How Do I Know if My Substance Use is Problematic?

Lady in field thinking if her Substance Use Is a Problem

When an individual is struggling with a substance use disorder (SUD), the very nature of the disorder can make it difficult to identify if their Substance Use is a Problem.

Many people who struggle with a SUD identify feelings of “powerlessness” over their use and find that their life has become “unmanageable” — this is also described in step one of 12-Step programs like Alcoholics Anonymous [1].

When considering whether or not you may be struggling with a SUD, review the ABC’s of problematic use to see and to see if your substance use is a problem: [1,2]

  1. Inability to consistently Abstain. Despite multiple attempts to stay sober or abstain from use, you continue to use substances.
  2. Impairment in Behavioral control. Substance use occurs more frequently, in larger amounts, and/or for longer durations than you intend. You spend a great deal of time on activities necessary to obtain the substance, use the substance, or recover from the substance’s effects.
  3. Craving or a strong desire or urge to use a substance. Your cravings may be so intense it is difficult to think about anything else.
  4. Diminished recognition of significant problems with your behaviors and interpersonal relationships. You continue to use despite problems with work, school or family/social obligations. This may include things like disagreements with friends or family over usage, repeated work tardiness or absence, poor school performance, neglect of children, or failure to meet household responsibilities.
  5. Experiencing Tolerance or Withdraw. With tolerance, you may notice you need increased amounts of the substance in order to achieve intoxication or the desired effect OR you may notice a markedly diminished effect with continued use of the same amount of the substance. With withdrawal, you may notice physical (for example, shakiness, headache, nausea) and/or psychological (for example, anxiety, sadness, irritability) symptoms. It’s important to note that withdraw symptoms vary based on substance. Another marker of experiencing withdrawal is if you use the same (or a closely related) substance in order to relieve or avoid withdrawal symptoms.
  6. Failure to refrain from using the substance despite the harm it causes. This includes repeated use in physically dangerous situations. For instance, using alcohol or other drugs while operating machinery or driving a car, or having unprotected sex as a result of being under the influence. This also includes repeated use despite it adding to physical or psychological problems. For example, continued cigarette use despite having a respiratory disorder such as asthma or COPD or continued alcohol use despite it worsening depressive symptoms.

If you identify with any of the ABC’s provided above, it may be indicative that substance use Is a problem. A formal assessment by a licensed professional who specializes in SUD will be able to determine whether or not criteria are met for a formal SUD diagnosis. From there, they will be able to recommend a treatment plan to help you overcome problematic use.


1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
2. American Society of Addiction Medication. (2011). Resources: Definition of Addiction. Retrieved from on March 29, 2019.

About the Author:

Chelsea Fielder-JenksChelsea Fielder-Jenks is a Licensed Professional Counselor in private practice in Austin, Texas. Chelsea works with individuals, families, and groups primarily from a Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) framework.

She has extensive experience working with adolescents, families, and adults who struggle with eating, substance use, and various co-occurring mental health disorders. You can learn more about Chelsea and her private practice at

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on April 3, 2019
Reviewed by Jacquelyn Ekern, MS, LPC on April 3, 2019
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About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.