Substance-Related and Addictive Disorders

Alcohol Use Disorder

A. A problematic patter of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occuring within a 12-month period. 1. Alcohol is often taken in larger amount or over a longer period of time than was intended. 2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use. 3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects. 4. Craving, or a strong desire or urge to use alcohol. 5. Recurrent alcohol use resulting in a failure to fulfill major role obligation at work, school, or home. 6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol. 7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use. 8. Recurrent alcohol use in situations in which it is physically hazardous. 9. Alcohol 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 alcohol. 10. Tolerance, as defined by the following: a. A need for markedly increased amounts of alcohol use of the same amount of alcohol to achieve intoxication or desired effect. b. Alcohol (or a closely related substance, such as benzodiazepine) is taken to relieve or avoid withdrawal symptoms. 11. Withdrawal, as manifested by either of the following: a. The characteristic withdrawal syndrome for alcohol b. Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.

Alcohol Withdrawal (p. 499)

A. Cessation of (or reduction in) alcohol use that has been heavy and prolonged. B. Two (or more) of the following, developing within a several hours to a few days after the cessation of (or reduction in) alcohol use described in Criterion A: 1. Autonomic hyperactivity (sweating, pulse greater than 100 bpm) 2. Increased hand tremor 3. insomnia 4. nausea or vomiting 5. transient visual, tactile, or auditory hallucinations or illusions 6. Psychomotor agitation. 7. anxiety 8. Generalized tonic-clonic seizures. C. The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The signs and symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.

Tobacco Use Disorder: Tolerance

Tolerance, as defined by either of the following: A. A need for markedly increased amounts of tobacco to achieve the desired effect. B. A markedly diminished effect with continued use of the same amount of tobacco.

Tobacco Use Disorder: Withdrawal

Withdrawal, as manifested by either of the of the following: A. The characteristic with withdrawal syndrome for tobacco B. Tobacco (or a closely related substance, such as nicotine) is taken to relieve or avoid withdrawal symptoms)

Behavioral addictions (p.481)

def: groups of repetitive behaviors. ex: internet gaming, sex addiction, exercise addiction, shopping addiction. Not included in DSM5 because there is insufficient peer-reviewed evidence to establish the diagnostic criteria and course descriptions needed to identify these behaviors as mental disorders. **Gambling disorder is included due to evidence that gambling behaviors activate reward systems similar to those activated by drugs of abuse and produce some behavioral symptoms that appear comparable to those produced by substance use disorders.