• 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 or
    -the substance (or one closely related) is used to avoid or relieve withdrawal symptoms
-The amount or duration of use is often greater than intended.
-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.

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, PCP)
In a Controlled Environment (does not apply to Nicotine)

• 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.

• 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 Substance Dependence.