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What are the symptoms of substance use disorders?1

Substance use disorders center around a dependence on drugs and alcohol that compromises a client’s ability to work and form relationships. It is characterized by prolonged use, unsuccessful efforts to quit, excessive time recovering from the effects, and a life that is centered around use. Priorities reverse, with family, education, work, and health taking a back seat. As the condition progresses, the client builds up a tolerance, requiring more and more of the substance to get the same effect causing changes to the circuitry of the brain. Efforts to quit may be met with debilitating or dangerous withdrawal symptoms, and may require inpatient detoxification and treatment.

How common are substance use disorders?

Alcohol use disorder is common in the United States, affecting about 9 % of men and about 7.5% of women2. Opioid use disorder 12-month prevalence is about .37% of adults, with males slightly more affected than females1. Stimulant use disorder affects about .2% of adults with similar rates between adult men and women, but slightly higher for adolescent females than males1.

What is CBT treatment for substance use disorders like?

For all disorders, the CBT therapist starts by educating clients about their diagnosis, helps them set goals, and socializes them to CBT by teaching essential thinking and behavioral skills. In treating substance use disorders, the CBT therapist may follow-up after the client has completed residential or intensive outpatient treatment. Clients are encouraged to continue with support groups and sponsors as part of their recovery team. The CBT therapist:
  • provides clients a framework to organize their recovery efforts and tools to help prevent relapse
  • works with clients to detail the costs and benefits of use and recovery
  • helps clients identify points of intervention in relapse prevention including strategies to deal with triggers for use, which may consist of negative mood states (anxiety, boredom, depression), interpersonal pressure to use, or interpersonal conflicts
  • helps clients respond to the beliefs and automatic thoughts activated by these triggers
  • teaches how to mindfully observe their urges as they rise and fall
  • provides tools to modify permission-giving beliefs — rationalizations that turn urges into action
  • helps clients circumvent their strategies — to buy time, contact their support system, to eliminate easy access
  • prepares clients to recover if they do have a lapse, to prevent a full-fledged relapse.

For health and mental health professionals

Learn to treat substance use disorders more effectively at our CBT for Substance Use Disorders workshop. 1American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. doi:10.1176/appi.books.9780890425596.744053 2National Institute on Alcohol Abuse and Alcoholism. (2016). Alcohol Facts and Statistics. Retrieved from