Something of substance

By Max Liles - Contributing Columnist

Max Liles

Max Liles

Substance use disorders (SUD): disease, choice, addiction, dependence – however you want to categorize or label the issue, at this point we’ve all heard of the opioid epidemic and we’re all familiar with the boom of the subsequent increased access to treatment that has followed.

Substance use disorders are a polarizing topic; one that brings about emotional reactions and responses from community members based on their effect of the local economy, families, and overall invasiveness.

There has been much work done to streamline and refine access to treatment, diagnosing behavioral health disorders, how those diagnosis are derived and what resources are provided to individuals seeking help. With that being said, let’s unpack some of the absolute truths about the disease characteristics of a substance use disorder.

1) It is PRIMARY

Often, people will look for the cause of a person’s excessive drinking or using – “He’s going through a lot right now.”

Sometimes, people will use their circumstances to justify their excessive drinking or using – “If you had my life, you’d drink, too!” (and you would).

Rather – substance use disorders are not inherently cause by anything else; that’s what PRIMARY means.

Can people be pre-disposed to the development of an SUD based on heredity? Yes.

Can people behave in thru their drinking and using that develops an SUD? Absolutely.

Can a person’s environment contribute to the likelihood of developing an SUD? Sure.

But with all that being said, that’s all it takes: a person and the substance. Nothing has to “cause” the disorder – it can present by itself.


Flo will not be doing a car insurance commercial, although I am plugged in with Sherman-Kricker (shop local).

SUD’s themselves get worse – especially without treatment interventions… ESPECIALLY if a person is continuing to use.

If someone has an assessment at the age of 24 and is diagnosed with a moderate substance use disorder (meeting 4-5 criteria), and doesn’t engage in a recommended treatment program, it is likely that they

are going to present later in their lives for another assessment where they will be diagnosed as a severe substance use disorder case (meeting 6 or more criteria).

What PROGRESSIVE means is, the disease gets worse.

Point blank, people don’t use forever: they either get help and change or they die.

3) It is CHRONIC

And not the beloved Dr. Dre Album (1992 or 2001), nor are we talking high-grade devils lettuce.

CHRONIC means that a condition is persistent; permanent; long-lasting. It’s not going anywhere.

This is why long term treatment, at appropriate levels of structure and dosage are important.

As a general rule of thumb, the longer a person can stay connected to suitable treatment based on their assessed needs the more likely they are to get into and remain in sustained remission of their SUD. My rule of thumb is 1 year (AKA Max Liles 1 Year plan for your life), give or take 3 to 6 months either way based on severity of the case.

Treatment works. We do recover.

4) It is FATAL

This is the most dangerous characteristic of a substance use disorder, and we’ve already touched on it – BUT to REALLY drive this point home… it can kill you.

Harm Reduction Ohio cites that drug overdose deaths have surpassed over 3,000 since 2015. That number jumped to over 4,000 in 2016, 2017, and 2019. It is estimated that 94,000 succumbed to an overdose in 2020. That is terrifying.

If you are a person that I actively using, PLEASE don’t use alone and get ahold of some Narcan. If you don’t know how to get ahold of it – reach out to The Counseling Center.


If #4 totally wigged you out – we’ve got some good news…

You don’t have to die in the perils of active addiction. Help is available and we want to be one of the connecting pieces to you getting your life back. Treatment is more accessible than ever before: through service improvements and growth within our own agency and the surrounding area; by way of Medicaid Expansion (Thanks Obama); with increased community collaborations and partnerships.

If you or someone you love is struggling, please reach out to us at one of the numbers below. We’re waiting on you.

Talk to your friends and family. Show people this information. Support one another.

Max Liles Liles

By Max Liles

Contributing Columnist

Max Liles is the Senior Director of The counseling center, INC. He can be reached at 740-357-7693 or visit

Max Liles is the Senior Director of The counseling center, INC. He can be reached at 740-357-7693 or visit