One of the reference guides used by clinicians to diagnose mental health disorders is known as the Diagnostic and Statistical Manual of Mental Disorders (DSM). The most recent version of the manual, the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5), was released in May 2013.

There is no disorder in the DSM-5 specifically relating the use of pharmaceutical drugs. Instead, the broad criteria of a “substance use disorder” apply. 

DSM-5 Diagnostic Criteria

According to the DSM-5, a substance use disorder is defined as:

A pattern of substance use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

1.    The substance is often taken in larger amounts or over a longer period than was intended

2.    There is a persistent desire or unsuccessful efforts to cut down or control substance use

3.    A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects

4.    Having craving, or a strong desire or urge to use the substance

5.    Recurrent substance use resulting in a failure to fulfil major role obligations at work, school, or home

6.    Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance

7.    Important social, occupational, or recreational activities are given up or reduced because of substance use

8.    Recurrent substance use in situations in which it is physically hazardous

9.    Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance

10. Tolerance, as defined by either of the following:

a.    A need for markedly increased amounts of the substance to achieve intoxication or desired effect.

b.    A markedly diminished effect with continued use of the same amount of the substance.

11. Withdrawal, as manifested by either of the following:

a.    The characteristic withdrawal syndrome for the substance

b.    The substance (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.

A mild substance use disorder is defined as the presence of 2-3 of the above symptoms.

A moderate substance use disorder is defined as the presence of 4-5 of the above symptoms.

A severe substance use disorder is defined as the presence of 6 or more of the above symptoms.

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