DSM-IV Criteria for Abuse and Dependency

The American Psychiatric Association publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the current revision is called the DSM-IV. This is the document that Psychiatrists, Psychologists, and the rest of the mental health field uses to define and diagnose mental disorders.

The DSM uses the same criteria for both alcohol and substance abuse or dependency, so I publish the two here together. The following was taken from the latest edition of the DSM-IV, published in 1994 by the American Psychiatric Association in Washington D.C., pages 181-183:

DSM-IV Substance Abuse Criteria:

Substance abuse is defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by one (or more) of the following, occurring within a 12-month period:

DSM-IV Substance Dependence Criteria:

 Substance dependence is defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring any time in the same 12-month period:

  • Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (such as repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; or neglect of children or household).
  • Recurrent substance use in situations in which it is physically hazardous (such as driving an automobile or operating a machine when impaired by substance use).
  • Recurrent substance-related legal problems (such as arrests for substance related disorderly conduct).
  • Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (for example, arguments with spouse about consequences of intoxication and physical fights).
  • Tolerance, as defined by either of the following: (a) A need for markedly increased amounts of the substance to achieve intoxication or the desired effect or (b) Markedly diminished effect with continued use of the same amount of substance.
  • Withdrawal, as manifested by either of the following: (a) The characteristic withdrawal syndrome for the substance or (b) the same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
  • The substance is often taken in larger amounts or over a longer period then intended.
  • There is a 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, use the substance, or recover from its effects.
  • Important social, occupational, or recreational activities are given up or reduced because of substance use.
  • The substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance


4 Responses to DSM-IV Criteria for Abuse and Dependency

  1. floyd barnhill says:

    Pete, I find what you are doing to be of great personal interest……….You have a knack for touching subjects that intrigue me….You bring clarity to issues that I find confusing….Perhaps it is the benefit of an enginers training………It has always seemed to me that enginers take science and apply it to real life……….Will look forward to following your progress…..
    Floyd……PS There are a couple of issues that I will watch for……….

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  3. Josephine says:

    Fact is, there is something in the body of the addict that will
    keep them from stopping at one or only useing drugs once.
    Additionally, young people are exposed to more
    than 1,000 beer and wine commercials on television each year.
    – Drug paraphernalia in pockets or usually within close proximity to the person.

    In most countries in Asia, shame and dishonor are still enormous factors that contribute to the distress of addicts and their families.
    Alcoholism is difficult to combat because many addicts are able
    to mask their addiction well while a few others think that it is
    not a real issue. 50 may end up in coma. Healthy Family Lives.
    In the middle of the brain is the reward pathway which includes the ventral tegmental area (VTA), the nucleus accumbens, and the prefrontal cortex.

  4. Lacy says:

    The more you continue to take alcohol, the more you will be able to
    absorb. One of my daughters recently told me that snorting smarties was popular
    at her school. Binge drinking is usually associated with neurocognitive cutbacks of
    frontal lobe developing as well as reduced working memory and
    also slowed auditory and spoken memory cutbacks.

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