SUD in the UK
SUD is the DSM-5 clinical term for problematic drug use, graded by severity. Here's what it means, how UK clinicians use it, and where to start.
Substance use disorder, or SUD, is the clinical term in the DSM-5 for problematic drug use. It is applied separately to each substance (cannabis use disorder, opioid use disorder, cocaine use disorder, stimulant use disorder, sedative use disorder and so on), each with the same eleven criteria adapted for that substance. Severity is graded mild, moderate or severe based on how many criteria are met in the last twelve months.
In the UK, you will see the term SUD used alongside older language: 'substance misuse' (the term used across UK government and NHS commissioning), 'drug dependence' (the WHO's ICD language, which the NHS uses in clinical records), and in some fellowships just 'addict'. All describe overlapping realities. This page sets out what the clinical term means, how it compares to the UK language, and the free help available regardless of which label fits.
Last updated: 11 November 2026.
The eleven SUD criteria are the same shape as the AUD criteria, adapted per substance. They fall into four groups: impaired control (using more or longer than intended, failing to cut back, spending a lot of time, cravings); social impairment (problems with work, family, relationships; giving up activities; continuing despite social harm); risky use (using in dangerous situations, continuing despite physical or psychological harm); and pharmacological (tolerance, withdrawal).
Two or more criteria in twelve months meets the threshold for SUD. Severity is graded: mild 2 or 3, moderate 4 or 5, severe 6 or more. The grading applies per substance: it is possible, and common, to meet mild criteria for one drug and severe criteria for another.
UK clinical practice often uses 'substance misuse' and 'drug dependence' interchangeably with SUD. Here is how the terms line up.
| Severity | DSM-5 criteria met | Older UK terms this maps onto | Where to start |
|---|---|---|---|
| Mild SUD | 2 or 3 of 11 | Problematic use, substance misuse | GP conversation, SMART Recovery, NA or CA, therapy. The am I a drug addict check is a quick starting point. |
| Moderate SUD | 4 or 5 of 11 | Substance misuse, drug dependence | Community drug service (free, self-referring), peer support, therapy. Change Grow Live and Humankind are the biggest commissioned providers. |
| Severe SUD | 6 or more of 11 | Drug dependence, addiction | GP or community drug service first, especially for opioids (methadone, buprenorphine substitution are standard NHS care). Medication-assisted treatment plus peer support plus therapy. Residential rehab is an option; see is rehab worth it?. |
In England, every local authority commissions community drug and alcohol services, free at the point of use and usually self-referring. The main UK providers are Change Grow Live, Humankind, Turning Point, Cranstoun and WDP. Services include keyworker support, needle exchange, medication-assisted treatment for opioid dependence (methadone, buprenorphine, long-acting buprenorphine), relapse-prevention medication, group work and signposting to rehab where appropriate.
In Scotland, services run through the Alcohol and Drug Partnership of each health board. In Wales, through the Area Planning Boards. In Northern Ireland, through HSC trusts. For a UK-wide information line, Talk to FRANK offers free 24-hour drugs information on 0300 123 6600, including local service signposting.
The OHID NDTMS annual reports are the live source for how many adults are in structured drug or alcohol treatment in England each year. The headline figures: hundreds of thousands of adults in treatment every year, successful completion rates in the 25% to 30% range for opiates and 36% to 44% for non-opiates. Scotland, Wales and Northern Ireland publish broadly comparable data through their own systems.
These numbers are not a verdict on treatment working or not. They are a measure of successful completion of structured treatment without re-presenting within six months. See UK rehab success rates for what these numbers do and do not measure.
SUD is a label that describes a pattern. You do not need a diagnosis to reach for help, and you can reach for help without knowing what to call the pattern. The am I a drug addict check is a two-minute self-check, the do I have a drug problem page walks through the broader signs, and I've relapsed is there if this is one of those nights.
If what you are using is opioids (heroin, methadone, codeine, oxycodone, fentanyl), one safety point worth flagging up front: if you have been off them for a stretch and go back, your tolerance has dropped and the dose that felt normal before can cause a fatal overdose. Naloxone (which reverses opioid overdose) is free from most UK drug services without a prescription.
SUD is the DSM-5 clinical term for problematic substance use, graded mild to severe. 'Addiction' is the older cultural term and often implies the more severe end. In UK practice they are used alongside each other. See [addiction vs dependence](/addiction-vs-dependence) for a related distinction.
Some NHS clinicians do, especially those trained in DSM-5. The older term 'drug dependence' (from the WHO's ICD) is widely used on clinical records, and 'substance misuse' is the standard UK commissioning term. All describe overlapping patterns.
Clinical terms are strict about this; everyday terms are not. Under DSM-5, SUD applies specifically to the substances it lists. Behavioural patterns such as gambling have their own disorder category (gambling disorder). Patterns such as compulsive internet use are not currently in DSM-5 but are in the WHO ICD-11. Fellowships for behavioural patterns such as [Gamblers Anonymous](/ga), [Overeaters Anonymous](/oa) and [SLAA](/slaa) exist and are open to anyone who recognises the pattern.
DSM-5 says two or more of the eleven in the last twelve months. Mild is 2 or 3, moderate is 4 or 5, severe is 6 or more. The grading applies per substance.
If you have a clinical conversation about drug use, it will be noted on your confidential medical record, as all healthcare conversations are. It is not shared with employers, insurers or family without your explicit consent. The DVLA has its own narrow rules on drug dependence and driving that a doctor may need to raise with you. See [are meetings confidential](/are-meetings-confidential) for related guidance.
Clinical language talks about sustained remission rather than cure. Long-term recovery is real and common, and the strongest single predictor of it is engaged support rather than the severity of the starting point. See [UK rehab success rates](/rehab-success-rates-uk) for what the UK data shows.