This document defines and compares substance dependence, abuse, intoxication, and withdrawal according to the DSM-IV and ICD-10 diagnostic criteria. Substance dependence involves a maladaptive pattern of use leading to behaviors, cognition, and physiology after repeated intake and reliance on the substance. Substance abuse also involves maladaptive use but is defined by recurrent adverse consequences from misuse. Both can involve compulsive use, tolerance, and withdrawal symptoms. Substance intoxication and withdrawal are also defined based on their physiological and psychological effects.

1. Definition of dependence and
abuse of drugs
Nur Amalina bt. Aminuddin Baki
60

2. Introduction
• Diagnostic and Statistical Manual of Mental
Disorders 4th
edition (DSM-IV)
o Common language and criteria for classification of
mental retardation
• International Classification of Diseases and
Related Health Problems 10th
edition (ICD-10)
o Medical classification list by WHO for
diseases, signs, symptoms, abnormal
findings, complaint and causes of
disorder

3. Differences
Substance Dependence
• Arise out of maladaptive
pattern of substance use,
leading to a cluster of
behavioral, cognitive , and
physiological phenomena
that developed after
repeated intake.
• Reliance/ controlled
Substance Abuse
• Arise out of maladaptive
pattern of substance use,
manifested by recurrent
and significant adverse
consequences related to
repeated intake.
• Misuse

4. Substance Dependence
• Strong desire to take drug
• Difficult to control use
• Persistent use despite
harmful consequences
• Prioritizes above other
• Increased tolerance
• Physical withdrawal state
Substance Abuse
• Occur recurrently during
same 12- month period
• Harmful sequences due to
repeated use
• compulsive use, tolerance ,
withdrawal

5. Substance Intoxication
• DSM-IV
o Unwanted physiological or psychological effect
that cause maladaptive behaviour
• ICD-10
o Produce disturbance in level of consciousness,
cognition, perception or behaviour that is
clinically significant

6. Substance Withdrawal
• DSM-IV
o Major symptoms resulting from cessation of
substance abuse , accompanied by behavioural
change
o Caffein or cannabis
• ICD-10
o Caffein or canabis

7. Physical Dependence
• Alteration in neural system,
manifested by tolerance
and withdrawal effect
Addiction
• Compulsive use of drugs
resulting in harm and
continued use despite that
harm