Figure 2-2: DSM-IV Diagnostic Criteria for Substance Dependence

Figure 2-2
DSM-IV Diagnostic Criteria for Substance Dependence
The DSM-IV defines the diagnostic criteria for substance dependence as a maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three or more of the following, occurring at any time in the same 12-month period:
  1. Tolerance, as defined by either of the following:
    • The need for markedly increased amounts of the substance to achieve intoxication or desired effect.
    • Markedly diminished effect with continued use of the same amount of the substance.
  2. Withdrawal, as manifested by either of the following:
    • The characteristic withdrawal syndrome for the substance.
    • The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
  3. Taking the substance often in larger amounts or over a longer period than was intended.
  4. A persistent desire or unsuccessful efforts to cut down or control substance use.
  5. Spending a great deal of time in activities necessary to obtain or use the substance or to recover from its effects.
  6. Giving up social, occupational, or recreational activities because of substance use.
  7. Continuing the substance use with the knowledge that it is causing or exacerbating a persistent or recurrent physical or psychological problem.
Source: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Copyright 1994, American Psychiatric Association.

From: Executive Summary and Recommendations

Cover of Substance Abuse Among Older Adults
Substance Abuse Among Older Adults.
Treatment Improvement Protocol (TIP) Series, No. 26.
Center for Substance Abuse Treatment.
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