Substance Use Disorders / Addiction

To make an appointment, please call (212) 305-6001 or submit our online form.

Facts to Know:

  • Substance use disorders are complex and debilitating, as they affect the brain, mind, and body.
  • Substance use disorders are quite common, affecting up to 10% of the population each year.
  • Substance use disorders are treatable with therapy and/or medication.

What are substance use disorders?  

Substance use disorders are characterized by substance seeking and use that is compulsive, or difficult to control, despite harmful consequences. Nearly 10% of Americans have had a diagnosable substance use disorder in the past year. The exact cause of substance use disorders is not known. We do know that substance use disorders involve both genetic and environmental factors; these disorders are not simply a weakness. Not everyone who uses drugs or alcohol develops a substance use disorder.

Each person's brain and body are different, as are their reactions to substances. Relationships, past experiences, surroundings, and stress can also make people more or less likely to develop a substance use disorder. Substance use disorders and other mental health problems such as depression, anxiety, or attention deficit disorder often co-occur.  When this is the case, it is important to get treatment for both depression, anxiety, or attention deficit disorder often co-occur.  When this is the case, it is important to get treatment for both.


Substance use disorders vary based on the substance (for example: alcohol, cannabis, cocaine) and range in severity from mild to moderate to severe. The most common types of substance use disorders are:

  • Alcohol use disorder
  • Cannabis use disorder
  • Opioid use disorder
  • Tobacco use disorder
  • Sedative, hypnotic, or anxiolytic use disorder
  • Stimulant use disorder


Symptoms of substance use disorders vary by person and by substance; however, they include a cluster of symptoms indicating ongoing use of the substance despite significant substance-related problems.

Impaired Control

  1. Taking the substance in larger amounts or for longer than was intended
  2. Wanting to cut down or stop using the substance but not managing to
  3. Spending a lot of time getting, using, or recovering from use of the substance
  4. Cravings or a strong desire or urge to use the substance

Social Impairment

  1. Not managing to do what you should at work, home, or school because of substance use
  2. Continuing to use, even when it causes problems in relationships
  3. Giving up important social, occupational, or recreational activities because of substance use

Risky Use 

  1. Using substances again and again, even when it puts you in danger
  2. 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

Pharmacological Criteria

  1. Needing more of the substance to get the effect you want (tolerance)
  2. Development of withdrawal symptoms, which can be relieved by taking more of the substance


A diagnosis of a substance use disorder is best made by a doctor or mental health professional such as a therapist. In order to meet criteria for a substance use disorder an individual would typically experience some of the symptoms noted above, and their use of the substance would cause significant impairment or distress.



Psychotherapy is an evidence-based treatment for substance use disorders. Our therapists and psychiatrists are trained in the latest therapy modalities, such as motivational enhancement and cognitive behavioral therapies, and can help you determine if therapy is right for you. In some cases, substance use disorders can be successfully treated with psychotherapy alone.

Psychopharmacology (Medication Management)

Medication treatment is available to treat some substance use disorders and may be an important component of treatment. Medications can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions, such as depression or anxiety, which may be contributing to a person’s substance use disorder. Here at ColumbiaDoctors, our psychiatrists combine a thorough evaluation of each individual’s problems with the latest research to design a customized treatment plan. 

How Can I Receive Treatment for Substance Use Disorders/Addiction at Columbia?

The Smithers Center is a specialized service that offers treatment for those who are looking to change their substance use and have co-occurring mental health conditions. We believe treatment approaches must be tailored to address each person’s individual needs and goals. 

Search our providers for a therapist or psychiatrist with expertise in substance use disorders/addiction.

To make an appointment, please call 212-305-6001 or submit our online form.