Do You Have a Substance Use Disorder?

You may have wondered if you have a problem. Often, the signs are subtle at first. Perhaps you’re drinking more often, or you have to drink more to feel the same buzz. Perhaps your weekend drinking or drug use has escalated to three or four days now instead.

Sound familiar?

Substance use disorder (SUD) is the clinical term used in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The DSM-5 is the handbook clinicians and health care providers use to diagnose SUDs and other psychiatric conditions. According to the DSM-5, SUDs apply to the following 10 drug classes:

  • alcohol
  • caffeine
  • tobacco
  • sedatives, hypnotics, or anxiolytics
  • hallucinogens
  • inhalants
  • cannabis
  • stimulants
  • opioids
  • phencyclidine (PCP) and related drugs
Marijuana by Gras Grun

Diagnostic Criteria for Substance Use Disorders

Therefore, someone with problematic heroin use who meets the DSM’s SUD criteria would be diagnosed with an opioid use disorder, or a heroin use disorder. Likewise, someone with problematic alcohol use who meets the DSM criteria would be diagnosed with an alcohol use disorder. So, opioid use disorder and alcohol use disorder each represent one type of SUD.

The SUD criteria is similar for all drug classes. For example, here is the DSM-5 criteria for alcohol use disorder:

Adapted from the American Psychiatric Association’s DSM-5, 2013

Where to Find Help

If you or a loved one identify with the criteria above, please know you are not alone. Help is available. The first step is to reach out to a substance use counselor or other mental health provider, who can meet with you to conduct an assessment and discuss your options.

Below is a list of recovery resources for families, friends, and people struggling with drugs and alcohol. You can also use the treatment finder tool from the Substance Abuse and Mental Health Services Administration (SAMHSA), which allows you to search providers by ZIP code.

supporting loved ones through mental health and substance use disorders
Support by the National Cancer Institute

Drug and Alcohol Support Resources

Support / Resources for Family and Friends

Crisis Hotlines

This post first appeared on


6 Roles in Addicted Families: Which One Describes You?

Whether alcohol or gambling is the drug of choice, addiction devastates families and creates chaos.

Addiction and codependency expert Sharon Wegscheider-Cruse, Ph.D., identifies six roles in families battling drug and alcohol addiction. She says these roles are not meant to label people but explain how each person copes with the addiction. See below for details.

1. Dependent

The Dependent is the substance user. Fueled by shame, Dependents use substances to self-soothe and numb guilt and other painful emotions.

However, as addiction seizes control, the drug of choice claims center stage, demanding priority over family.

Axel Bueckert,

2. Enabler

In contrast, the Enabler is often the Dependent’s spouse, who caretakes the Dependent through his addiction. Enablers justify and minimize the substance use, often downplaying the severity of the problem.

However, by shielding the Dependent from the consequences of his actions, the Enabler helps maintain the addiction, giving the Dependent no incentive to change.

Unfortunately, some Enablers live in denial until a tragedy forces them to face the truth.

3. Hero

Next, Heroes are often the oldest children, who help the family appear normal to outsiders. For instance, Heroes fulfill the parenting duties as the Dependent sinks deeper into addiction, and the Enabler caretakes him.

Heroes are mature beyond their years, acting as miniature mothers and fathers to their younger siblings. Although Heroes draw their self-worth from handling these adult tasks, they later long for the childhood they missed.

Senjuti Kundu,

4. Mascot

Fourth, Mascots are the family clowns who lighten the family’s mood. Although these spirited children defuse the family’s tension with their antics, their behavior masks their fears.

Mascots gain attention by entertaining others, but they are more fragile than they appear. In addition, Mascots are the most vulnerable family members, whether or not they show it.

Ray Aucott,

5. Scapegoat

Next, the Scapegoat is the identified problem child who shoulders the family’s burdens. Scapegoats often engage in substance use and other risky behaviors to shift the family’s focus away from the Dependent’s substance use.

On the other hand, Scapegoats force the family into action because their rebellion is hard to ignore. Yet, Scapegoats are also more vulnerable than they seem. However, their frustrated family members may fail to recognize the pain driving their behavior.

6. Lost Child

Finally, the Lost Child retreats into her inner world to escape the family chaos. While her siblings try to shift attention to other family members, the Lost Child withdraws into the comfort of solitude instead.

According to author and addiction expert Michael Reiter, Ph.D., this isolation harms mental health and increases depression and suicide risk.

If you or a loved one is struggling with addiction, please see here for resources and support groups.

This post has been adapted from the original, which first appeared on our previous blog, My Recovery Zone, in May 2021.


Center for Growth. (2021). The addictive family system.

Meadows. (2021, August 30). Family roles in addiction and impact on recovery.

Reiter, M. D. (2019). Substance abuse and the family: Assessment and treatment (2nd ed.). Taylor & Francis.


Drug and Alcohol Addiction Support: Where to Find Help

If you or a loved one is struggling with a drug or alcohol problem, please know you aren’t alone. Below is a list of resources to help individuals and families battling addiction.

Drug and Alcohol Support for Individuals

  • Alcoholics Anonymous: This twelve-step group supports individuals through recovery from alcoholism. Visit the website to search for in-person and online meetings.
  • Narcotics Anonymous: This twelve-step group supports individuals battling narcotic drug addiction. Search the website for in-person and online meetings.
  • National Council on Alcoholism and Drug Dependence (NCAAD): 1-800-622-2255. Call this confidential help line to receive referrals and treatment resources near you.
  • SMART Recovery : This non-12-step recovery community teaches evidence-based relapse prevention techniques and offers meetings nationwide. Also visit the website to find in-person and online meetings, along with a wealth of recovery resources for individuals and loved ones.
  • SAMHSA’s Treatment Finder: Search providers by ZIP code or address. Go to the home page, and enter an address or ZIP code. Then, in the box at the top right, search for facilities within a specified distance. Under “Service,” check all boxes that apply. For instance, check “Substance Use,” “Mental Health,” or “SU & MH” to search facilities that offer one or both types of services.

Resources for Loved Ones

  • Al-Anon: This twelve-step community supports friends and families through their loved ones’ alcohol use. Connect with the community and learn how to practice self-care. Also search the website to find in-person and online meetings.
  • Nar-Anon Family Groups: This twelve-step community supports friends and families through their loved one’s drug use. Meetings available in person or online.

Crisis Helplines

Please reach out if you have questions or need help finding other resources: