for Substance Dependence
The patient's maladaptive pattern of substance use leads to clinically
important distress or impairment as shown in a single 12-month period by
3 or more of the following:
-Tolerance, shown by either of:
- markedly increased intake of the substance is needed
to achieve the same effect or
-with continued use, the same amount of the substance
has markedly less effect
-Withdrawal, shown by either of:
-the substance's characteristic withdrawal syndrome
-the substance (or one closely related) is used
to avoid or relieve withdrawal symptoms
-The amount or duration of use is often greater
-The patient repeatedly tries without success
to control or reduce substance use.
-The patient spends much time using the substance,
recovering from its effects or trying to obtain it.
-The patient reduces or abandons important social,
occupational or recreational activities because of substance use.
-The patient continues to use the substance,
despite knowing that it has probably caused physical or psychological problems.
With Physiological Dependence. There is evidence of tolerance or withdrawal
Without Physiological Dependence.
Choose one or none to specify course:
Early Full Remission (months 2 through 12)
Early Partial Remission (months 2 through 12)
Sustained Full Remission (months 13+)
Sustained Partial Remission (months 13+)
Specify one, either or both of:
On Agonist Therapy (does not apply to Cannabis, Hallucinogens, Inhalants,
In a Controlled Environment (does not apply to Nicotine)
for Substance Withdrawal
A syndrome specific to a substance develops when someone who has used it
frequently and for a long time suddenly stops or markedly reduces its intake.
This syndrome causes clinically important distress or impairs work, social
or personal functioning.
This syndrome is neither the result of a general medical condition nor
better explained by a different mental disorder.
for Substance Abuse
The patient's maladaptive substance use pattern causes clinically important
distress or impairment as shown in a single 12-month period by 1 or more
of the following:
- Because of repeated use, the patient fails to carry out major obligations
at work or at home.
- The patient uses substances even when it is physically dangerous.
- The patient repeatedly has legal problems from substance use.
- Despite knowing that it has caused or worsened social or interpersonal
problems, the patient continues to use the substance.
- For this class of substance, the patient has never fulfilled criteria for