Sustance Use Disorder

DSM 5 - Substance Use Disorders
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 illness—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.
-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 DSM Criteria for substance
abuse disorders
The following distinctions are important to understanding and diagnosing substance-related

disorders:
• Substance abuse generally involves an excessive use of a substance resulting in

(1) potentially hazardous behavior such as driving while intoxicated or
(2) continued use despite a persistent social, psychological, occupational, or health problem.
• Substance dependence includes more severe forms of substance-

use disorders and usually involves a marked physiological
need for increasing amounts of a substance to achieve the
desired effects.
Dependence in these disorders means that an

individual will show a tolerance for a drug and/or experience withdrawal symptoms when the
drug is unavailable.
• Tolerance—the need for increased amounts of a substance to achieve the desired effects—
results from biochemical changes in the body that affect the rate of metabolism and elimination
of the substance from the body.
• Withdrawal refers to physical symptoms such as sweating, tremors, and tension that accompany
abstinence from the drug.
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.
The pharmacological mechanisms for each class of drug are different. But 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. Some people have lower levels of selfcontrol
that predispose them to develop problems if they're exposed to drugs.
There are two groups of substance-related disorders:

1. substance-use 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.
There are two type of substance Use disorder i.ie.
a) Substance Abuse-
b) Substance Dependency
2. Substance-induced disorders - Substance-induced disorders, including intoxication,

withdrawal, and other substance/medication-induced mental disorders, are detailed
alongside substance use disorders.
Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person
who was exposed to alcohol before birth. These effects can include physical problems and
problems with behavior and learning. Often, a person with an FASD has a mix of these
problems.
Criteria for Substance Use Disorders
Substance use disorders span a wide variety of problems arising from substance
use, and cover 11 different criteria:
1. Taking the substance in larger amounts or for longer than you're meant to.
2. Wanting to cut down or stop using the substance but not managing to.
3. Spending a lot of time getting, using, or recovering from use of the substance.
4. Cravings and urges to use the substance.
5. Not managing to do what you should at work, home, or school because of
substance use.
6. Continuing to use, even when it causes problems in relationships.
7. Giving up important social, occupational, or recreational activities because of
substance use.
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8. Using substances again and again, even when it puts you in danger.
9. 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.
10. Needing more of the substance to get the effect you want (tolerance).
11. Development of withdrawal symptoms, which can be relieved by taking more
of the substance.
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.”
These further describe the current state of the substance use disorder.
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. They
include:
• Substance-induced psychotic disorder
• Substance-induced bipolar and related disorders
• Substance-induced depressive disorders
• Substance-induced anxiety disorders
• Substance-induced obsessive-compulsive and related disorders
• Substance-induced sleep disorders
• Substance-induced sexual dysfunctions
• Substance-induced delirium
• Substance-induced neurocognitive disorders
Intoxication
Substance intoxication, a group of substance-induced disorders, details the
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1 Source
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts
within our articles. Read our editorial process to learn more about how we fact-check and keep our
content accurate, reliable, and trustworthy.
1. McLellan AT. Substance misuse and substance use disorders: Why do they matter in
healthcare?. Trans Am Clin Climatol Assoc. 2017;128:112-130.
Additional Reading
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 intoxication
• Cocaine intoxication
• Methamphetamine intoxication (stimulants)
• Heroin intoxication (opioids)
• Acid intoxication (other hallucinogen intoxication or "acid trip")
• Substance intoxication delirium
References
 Firefox https://www.verywellmind.com/dsm-5-criteria-for-substance-use-disorde... 5 of 6 30-05-2022,
12:26
 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders—
 DSM 5. American Psychiatric Association; 2013.
 Firefox https://www.verywellmind.com/dsm-5-criteria-for-substance-use-disorde... 6 of 6 30-05-2022,
12:26
 Elizabeth Hartney, BSc, MSc, MA, PhD (2020). Medically reviewed Steven Gans, Firefox
https://www.verywellmind.com/dsm-5-criteria-for-substance-use-disorde... 1 of 6 30-05-2022, 12:26
 https://www.ncbi.nlm.nih.gov/books/NBK519702/table/ch2.t1/?report=thumb

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DSM 5 - Substance Use Disorders

-The DSM 5 recognizes substance-related disorders resulting from the use of 10

The following distinctions are important to understanding and diagnosing substance-related

• Substance abuse generally involves an excessive use of a substance resulting in

• Substance dependence includes more severe forms of substance-

Dependence in these disorders means that an

There are two groups of substance-related disorders:

2. Substance-induced disorders - Substance-induced disorders, including intoxication,

Severity of Substance Use Disorders

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