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There are 10 categories of substance-related disorders in the current Diagnostic and Statistical Manual, fifth edition. The category is called Substance Related and Addictive Disorders.

  • Alcohol related disorders
  • Caffeine related disorders
  • Cannabis related disorders
  • Hallucinogen related disorders
  • Inhalant related disorders
  • Opioid related disorders
  • Sedative, hypnotic or anxiolytic related disorders
  • Stimulant related disorders
  • Tobacco related disorders
  • Other substance related disorders

Substance abuse and dependence can readily occur with prescription and over-the-counter medications such as painkillers, antihistamines, steroids, and muscle relaxants.

With the exception of nicotine, abuse of these substances have been associated with the onset or exacerbation of mood and/or anxiety disorders and sometimes aggressive and psychotic episodes. Alcohol, inhalants, and sedatives/hypnotics/anxiolytics have been associated with dementia when used excessively over time.

A diagnosis of Substance Use Disorder is applied to every class of substance except caffeine.  There are 3 severity levels according to the Diagnostic and Statistical Manual (DSM-V):

  • MILD = 2-3 symptoms
  • MODERATE = 4-5 symptoms
  • SEVERE = 6+ symptoms

Substance Use Disorder is characterized by an individual’s continued use of a substance despite clinically significant impairment or distress, as manifested by 2 or more symptoms of the following:

  • Tolerance for the substance—as demonstrated by the need for more of it to achieve the desired effect or markedly reduced effect from the same amount.
  • Withdrawal as demonstrated by unpleasant physiological and cognitive changes or the use of the same/related substance to relieve or avoid withdrawal symptoms.
  • Taking more of the substance or for a longer period than intended.
  • Persistent desire and unsuccessful efforts to cut or control substance use.
  • Extraordinary efforts to acquire the substance, use or recover from use.
  • Sacrifices of important social, occupational, or recreational activities because of use.
  • Continued use despite knowledge of negative effects and having recurrent social or interpersonal problems.
  • Craving or a strong desire to use.
  • Recurrent use results in failure to fulfill major obligations at work, home or school.
  • Engaging in risky behaviors which are physically hazardous.

Substance use, abuse, and dependence often accompany anxiety disorder and depression. The incidence of alcoholism, for example, is higher in families with a history of depression than in those with no evidence of mood disorder. For this reason, substance abuse or dependence may indicate there are other problems driving the person to abuse a substance as a way of reducing his or her distress. Medication in this case must be administered judiciously, and counseling is indicated.

Chemical Dependency Definitions

  • Addiction: A chronic relapsing disease characterized by compulsive drug seeking and use.  There are neurological and molecular changes in the brain.
  • Chemical: The term chemical is used to refer to all substance that can be mood-altering or potentially physically and/or psychologically addicting. Chemicals include legal and illegal drugs.
  • Chemical Health: is the promotion of healthy environments, behaviors and decisions that reduce or eliminate the problematic use of alcohol, prescription drugs, over the counter drugs used as inhalants and illegal drugs. Chemical health encourages the appropriate, safe and legal use of mood altering chemicals.
  • Craving: A powerful, often uncontrollable desire to use chemicals.
  • Detoxification: The process of allowing the body to rid itself of a chemical while managing the symptoms of withdrawal.
  • Withdrawal: A variety of symptoms that occur while the body is ridding itself of chemicals.