DSM 5 Criteria for Substance Use Disorders

DSM 5 Criteria for Substance Use Disorders Addiction Drug Use Print DSM 5 Criteria for Substance Use Disorders By Elizabeth Hartney, BSc., MSc., MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. Learn about our editorial policy Elizabeth Hartney, BSc., MSc., MA, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on July 14, 2019 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on September 05, 2019 GP Kidd / Getty Images More in Addiction Drug Use Cocaine Heroin Marijuana Meth Ecstasy/MDMA Hallucinogens Opioids Prescription Medications Alcohol Use Addictive Behaviors Nicotine Use Coping and Recovery The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, often called the DSM-V or DSM 5, is the latest version of the American Psychiatric Association’s gold-standard text on the names, symptoms, and diagnostic features of every recognized mental illnessâ€"including addictions. The DSM 5 criteria for substance use disorders are based on decades of research and clinical knowledge. This edition was published in May 2013, nearly 20 years after the original publication of the previous edition, the DSM-IV, in 1994. Verywell / Brianna Gilmartin   What Are Substance Use Disorders? The DSM 5 recognizes substance-related disorders resulting from the use of 10 separate classes of drugs: alcohol; caffeine; cannabis; hallucinogens (phencyclidine or similarly acting arylcyclohexylamines, and other hallucinogens, such as LSD); inhalants; opioids; sedatives, hypnotics, or anxiolytics; stimulants (including amphetamine-type substances, cocaine, and other stimulants); tobacco; and other or unknown substances. Therefore, while some major groupings of psychoactive substances are specifically identified, the use of other or unknown substances can also form the basis of a substance-related or addictive disorder. The activation of the brain’s reward system is central to problems arising from drug use; the rewarding feeling that people experience as a result of taking drugs may be so profound that they neglect other normal activities in favor of taking the drug. While the pharmacological mechanisms for each class of drug are different, the activation of the reward system is similar across substances in producing feelings of pleasure or euphoria, which is often referred to as a “high.” The DSM 5 recognizes that people are not all automatically or equally vulnerable to developing substance-related disorders and that some people have lower levels of self-control that predispose them to develop problems if theyre exposed to drugs. There are two groups of substance-related disorders: substance-use disorders and substance-induced disorders. Substance-use disorders are patterns of symptoms resulting from the use of a substance that you continue to take, despite experiencing problems as a result.?Substance-induced disorders, including intoxication, withdrawal, and other substance/medication-induced mental disorders, are detailed alongside substance use disorders. Criteria for Substance Use Disorders Substance use disorders span a wide variety of problems arising from substance use, and cover 11 different criteria?? : Taking the substance in larger amounts or for longer than  youre  meant to.Wanting to cut down or stop using the substance  but not managing to.Spending a lot of time getting, using, or recovering from use of the substance.Cravings and urges to use the substance.Not managing to do what you should at work, home,  or school  because of substance use.Continuing to use, even when it causes problems in relationships.Giving up important social, occupational, or recreational activities because of substance use.Using substances again and again, even when it puts you in danger.Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.Needing more of the substance to get the effect you want (tolerance).Development of withdrawal symptoms, which can be relieved by taking more of the substance. The Severity of Substance Use Disorders The DSM 5 allows clinicians to specify how severe or how much of a problem the substance use disorder is, depending on how many symptoms are identified. Two or three symptoms indicate a mild substance use disorder?? ; four or five symptoms indicate a moderate substance use disorder, and six or more symptoms indicate a severe substance use disorder. Clinicians can also add “in early remission,” “in sustained remission,” “on maintenance therapy,” for certain substances and “in a controlled environment.” Intoxication Substance intoxication, a group of substance-induced disorders, details the symptoms that people experience when they are high from drugs. Disorders of substance intoxication include: Marijuana intoxicationCocaine intoxicationMethamphetamine intoxication (stimulants)Heroin intoxication (opioids)Acid intoxication (other hallucinogen intoxication or acid trip)Substance intoxication delirium Substance/Medication-Induced Mental Disorders Substance/medication-induced mental disorders are mental problems that develop in people who did not have mental health problems before using substances, and include: Substance-induced psychotic disorderSubstance-induced bipolar and related disordersSubstance-induced depressive disordersSubstance-induced anxiety disordersSubstance-induced obsessive-compulsive and related disordersSubstance-induced sleep disordersSubstance-induced sexual dysfunctionsSubstance-induced deliriumSubstance-induced neurocognitive disorders A Word From Verywell If you think you might have a substance use disorder or a substance-induced disorder, see your doctor. She may need to refer you to a specialist or an addiction program to ensure that you receive the correct course of treatment. Untreated substance use disorders can be harmful to your health, your relationships, and your life as a whole. They can even be fatal, so get help as early on in the process as possible.