Substance-related disorders are now evaluated on a continuum of severity rather than separate abuse and dependence diagnoses. The diagnostic criteria are almost identical to the previous abuse and dependence diagnoses, evaluating impaired control, social/interpersonal problems, risky use, and pharmacological criteria like tolerance and withdrawal. A new disorder, gambling disorder, was added as gambling can activate the same brain regions and often leads to similar problems as substance use disorders.

1. Substance-related Disorders

2.  (information from:
http://www.psych.org/practice/dsm/dsm5,
updated May 17, 2013)
 Abuse was problematic substance use that
impaired functioning
 Dependence took Abuse a step further,
including withdrawal, tolerance, or
psychological dependence on a substance

3.  Diagnostic criteria (symptoms) are almost
identical to old abuse and dependence
diagnoses
◦ Taken in larger amounts than intended
◦ Unsuccessful efforts to reduce or control use
◦ Excessive time spent using, obtaining, or recovering
from use
◦ Failure to fulfill major role obligations
◦ Withdrawal reactions
◦ Tolerance effects
◦ Craving (new)
◦ And others…

4.  Continuum instead of separate Abuse vs.
Dependence diagnoses
◦ Mild: 2-3 criteria
◦ Moderate: 4-5 criteria
◦ Severe: 6 or more criteria
 New specifiers: “in a controlled environment”,
“on maintenance therapy”
 Cannabis withdrawal

5.  Gambling Disorder
◦ Gambling can activate the same regions of the brain
as substance use
◦ Gambling can lead to many of the same problems
 Sex Addiction is NOT a diagnosable disorder!