Diagnosing Another Person With A Substance Use Disorder

“Addiction: the disease that makes you selfishly blind to all the wreckage you inflict on those who love you.” – Gareth Carter

Families asking “Is my loved one addicted?” need to know that addiction is not caused by a person’s lack of willpower. Addictive substances can hijack the reward pathways of the brain. With chronic drug use, the brain’s circuits change and become less sensitive to dopamine, needing more and more drugs to achieve prior levels of pleasure.

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Substance Use Disorders are generally classed as mild, moderate or severe. A score of 2 to 3 is mild, 4 or 5 is moderate and 6 or more is severe.

Addiction overstimulates the brain’s reward centre resulting in severe craving and uncontrollable drug use, despite addicted people’s best efforts to stop.  Once addicted, the structure and function of the brain change – affecting memory, learning and reward.  Withdrawal symptoms then compound the addiction making sincere attempts to stop using ever more futile.

Addicts and alcoholics often don’t realise the gravity of their situation. This is normal. Family and friends frequently play a central role in getting their loved one into treatment and recovery. It’s a mistaken belief that the addict or alcoholic must want to get treatment for rehab to work. If you’re waiting around for the addict to have a moment of clarity, some bolt of lightning, burning bush moment, that’s the wrong approach.

Most addicts and alcoholics are forced into rehab through some personal or work-related leverage. It’s only during the treatment process that they gain insight, begin to see sense and take responsibility for their recovery.

“Don’t wait for rock bottom, bring the rock bottom up to meet them.” – Sheryl Rahme

Substance use disorder (SUD) symptoms can be behavioural, psychological or physical. They may differ greatly from person to person. If you believe someone close to you is battling substance addiction, the below questions can help to bring some clarity.

These questions are a preliminary tool to help gauge potential addiction issues. An accurate diagnosis of Substance Use Disorder (SUD) or Alcohol Use Disorder (AUD) can only be made by a qualified addiction professional.

The insidious nature of addiction often results in denial and a lack of self-awareness in the affected individuals, highlighting the importance of early recognition and intervention. Recovery is possible without reaching “rock bottom,” and seeking timely professional help, such as inpatient detox and rehabilitation, is a vital step towards recovery and sobriety.

Understanding and addressing addiction is fundamental for both the affected individuals and their loved ones. Family and friends can play a critical role, either by unintentionally enabling the addiction through denial or by actively seeking help and encouraging the individual to acknowledge and face their addiction.


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The process of professionally diagnosing a substance use disorder typically comprises several key steps, which can be undertaken in different sequences and at various junctures. This flexibility depends on the patient’s engagement, the involvement of family members and the strategies most conducive to effective treatment. Individuals without expertise in substance use disorders may inaccurately emphasise certain aspects of diagnosis based on their relationship with the affected person. Unbiased therapeutic relationships focused on the recovery process aviod a number of pitfalls where personal relationships are often too close to the issues of the active addiction cycle and seeking objective guidance from third-party professionals is generally the most effective way to help the individual.


The initial consultation in addiction treatment involves a private meeting with a qualified professional who simply conducts a interview to understand the individual’s substance use history and behaviour patterns. This session is key in identifying the nature and extent of the substance use, its triggers and the overall impact on the individual’s life, including physical health, mental well-being and social relationships. It also serves to establish a rapport and trust between the professional and the individual, essential for effective treatment. The information gathered during this consultation is central in creating a personalised treatment plan, emphasising confidentiality and ethical considerations to ensure the individual’s comfort and privacy.

Medical and Psychological

This step is vital for detecting any physical complications or mental health disorders related to substance abuse. A medical professional conducts the physical exam to identify signs of substance use and related health issues, while a mental health professional performs the psychological assessment to evaluate mood, behaviour and cognitive functions. Laboratory tests, including blood work and urine analysis, are used to confirm substance use and assess its impact on the body. This comprehensive evaluation is fundamental for differentiating substance use disorder symptoms from other medical conditions, informing the treatment plan and guiding ongoing monitoring and adjustments in the treatment process.

History and Diagnostics

Following the initial consultation and medical evaluation, the next steps involve gathering information about the individual’s substance use history, including the types and amounts of substances used, duration of use and any past attempts at quitting or periods of abstinence. This information is critical for understanding the depth of the addiction and tailoring the treatment approach. Additionally, it’s essential to identify any co-occurring mental health disorders, as these often accompany substance use disorders and significantly impact the treatment plan.

Professionals utilise standardised diagnostic criteria, such as those outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose a substance use disorders. Based on this diagnosis, a personalised treatment plans are developed based on. This plan can encompass a range of interventions, including detoxification, various forms of therapy (individual, group, family), medication-assisted treatment, lifestyle changes and ongoing follow-up care.

As the individual progresses through recovery, the treatment plan is regularly reassessed and adjusted to address new challenges and ensure it remains effective and relevant to the individual’s evolving needs.

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