In the American Psychiatric Association’s 5th edition of the Diagnostic and Statistical Manual (DSM-5), substance (i.e., drug or alcohol) use disorders include several criteria that are measured on a continuum from mild to severe.
The various criteria are clustered into four major groups.
IMPAIRED CONTROL
• Ingesting larger amounts of the substance over longer periods than intended
• Unsuccessful efforts to cut back or stop using the substance
• Spending considerable time seeking, using, or recovering from substance use
• Strong urges or cravings for the substance
SOCIAL IMPAIRMENT
• Failure fulfilling work, school, or home obligations because of substance use
• Persistent substance use despite social or interpersonal problems from such use
• Important activities given up or reduced because of substance use
RISKY BEHAVIOR
• Continued use in physically hazardous situations
• Persistent use despite physical or psychological problems due to such use
PHYSICAL DEPENDENCE
• Tolerance to the substance (i.e., need for increased amounts to achieve desired effects or diminished effect with continued use of the same amount)
• Withdrawal symptoms when use is decreased or discontinued
Alcoholics or drug abusers don’t necessarily have to meet all of these criteria for a diagnosis. Only two or more of the 11 criteria are necessary for the diagnosis.