Do I have an Alcohol or Substance Use Disorder?
The American Psychiatry Association uses criteria from a research manual known as the DSM-5 to diagnose substance-use disorders. The DSM-5 recognizes 10 separate drugs: alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, anxiolytics, stimulates (including methamphetamine and cocaine), tobacco and other/unknown substances.
It is important to note that substance use disorder is no longer determined by an individual’s involvement with local courts or law enforcement, legal history, arrest history or amount of time spent in jail or prison. Criteria used to diagnose substance use disorders are determined by a qualified medical professional and may be identified by the following:
- Taking the substance in larger amounts or for longer than you’re meant to.
- Wanting to cut down or stop using the substance but not managing to.
- Spending a lot of time getting, using, or recovering from use of the substance.
- Cravings and urges to use the substance.
- Not managing to do what you should at work, home, or school because of substance use.
- Continuing to use, even when it causes problems in relationships.
- Giving up important social, occupational, or recreational activities because of substance use.
- Using substances again and again, even when it puts you in danger.
- Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.
- Needing more of the substance to get the effect you want (tolerance).
- Development of withdrawal symptoms, which can be relieved by taking more of the substance.
The DSM categorizes the severity of substance use disorder and alcohol use disorder based upon a symptom scale of mild, moderate and severe. The below scale is meant for educational purposes only, and should not be used as an official assessment. Please speak with your physician or counselor in order to diagnose use disorder and severity.
- Mild-Presence of two or three symptoms
- Moderate-Presence of four or five symptoms
- Severe-Presence of six or more symptoms
What is MAT?
Medication Assisted Treatment (MAT) was created by the American Medical Association as a response to the United States’ high rates of substance-related overdose statistics. MAT uses a combination of medication and therapeutic approaches as treatment for substance use disorders. A patient using the MAT approach would work alongside a Medical Doctor and a Licensed Clinical Social Worker in order to determine a treatment plan and a medication regimen.
Medically, MAT works to reduce withdrawal systems, relieve substance use cravings and stabilize chemical imbalances caused by substance use. Socially, MAT provides patients with resources to work with an addictions counselor to establish and achieve personal goals, build a sober-living community and maintain sobriety.
MAT treatment is used primarily to treat opioid use disorder, alcohol use disorder and tobacco use disorder. CHCS currently offers MAT for opioid use disorder. Speak with your provider about treatment referrals for other conditions.
Community Healthcare Systems’ MAT program is not a drug and alcohol detoxification center, nor is it an addiction treatment center. Our MAT program is simply a physician-supervised medication plan aimed at helping patients develop a holistic approach to their sobriety and reduce instances of overdose and death.
How Would Medication Help Me?
The three most common medications prescribed for opioid addiction are Methadone, Naltrexone and Buprenorphine. Methadone is manufactured in a liquid form and is consumed daily. The DEA currently requires that only specially regulated clinics dispense Methadone. Naltrexone comes in a pill consumed daily or an injection administered monthly. Naltrexone blocks the effects of other narcotics so that the consumer will not feel pain relief or pleasure from opiate consumption. Do not take naltrexone in combination with methadone because it will create sudden withdrawal symptoms.
CHCS currently uses Buprenorphine to treat opioid addiction. Buprenorphine is an opioid partial agonist and reduces withdrawal risk through blocking other narcotics. Buprenorphine also lessens symptoms of withdrawal and cravings, reduces potential for opiate misuse and can stabilize an overdose.
Buprenorphine is manufactured in three ways:
Dissolving tablet: Patient has the choice of Zubsolv or Suboxone. Both come in the form of a daily tablet. Zubsolv dissolves on the tongue and Suboxone dissolves under the tongue.
Cheek Film: Known as Bunavail, this medication comes in the form of a daily tablet. Bunavail tablets are consumed between one’s gum and cheek.
Implant: Probuphine consists of four, one inch long implants that are placed underneath the skin by a licensed provider. The implants remain under the skin for six months. Probuphine is best suited for patients who are in the maintenance stage of treatment. Patients must be currently prescribed no more than 8 mg per day of other Buprenorphine products before gaining a prescription for Probuphine.
Naloxone is often added to Buprenorphine in order to discourage misuse of medications. Naloxone blocks the opioid receptors so that the user does not feel euphoric effects if Buprenorphine is crushed or injected.
How Long Will I Take the Medications?
There are generally three phrases of Buprenorphine treatment. The first phase is known as the “Induction Phase.” Patients must abstain from substance use for 12-24 hours prior to administration of the medication. The next phases are known as the Stabilization Phase and the Maintenance Phase. The outcome of these phases and length of time involved vary greatly from patient to patient, and are best discussed between the patient and their physician.
The cost of treatment and medication will vary according to insurance coverage and status. Some self-pay patients may qualify for medication assistance through CHCS. If you are concerned about the cost of treatment, please call our office to speak with our Care Coordinator.
- Additional information on MAT here and here.
- Information on FDA-approved treatment drugs
- Nami Augusta: local resource offering free mental health support groups for individuals and for their families: https://namiaugusta.org/
If you are in need of emergency assistance:
- Substance Abuse and Mental Health Services Administration (SAMHSA): 1-800-662-4357 – English/Spanish speaking counselors provide referrals to treatment facilities, support groups, and community-based services.
- National Suicide Prevention: 1-800-273-8255 – Support to help those in crisis process their emotional distress and prevent suicide.
- Georgia Crisis and Access Line (GCAL): 1-800-715-4225-Provides over-the-phone crisis intervention services, dispatches mobile crisis teams, assists in finding an open crisis or detox bed across the state of Georgia, links individuals with urgent appointment services, help find a provider in your area (non-emergency)
- Veterans Crisis Line: A support line for veterans facing mental health, suicide or drug/alcohol use. Free and confidential.