The 11 Criteria for Understanding Substance Use Disorders

Additionally, peer influences and a desire for social acceptance can overshadow an adolescent’s ability to self-regulate. The presence of even a few SUD criteria in a teenager warrants careful attention and possibly professional evaluation. DSM-IV included a specifier for physiological cases (i.e., those manifesting tolerance or withdrawal, a DSM-III carryover), but the predictive value of this specifier was inconsistent (99–106). A PubMed search indicated that this specifier was unused outside of studies investigating its validity, indicating negligible utility. C Two or more substance use disorder criteria within a 12-month period. You may need continuing care throughout your life, as SUD is a chronic condition.

Notably, cultural considerations have influenced the evolution of these criteria, with some elements, such as legal issues, being removed to accommodate diverse contexts. The prevalence of SUD is significant, with millions of individuals in the U.S. estimated to meet the criteria, highlighting the importance of awareness and treatment options. As research continues, the DSM-5 also opens the door to understanding behavioral addictions, reflecting the complexity and multifaceted nature of addiction in contemporary society. With the addition of gambling disorder to the chapter, a change in the title was necessary.

What are the risk factors for cannabis use disorder?

Gather collateral information from multiple sources using varied developmentally sensitive techniques including interviews, behavioral observation, and standard rating scales 1. The reliability of patient self-report may be affected by cognitive development, emotional intensity, and psychological distress at time of interview 1. BPD commonly co-occurs with mood disorders (83% have comorbid mood disorders including major depression or bipolar disorder) 3. To differentiate, assess whether depressive symptoms are pervasive and sustained (suggesting MDD) versus reactive and brief (more consistent with BPD affective instability) 1.

• They are defined by a person’s overwhelming inability to regulate their consumption of substances, even when faced with severe negative repercussions.
• Two main findings arose, with similar results across substances, countries, adults, adolescents, patients and nonpatients.
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• Thus, legal problems are not a useful substance use disorder criterion, although such problems may be an important treatment focus in some settings.
• That’s why it’s best to get medical attention during detoxification if a doctor recommends it.
• DSM-IV improved this (113) via standardized guidelines to differentiate between “primary” and “substance-induced” mental disorders.

DSM criteria for substance use disorders

Over 40 research groups conduct basic neuroscience research and clinical investigations of mental illnesses, brain function, and behavior at the NIH campus in Bethesda, Maryland. Use these free digital, outreach materials in your community and on social media to spread the word about mental health. Use these free education and outreach materials in your community and on social media to spread the word about mental health and related topics. Download, read, and order free NIMH brochures and fact sheets about mental disorders and related topics. NIMH statistics pages include statistics on the prevalence, treatment, and costs of mental illness for the population of the United States. NIMH offers expert-reviewed information on mental disorders and a range of topics.

What is a clinical trial?

For some individuals, major depression can result in severe impairments that interfere with or limit one’s ability to carry out major life activities. Behavioral addictions can occur with any activity that’s capable of stimulating your brain’s reward system. Behavioral scientists continue to study the similarities and differences between substance addictions, behavioral addictions and other compulsive behavior conditions like obsessive-compulsive disorder (OCD) and bulimia nervosa. The American Society of Addiction Medicine (ASAM) defines addiction as a chronic brain disorder. Addiction doesn’t happen from having a lack of willpower or as a result of making bad decisions. It’s important to turn to healthy coping mechanisms during these substance use disorder times of change, such as exercising, meditating or learning a new hobby.

As an update from previous editions of the DSM, the DSM-5 considers substance use disorder as a single diagnosis that is measured on a scale from mild to severe. Changes to the DSM criteria may affect rates of diagnoses and severity assessments. A revised edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) was published in 2022, however, it did not change the criteria for substance use disorders. The studies in Table 2 and others (89–91) demonstrate that the substance use disorders criteria represent a dimensional condition with no natural threshold. However, a binary (yes/no) diagnostic decision is often needed.

The DSM-5, or the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, provides a comprehensive framework for diagnosing substance use disorders. The Substance Abuse and Mental Health Services Administration (SAMHSA) reported on data collected for the 2022 National Survey on Drug Use and Health (NSDUH). The NSDUH is an annual survey of civilians in the United States aged twelve years and older; it includes national estimates of substance use and substance use disorder.

Associated Data

• If you or a loved one has cannabis use disorder, talk to a healthcare provider as soon as possible.
• Your healthcare provider should review your treatment plan with you and adapt it based on your changing needs.
• Some of the options below may be covered by insurance, but it’s best to ask a representative to check your coverage before deciding on a specific program.

Consider seeing a mental health professional if you’re having issues managing your stress. Substance use disorder, including cannabis use disorder, is a lifelong disease. Different tools work for different people, but ongoing therapy and self-help groups help many.

But instead of motivating you to do the things you need to do to survive (eat, work and spend time with loved ones), such massive dopamine levels can have damaging effects on your thoughts, feelings and behavior. Addiction is a chronic (lifelong) condition that involves compulsive seeking and taking of a substance or performing of an activity despite negative or harmful consequences. Do not overlook trauma history – The etiology of BPD is related to both genetic factors and adverse childhood experiences, particularly sexual and physical abuse 3. Implementing interventions before trauma-informed assessment is a critical pitfall 4. Do not diagnose BPD during acute crisis states – Longitudinal observation is essential to distinguish pervasive personality patterns from episodic psychiatric syndromes 7.

Record Treatment and Response

Many studies showed that DSM-IV dependence was reliable and valid (5), suggesting that major components of the DSM-5 substance use disorders criteria are reliable as well. In addition, the term “primary” was confusing, implying a time sequence or diagnostic hierarchy. However, concerns from the other DSM-5 work groups led the Board of Trustees to a flexible approach that reversed the DSM-IV standardization. This flexible approach lacked specific symptom and duration requirements and included the addition of disorder-specific approaches crafted by other DSM-5 work groups. These substances can produce tolerance and withdrawal as normal physiological adaptations when used appropriately for supervised medical purposes. With a threshold of two or more criteria, these criteria could lead to invalid substance use disorder diagnoses even with no other criteria met.