2016. In 2017, substance use disorders from illicit substances directly resulted in 585,000 deaths. Direct deaths from drug use, other than alcohol, have increased over 60 percent from 2000 to 2015. Alcohol use resulted in an additional 3 million deaths in 2016.

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Substance use disorder