DIAGNOSING A SUBSTANCE USE DISORDER

There are various definitions of “addiction” with little consensus or clarity on the term.  The DSM-5 is a tool that is most widely used to identify a substance related disorder with specifiers to determine if the problem is mild, moderate, or severe.  Criteria includes impaired control, social impairment, risky use, tolerance and withdrawal.

The presence of 2–3 criteria = MILD
The presence of 4–5 criteria = MODERATE
The presence of 6+ criteria = SEVERE

IMPAIRED CONTROL

  1. The substance is taken in larger amounts over a longer period than was intended.
  2. The individual reports unsuccessful efforts to quit or cutdown.
  3. A great deal of time is spent obtaining the substance, using the substance, or recovering from its effects.
  4. A craving is manifested by an intense desire or urge for the substance.

SOCIAL IMPAIRMENT

  1. Failure to fulfill major obligations at work, school, or home.
  2. Important social, occupational or recreational activities may be given up or reduced because of substance use, or the individual may withdraw from family activities and hobbies in order to use the substance.
  3. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or worsened by the effects of the substance.

RISKY USE

  1. Recurrent substance use in situations in which it is physically hazardous.
  2. Continued substance use despite knowledge of a persistent or recurrent physical or psychological problem that is likely to have been caused or worsened by the substance.

PHARMACOLOGICAL/PHYSICAL MARKERS

  1. Tolerance is when one has need of more of the substance to achieve the desired effect.
  2. Withdrawal is when the substance leaves the body and causes psychological or physiological symptoms.

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