Table of ContentsView AllTable of ContentsWhat Are Substance Use Disorders?Diagnostic CriteriaSubstance-Induced DisordersDiagnosisGetting Help for a Substance Use Disorder
Table of ContentsView All
View All
Table of Contents
What Are Substance Use Disorders?
Diagnostic Criteria
Substance-Induced Disorders
Diagnosis
Getting Help for a Substance Use Disorder
The"Diagnostic and Statistical Manual of Mental Disorders", Fifth Edition, text revision, often called the DSM-V-TR or DSM-5-TR, is the latest version of the American Psychiatric Association’s gold-standard text on the names, symptoms, and diagnostic features of every recognized mental illness—including addictions.
The DSM-5-TR criteria forsubstance use disordersare based on decades of research and clinical knowledge. The DSM-5-TR was published in 2013, and in 2022, a text revision was published that included updated criteria for more than 70 disorders, including the requirements for stimulant-induced mild neurocognitive disorder.
Keep reading to learn more about the DSM-5-TR criteria for substance use disorders and how these conditions are diagnosed.
What is the most important information I should know about substance use disorders?
Verywell / Brianna Gilmartin
The DSM-5-TR recognizes substance-related disorders resulting from the use of 10 separate classes of drugs:
While some major groupings ofpsychoactive substancesare specifically identified, the use of other or unknown substances can also form the basis of a substance-related or addictive disorder.
The activation of the brain’s reward system is central to problems arising from drug use. The rewarding feeling people experience due to taking drugs may be so profound that they neglect other normal activities in favor of taking the drug.
The pharmacological mechanisms for each class of drug are different. However, the activation of the reward system is similar across substances in producing feelings of pleasure or euphoria, often referred to as a “high.”
The DSM-5-TR recognizes that people are not all automatically or equally vulnerable to developingsubstance-related disorders. Some people have lower levels of self-control that predispose them to develop problems if exposed to drugs.
Substance-Use vs. Substance-Induced Disorders
There are two groups of substance-related disorders: substance-use disorders and substance-induced disorders.
DSM-5-TR Substance Use Disorder Criteria
Substance use disorders span a wide variety of problems arising from substance use, and cover 11 different criteria:
The 11 criteria outlined in the DSM-5-TR can be grouped into four primary categories: physical dependence, risky use, social problems, and impaired control.
It is important to note that people can experience tolerance and withdrawal in the context of taking prescription drugs to treat a medical or mental health condition. This does not necessarily mean that they have a substance use disorder, however.
Severity of Substance Use Disorders
The DSM-5-TR allows clinicians to specify how severe or how much of a problem the substance use disorder is, depending on how many symptoms are identified.
Clinicians can also add “in early remission,” “in sustained remission,” “on maintenance therapy” for certain substances, and “in a controlled environment.” These further describe the current state of the substance use disorder.
Understanding the severity of a substance use disorder can help doctors and therapists better determine which treatments to recommend. Choosing the appropriate level of care may improve a person’s chances of recovery.
Substance/Medication-Induced Mental Disorders
Substance/medication-induced mental disorders are mental problems that develop in people who did not have mental health problems before using substances. They include:
Intoxication
Substance intoxication, a group of substance-induced disorders, details the symptoms that people experience when they are under the influence of drugs. Disorders of substance intoxication include:
Withdrawal
Substance withdrawalinvolves experiencing physical, cognitive, and behavioral symptoms due to reducing or halting substance use. To be diagnosed with withdrawal, these symptoms must not be due to another mental disorder or medical condition.
Withdrawal from some substances (such as alcohol or barbiturates) can be severe and sometimes life-threatening. Other substances may not produce withdrawal effects when their use is halted. Some substances, such as opioids, may lead to withdrawal even when taken for a short period and for legitimate medical purposes.
Withdrawal symptoms can range from mild to severe; they can also sometimes be potentially dangerous. Talk to your doctor about how you can stop using a substance safely.
Diagnosing Substance Abuse Disorders
If you think that you or a loved one might have a substance use disorder, effective treatments are available that can help. The first step is to talk to your doctor or mental health professional about your options. Your treatment and recovery needs will vary depending on the nature and severity of your substance use.
In some cases, suddenly stopping your substance use can be risky or potentially fatal. You should work with your doctor to devise a plan for medically-supervised detox. Your doctor may also recommend medications that can help you recover and manage withdrawal symptoms and cravings.
Residential treatment, outpatient treatment, day treatment/partial hospitalization, and sober living communities are some of the treatment options you might consider. Your treatment may involve psychotherapy, such asmotivational-enhancement therapy(MET) orcognitive-behavioral therapy(CBT). Support groups can also aid your recovery, including in-person or online options.
Research also suggests that having adequatesocial supportis important duringaddiction recovery.Reach out to trusted friends and family who can help you through this process.Mutual support groupsand12-step recovery groupscan also be a great place to find encouragement, resources, and support.
There is no one-size-fits-all approach for treating substance use disorders. Work with your doctor to find the right approach to address your needs, provide appropriate support, and foster long-term recovery.
If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.
If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
For more mental health resources, see ourNational Helpline Database.
Substance Use vs. Substance Abuse: What Are the Differences?
