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A diagnosis of both substance use and substance withdrawal is indicated by the presence of withdrawal symptoms. Withdrawal symptoms occur when an individual who has been using a substance stops or reduces their intake significantly, leading to physiological and psychological reactions. These symptoms can vary widely depending on the substance involved and may include nausea, sweating, anxiety, trembling, and other physical signs. Recognizing these symptoms is crucial for proper diagnosis, as they confirm that the individual not only meets the criteria for substance use but is also experiencing the negative consequences associated with cessation or reduction of use—indicative of withdrawal.

In contrast, the other choices reflect components of substance use disorders but do not specifically identify both conditions of active use and withdrawal. Impaired control relates to the inability to limit substance use. Risky use points to the behavior surrounding the continued use despite known risks, and social impairment indicates how substance use negatively affects social or interpersonal relationships. While these aspects are important in understanding the overall picture of substance use disorders, they do not directly address the dual diagnosis of ongoing use alongside withdrawal symptoms.