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Check-Up > Criteria for Substance Dependence
Diagnosis
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Substance Dependence
Diagnosis - From NIDA |
Diagnostic and Statistical Manual - III - R
[DSM-III-R is not currently used but has historical utility.] At least
three of the following are necessary; some of the symptoms of the
disturbance must have persisted for at least one month or have occurred
repeatedly over a longer period of time:
- Substance is often taken in larger amounts or over longer period
than intended
- Persistent desire or one or more unsuccessful efforts to cut down
or control substance use
- A great deal of time is spent in activities necessary to get the
substance (e.g., theft), taking the substance (e.g., chain smoking),
or recovering from its effects
- Important social, occupational, or recreational activities given
up or reduced because of substance abuse
- Continued substance use despite knowledge of having a persistent
or recurrent social, psychological, or physical problem that is caused
or exacerbated by use of the substance
- Marked tolerance: need for markedly increased amounts of the
substance (> 500/ increase) in order to achieve intoxication or
desired effect, or markedly diminished effect with continued use of
the same amount
- Characteristic withdrawal symptoms
- Substance often taken to relieve or avoid withdrawal symptoms
- Frequent intoxication or withdrawal symptoms when expected to
fulfill major role obligations or when use is physically hazardous
Diagnostic and Statistical Manual - IV
A maladaptive pattern of substance use leading to clinically
significant impairment or distress as manifested by three (or more) of
the following, occurring at any time in the same 12-month period:
- Substance is often taken in larger amounts or over longer period
than intended
- Persistent desire or unsuccessful efforts to cut down or control
substance use
- A great deal of time is spent in activities necessary to obtain
the substance (e.g., visiting multiple doctors or driving long
distances), use the substance (e.g., chain smoking), or recover from
its effects
- Important social, occupational, or recreational activities given
up or reduced because of substance abuse
- Continued substance use despite knowledge of having a persistent
or recurrent psychological, or physical problem that is caused or
exacerbated by use of the substance
- Tolerance, as defined by either:
- need for read amounts of the substance in order to achieve
intoxication or desired effect; or
- markedly diminished effect with continued use of the same amount
- Withdrawal, as manifested by either:
- characteristic withdrawal syndrome for the substance; or
- the same (or closely related) substance is taken to relieve or
avoid withdrawal symptoms
International Classification of Diseases - 10
[ICD-10 research criteria differ from the clinical diagnostic quidelines
listed here.] Three or more of the following must have been experienced
or exhibited at some time during the previous year:
- Difficulties in controlling substance-taking behavior in terms of
its onset, termination, or levels of use
- A strong desire or sense of compulsion to take the substance
- Progressive neglect of alternative pleasures or interests because
of psychoactive substance use, increased amount of time necessary to
obtain or take the substance or to recover from its effects
- Persisting with substance use despite clear evidence of overtly
harmful consequences, depressive mood states consequent to heavy use,
or drug related impairment of cognitive functioning
- Evidence of tolerance, such that increased doses of the
psychoactive substance are required in order to achieve effects
originally produced by lower doses
- A physiological withdrawal state when substance use has ceased or
been reduced, as evidence by: the characteristic withdrawal syndrome
for the substance; or use of the same (or a closely related) substance
with the intention of relieving or avoiding withdrawal symptoms
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