How to Use DSM-V for Substance Use Disorders?

2. Substance-Use Disorders in
DSM-V
Muhammad Talha Khalid
Ph.D. (Scholar)
International Certified Addiction Professional
(ICAP-I)
Presented by:

3. Addiction
Definition
 Addiction is defined as a chronic, relapsing disorder
characterized by compulsive drug seeking, continued use
despite harmful consequences, and long-lasting changes in
the brain (NIDA).

4. SUDs in DSM-V
 In May 2013, APA updated the DSM.
 Replacing the categories of
substance abuse and substance
dependence with a single category:
substance use disorder.

5. What’s New?
 Restructuring of substance use disorders for
consistency and clarity.

6. Categories of SUDs in DSM-V
10 separate classes of drugs:
1. Alcohol;
2. Caffeine;
3. Cannabis;
4. Inhalants;
5. Opioids;
6. Sedatives,
7. Hypnotics, and anxiolytics;
8. Stimulants
9. Tobacco; and
10.Other (or unknown) substances.

7. Non-Substance-Related Disorders
 Gambling Disorder
Behavioral Addictions (excessive & repetitive behavioral
Patterns) Not Included in DSM as Substance use Disorder;
 Internet gaming
 sex addiction
 exercise addiction
 shopping addiction etc.

8.  Substance-use disorders are patterns of symptoms
resulting from the use of a substance that individual
continue to take, despite experiencing problems as a
result.
 Substance-induced disorders, including intoxication,
withdrawal, and other substance/medication-induced
mental disorders, are detailed alongside substance use
disorders.
Groups Of Substance-related Disorders

9. Diagnostic criteria:
1. Taking the substance in larger amounts or for longer
than you're meant to.
2. Wanting to cut down or stop using the substance but
not managing to.
3. Spending a lot of time getting, using, or recovering
from use of the substance.
4. Cravings and urges to use the substance.
5. Not managing to do what you should at work, home, or
school because of substance use.
6. Continuing to use, even when it causes problems in
relationships.
How to Diagnose?

10. Diagnostic criteria: (cont…)
7. Giving up important social, occupational, or
recreational activities because of substance use.
8. Using substances again and again, even when it puts
you in danger.
9. Continuing to use, even when you know you have a
physical or psychological problem that could have
been caused or made worse by the substance.
10.Needing more of the substance to get the effect you
want (tolerance).
11.Development of withdrawal symptoms, which can be
relieved by taking more of the substance.

11. Severity and Specifiers
Severity:
 Mild: 2-3 Symptoms
 Moderate: 4-5 Symptoms
 Severe: 6 or More
Grouping:
 Impaired control (1-4)
 Social impairment (5-7)
 Risky use (8-9)
 Pharmacological criteria (10-11)

12. Specifiers:
 In early remission: (min. 3 months to less than 12 months)
 In sustained remission: (min.12 months or more)
 On maintenance therapy
 In a controlled environment
Tentative Diagnosis: Example
According to DSM;
(F11.20) Severe Opioid Use Disorder
Current Severity: Severe
Specify with: In a controlled Environment