Substance-Related and Addictive Disorders

Overview of the DMS 5 changes

• Consolidates substance abuse and dependence into a single diagnosis: substance use disorder

• New criteria for substance use disorder include intoxication, withdrawal, and substance/medication-induced disorders

• The previous criterion of recurrent legal problems for substance abuse has been removed, replaced by a focus on craving or a strong desire to use substances.

Substance Abuse

Characterized by excessive use leading to hazardous behavior and continued use despite persistent problems.

Substance Dependence/ Addiction

Defined by a physiological need for increasing amounts of a substance, evident through tolerance and withdrawal symptoms.

Substance Use Disorder

It is marked by maladaptive behavior due to substance use, leading to significant impairment in social, educational, or occupational functioning.

Substance Use

It is the ingestion of psychoactive substances in moderate amounts that does not significantly interfere with social, educational, or occupational functioning.

Substance Intoxication

Refers to the physiological reaction to substances, resulting in impaired judgment and mood changes.

Substance Abuse

Defined by the extent to which substance use disrupts life, including education, job performance, and relationships.

Key Feature of Substance Use Disorder

• Tolerance

• Withdrawal

• Craving

Tolerance

The need for increasingly larger amounts of a substance to achieve the same effect, indicating physiological adaptation.

Withdrawal

Negative physical responses when the substance is not ingested, highlighting dependence.

Craving

A strong desire or urge to use the substance, often leading to relapse.

Alcohol Withdrawal Delirium (Delirium Tremens)

Delirium caused by termination of heavy alcohol consumption.

Polysubstance Use

Using multiple substances; comorbidity

Mild Level

2-3 criteria

Moderate Level

4-5 criteria

Severe Level

6 or more criteria

Depressants

Substances result in behavioral sedation and can induce relaxation.

Stimulants

Substances that cause us to be more active and alert, and can elevate mood.

Opiates

It produces analgesia temporarily to reduce pain, and euphoria.

Hallucinogens

Substances that alter sensor perception and can produce delusions, paranoia, and hallucinations.

Caffeine

Most common psychoactive substance because it is legal, elevates mood and decreases fatigue.

Cocaine

This substance causes euphoria, appetite loss, and increased alertness; produce irritable babies.

Nicotine

This substance stimulates the nervous system and relieves stress.

Amphetamines

These create feelings of elation and vigor and reduce fatigue. They are prescribed to people with narcolepsy and ADHD.

Other Drugs of Abuse

Substances that are abused but do not fit neatly into one of the categories like inhalants, anabolic steroids, and other o-t-c and prescription medications.

Alcohol Use Disorder

Characterized by an inability to stop drinking and persistent cravings.

Alcohol Intoxication

Physiological effects of alcohol consumption, including impaired motor skills and judgment.

Alcohol Withdrawal

Symptoms that occur when alcohol consumption is reduced or stopped, potentially leading to delirium tremens.

Cannabis Use Disorder

Involves problematic use of cannabis, leading to significant impairment.

Hallucinogen-Related Disorders

Include various disorders related to the use of hallucinogenic substances, such as phencyclidine (PCP) and LSD.

Gambling Disorder

Characterized by problematic gambling behavior leading to significant impairment, similar to substance use disorders in terms of cravings and dependence.