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Substance use disorder (SUD) is a chronic condition involving compulsive use of a substance despite harmful consequences, characterized by loss of control over use and continued use despite adverse effects.
Quick Answer
Substance use disorder (SUD) is a chronic condition involving compulsive use of a substance despite harmful consequences, characterized by loss of control over use and continued use despite adverse effects. Dr. Ruja Shrestha (NMC 19766, Experienced clinical practice in psychiatry and mental health) evaluates substance use disorder at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, Opposite of Yak & Yeti Hotel, Kathmandu 44600, Nepal — evidence-based, medically reviewed.
SUD involves a pattern of substance use leading to clinically significant impairment or distress. It is defined by a cluster of cognitive, behavioral, and physiological symptoms indicating continued use despite harm. The condition involves neuroadaptive changes in brain reward, motivation, and memory circuits. SUDs are classified by severity (mild, moderate, severe) based on the number of diagnostic criteria met. Evidence-based management includes pharmacotherapy, behavioral therapies, and mutual-support programs.
Diagnosis is clinical, based on DSM-5 or ICD-11 criteria: a pattern of use leading to impairment or distress, as evidenced by at least two of the specified symptoms within a 12-month period. Severity is classified as mild (2-3 criteria), moderate (4-5 criteria), or severe (6 or more criteria). Biological markers (liver function, blood alcohol levels) may support diagnosis. Screening tools include AUDIT, DAST-10, and CAGE-AID.
Pharmacotherapy varies by substance: naltrexone and acamprosate for alcohol use disorder; buprenorphine and methadone for opioid use disorder; nicotine replacement and varenicline for tobacco use disorder. Behavioral therapies (contingency management, CBT, motivational interviewing) are effective across substances. 12-step facilitation and mutual-support groups (AA, NA) provide ongoing recovery support. Treatment should address co-occurring psychiatric conditions simultaneously.
Management is individualized and discussed with benefits, limitations, and follow-up.
Education about substance use risks, limiting access to substances, addressing risk factors (adverse childhood experiences, mental health conditions), and early intervention for problematic use. School-based and community prevention programs can reduce initiation of substance use among youth.
SUD is a chronic medical condition involving changes in brain circuits related to reward, stress, and self-control. While initial use may be voluntary, continued use alters brain function, making stopping difficult without support.
Medication options depend on the substance. For alcohol: naltrexone, acamprosate, disulfiram. For opioids: buprenorphine, methadone, naltrexone. For tobacco: nicotine replacement, varenicline, bupropion. These medications are evidence-based and reduce relapse risk.
SUD is a chronic condition. Short-term acute treatment (detoxification, stabilization) may take days to weeks. Long-term maintenance treatment, including ongoing therapy and medication, may last months to years. Recovery is an ongoing process.
Yes � Dr. Jitendra Prasad Yadav (NMC 8029) provides SUD assessment and treatment at Kathmandu Neurology Clinic & Cognitive Center.
Dual diagnosis refers to the co-occurrence of SUD and another psychiatric condition (depression, anxiety, PTSD, bipolar disorder). Integrated treatment addressing both conditions simultaneously produces better outcomes.
Comprehensive psychiatric evaluation for mood, anxiety, psychosis, and other mental health concerns, including medication assessment and long-term care planning.
Structured, evidence-based cognitive behavioral therapy for anxiety, depression, insomnia, and related conditions.
Evaluation and treatment for major depressive disorder, persistent depressive disorder, and depressive episodes associated with medical conditions.
Generalized anxiety disorder (GAD) involves persistent, excessive worry about everyday matters that is difficult to control and may cause physical symptoms.
Major depressive disorder (MDD) is a common mood disorder characterized by persistent sadness, loss of interest, and a range of emotional and physical symptoms that impair daily functioning.
Post-traumatic stress disorder (PTSD) develops after exposure to a traumatic event and is characterized by intrusive memories, avoidance, negative alterations in cognition and mood, and hyperarousal.
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Content on this website is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified healthcare professional. Always seek the advice of your physician or other qualified provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. In case of a medical emergency, contact emergency services immediately. No doctor–patient relationship is established by use of this site or by contacting the clinic through the site.
Reviewed by Dr. Jitendra Prasad Yadav • Last reviewed: 2026-09-04
Content is educational and aligns with standard medical references; individual evaluation may vary. External links provide context and do not imply endorsement.
Doctor — medically reviewed
Dr. Ruja Shrestha
Consultant Psychiatrist & CBT Therapist • MBBS, MD (Psychiatry) • NMC 19766
This condition guide was medically reviewed by Dr. Ruja Shrestha.
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