9 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.First MB, Yousif LH, Clarke DE, Wang PS, Gogtay N, Appelbaum PS.DSM‐5‐TR: Overview of what’s new and what’s changed.World Psychiatry. 2022;21(2):218-219. doi:10.1002/wps.20989American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Grant JE, Chamberlain SR.Expanding the definition of addiction: DSM-5 vs. ICD-11.CNS Spectr. 2016;21(4):300-3. doi:10.1017/S1092852916000183Merck Manual: Professional Version.Substance-induced disorders.McLellan AT.Substance misuse and substance use disorders: Why do they matter in healthcare?.Trans Am Clin Climatol Assoc. 2017;128:112-130.Phillips KA, Stein DJ.Other obsessive-compulsive and related disorders in DSM-5. In: Phillips KA, Stein DJ, eds.,Handbook on obsessive-compulsive and related disorders. Arlington, VA: American Psychiatric Association Publishing; 2015.Khan A, Wedes S.Alcohol-induced neurocognitive disorder in elderly presenting as mania? A case report.The American Journal of Geriatric Psychiatry. 2016;24(3):S129-S130. doi:10.1016/j.jagp.2016.01.131Lappin JM, Sara GE.Psychostimulant use and the brain.Addiction. 2019;114(11):2065-2077. doi:10.1111/add.14708Brooks AT, Lòpez MM, Ranucci A, Krumlauf M, Wallen GR.A qualitative exploration of social support during treatment for severe alcohol use disorder and recovery.Addict Behav Rep. 2017;6:76-82. doi:10.1016/j.abrep.2017.08.002
9 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.First MB, Yousif LH, Clarke DE, Wang PS, Gogtay N, Appelbaum PS.DSM‐5‐TR: Overview of what’s new and what’s changed.World Psychiatry. 2022;21(2):218-219. doi:10.1002/wps.20989American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Grant JE, Chamberlain SR.Expanding the definition of addiction: DSM-5 vs. ICD-11.CNS Spectr. 2016;21(4):300-3. doi:10.1017/S1092852916000183Merck Manual: Professional Version.Substance-induced disorders.McLellan AT.Substance misuse and substance use disorders: Why do they matter in healthcare?.Trans Am Clin Climatol Assoc. 2017;128:112-130.Phillips KA, Stein DJ.Other obsessive-compulsive and related disorders in DSM-5. In: Phillips KA, Stein DJ, eds.,Handbook on obsessive-compulsive and related disorders. Arlington, VA: American Psychiatric Association Publishing; 2015.Khan A, Wedes S.Alcohol-induced neurocognitive disorder in elderly presenting as mania? A case report.The American Journal of Geriatric Psychiatry. 2016;24(3):S129-S130. doi:10.1016/j.jagp.2016.01.131Lappin JM, Sara GE.Psychostimulant use and the brain.Addiction. 2019;114(11):2065-2077. doi:10.1111/add.14708Brooks AT, Lòpez MM, Ranucci A, Krumlauf M, Wallen GR.A qualitative exploration of social support during treatment for severe alcohol use disorder and recovery.Addict Behav Rep. 2017;6:76-82. doi:10.1016/j.abrep.2017.08.002
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
First MB, Yousif LH, Clarke DE, Wang PS, Gogtay N, Appelbaum PS.DSM‐5‐TR: Overview of what’s new and what’s changed.World Psychiatry. 2022;21(2):218-219. doi:10.1002/wps.20989American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Grant JE, Chamberlain SR.Expanding the definition of addiction: DSM-5 vs. ICD-11.CNS Spectr. 2016;21(4):300-3. doi:10.1017/S1092852916000183Merck Manual: Professional Version.Substance-induced disorders.McLellan AT.Substance misuse and substance use disorders: Why do they matter in healthcare?.Trans Am Clin Climatol Assoc. 2017;128:112-130.Phillips KA, Stein DJ.Other obsessive-compulsive and related disorders in DSM-5. In: Phillips KA, Stein DJ, eds.,Handbook on obsessive-compulsive and related disorders. Arlington, VA: American Psychiatric Association Publishing; 2015.Khan A, Wedes S.Alcohol-induced neurocognitive disorder in elderly presenting as mania? A case report.The American Journal of Geriatric Psychiatry. 2016;24(3):S129-S130. doi:10.1016/j.jagp.2016.01.131Lappin JM, Sara GE.Psychostimulant use and the brain.Addiction. 2019;114(11):2065-2077. doi:10.1111/add.14708Brooks AT, Lòpez MM, Ranucci A, Krumlauf M, Wallen GR.A qualitative exploration of social support during treatment for severe alcohol use disorder and recovery.Addict Behav Rep. 2017;6:76-82. doi:10.1016/j.abrep.2017.08.002
First MB, Yousif LH, Clarke DE, Wang PS, Gogtay N, Appelbaum PS.DSM‐5‐TR: Overview of what’s new and what’s changed.World Psychiatry. 2022;21(2):218-219. doi:10.1002/wps.20989
American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.
Grant JE, Chamberlain SR.Expanding the definition of addiction: DSM-5 vs. ICD-11.CNS Spectr. 2016;21(4):300-3. doi:10.1017/S1092852916000183
Merck Manual: Professional Version.Substance-induced disorders.
McLellan AT.Substance misuse and substance use disorders: Why do they matter in healthcare?.Trans Am Clin Climatol Assoc. 2017;128:112-130.
Phillips KA, Stein DJ.Other obsessive-compulsive and related disorders in DSM-5. In: Phillips KA, Stein DJ, eds.,Handbook on obsessive-compulsive and related disorders. Arlington, VA: American Psychiatric Association Publishing; 2015.
Khan A, Wedes S.Alcohol-induced neurocognitive disorder in elderly presenting as mania? A case report.The American Journal of Geriatric Psychiatry. 2016;24(3):S129-S130. doi:10.1016/j.jagp.2016.01.131
Lappin JM, Sara GE.Psychostimulant use and the brain.Addiction. 2019;114(11):2065-2077. doi:10.1111/add.14708
Brooks AT, Lòpez MM, Ranucci A, Krumlauf M, Wallen GR.A qualitative exploration of social support during treatment for severe alcohol use disorder and recovery.Addict Behav Rep. 2017;6:76-82. doi:10.1016/j.abrep.2017.08.002
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