substance use disorder

A clinical (medical and psychiatric) diagnosis in the DSM-V. In common language, it is referred to as addiction.

This is broken down into groups of diagnostic criteria:

1. Impaired control over substance use (DSM-5 criteria 1 to 4):

• Consuming the substance in larger amounts and for a longer amount of time than intended.
• Persistent desire to cut down or regulate use. The individual may have unsuccessfully attempted to stop in the past.
• Spending a great deal of time obtaining, using, or recovering from the effects of substance use.
• Experiencing craving, a pressing desire to use the substance.

2. Social impairment (DSM-5 criteria 5 to 7):

• Substance use impairs ability to fulfill major obligations at work, school, or home.
• Continued use of the substance despite it causing significant social or interpersonal problems.
• Reduction or discontinuation of recreational, social, or occupational activities because of substance use.

3. Risky use (DSM-5 criteria 8 and 9):

• Recurrent substance use in physically unsafe environments.
• Persistent substance use despite knowledge that it may cause or exacerbate physical or psychological problems.

4. Pharmacologic (DSM-5 criteria 10 and 11):

• Tolerance: Individual requires increasingly higher doses of the substance to achieve the desired effect, or the usual dose has a reduced effect; individuals may build tolerance to specific symptoms at different rates.
• Withdrawal: A collection of signs and symptoms that occurs when blood and tissue levels of the substance decrease. Individuals are likely to seek the substance to relieve symptoms. No documented withdrawal symptoms from hallucinogens, PCP, or inhalants.
• Note: Individuals can have an substance use disorder with prescription medications, so tolerance and withdrawal (criteria 10 and 11) in the context of appropriate medical treatment do not count as criteria for an substance use disorder.

Follow the guidelines of Reporting on Addiction. Try to avoid stigmatizing language when discussing both the diagnosis of substance use disorder and issues of addiction in general.

Use terms person-first language and use terms such as substance use disorder, substance abuse, and addiction with care. Avoid use of pejorative or stigmatizing terms such as junkie or druggie.

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