You may be wondering what defines an addict or a substance use disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM), which is the official text on which diagnoses are based, contains the criteria for substance use disorders and other mental health problems. The latest version of DSM is the fifth edition, known as DSM-5, and it has some significant changes to both the list of substance use disorders and the criteria that must be met in order to diagnose some of these conditions.
Substance Use Disorders
In the last edition of the DSM, DSM-IV, there were two categories: substance abuse and substance dependence. DSM-5 combines these two categories into one called "substance use disorder."
If your substance use causes significant problems in your life, such as health issues, disability, and or not meeting your responsibilities at work, home, or school, you may have a substance use disorder.
Criteria for a Substance Use Disorder
Substance use disorders are classified as mild, moderate, or severe, depending on how many of the diagnostic criteria you meet. The 11 DSM-5 criteria for a substance use disorder include:
Hazardous use: You've used the substance in ways that are dangerous to yourself and/or others, i.e., overdosed, driven while under the influence, or blacked out.
Social or interpersonal problems related to use: Your substance use has caused relationship problems or conflicts with others.
Neglected major roles to use: You've failed to meet your responsibilities at work, school, or home because of your substance use.
Withdrawal: When you've stopped using the substance, you've experienced withdrawal symptoms.
Tolerance: You've built up a tolerance to the substance so that you have to use more to get the same effect.
Used larger amounts/longer: You've started to use larger amounts or use the substance for longer amounts of time.
Repeated attempts to control use or quit: You've tried to cut back or quit entirely, but haven't been successful.
Much time spent using: You spend a lot of your time using the substance.
Physical or psychological problems related to use: Your substance use has led to physical health problems like liver damage or lung cancer, or psychological issues, such as depression or anxiety.
Activities given up to use: You've skipped activities or stopped doing activities you once enjoyed in order to use the substance.
Craving: You've experienced cravings for the substance.
Being Diagnosed With a Substance Use Disorder
In order to be diagnosed with a substance use disorder, you must meet two or more of these criteria within a 12 month period. If you meet two or three of the criteria, you have a mild substance use disorder. Four to five is considered moderate, and if you meet six or more criteria, you have a severe substance use disorder.
Types of Substance Use Disorders
Each substance use disorder is classified as its own disorder. Here are the six most common substance use disorders in the United States:
Alcohol use disorder
Tobacco use disorder
Cannabis use disorder
Stimulant use disorder
Hallucinogen use disorder
Opioid use disorder