Substance-Related Disorders

In the previous posts, we looked at some introductory concepts for Substance-Related Disorders, namely: the reward circuit and addiction. The clinical framework of these disorders is complex but also repetitive. I say this because the criteria used to diagnose, for example, an alcohol use disorder or a cannabis use disorder are quite similar—the main differences lie in the physical symptoms that develop in cases of intoxication and withdrawal from one substance versus another.

The diagnostic manual (DSM-5) distinguishes Substance-Related Disorders into two groups:

1. Substance Use Disorders
2. Substance-Induced Disorders
   

Substance-Induced Disorders are further divided into three groups:
2.1 Intoxication
2.2 Withdrawal
2.3 Substance-Induced Mental Disorders

To diagnose a Substance Use Disorder, the DSM-5 requires that at least two of the following eleven criteria be met within a one-year period:

1. The substance is taken in larger amounts or over a longer period than originally intended. 
2. There are unsuccessful attempts to control or reduce substance use.
3. A great deal of time is spent obtaining the substance or recovering from its effects.
4. Presence of craving.
5. Continued use of the substance causes significant impairment in social or occupational functioning.
6. Continued use of the substance despite awareness of its negative effects on social or occupational life.
7. Substance use disrupts or replaces social and recreational activities that the individual once found enjoyable.
8. The substance is used even in physically dangerous situations.
9. The substance is used despite awareness of its physical or psychological harm.
10. Tolerance develops.
11. Withdrawal develops.
    

Substance Intoxication, according to the DSM-5, can be diagnosed when the following four criteria are met:

• Recent use of the substance.
• Development of problematic behavior during or shortly after use.
• Appearance of physiological symptoms typical of that substance within a relatively short timeframe (which varies depending on the substance used).

• The symptoms cannot be better explained by another condition.

Substance Withdrawal, according to the DSM-5, can be diagnosed when the following four criteria are met:

• Cessation or drastic reduction of heavy and prolonged use of a substance.
• Appearance of physiological symptoms typical of that substance within a relatively short timeframe (which varies depending on the substance used).
• The physiological symptoms cause significant social or occupational distress.
• The symptoms cannot be better explained by another condition.

Sources:

• American Psychiatric Association (2013) – Diagnostic and Statistical Manual of Mental Disorders (5th ed.)
• Bernhill, J. W. (2014) – DSM-5 Clinical Cases.

Recommended videos:

• https://www.youtube.com/watch?v=jZHtIb2ZMcA
• https://www.youtube.com/watch?v=0rehK3Mkyf4
• https://www.youtube.com/watch?v=kSgvhB23060 
• https://www.youtube.com/watch?v=3tfRcpcMXMk
• https://www.youtube.com/watch?v=6rwsm6MXZ80
  

If you’d like me to describe another psychology topic in my own words, write it in the comments.