DSM 1V Classification

DSM IV (The American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders 4th edition), classifies substance related disorders according to the effects of the substance, for example intoxication; abuse; dependence; withdrawal; psychotic disorders; mood disorders; anxiety disorders; sexual dysfunction.

DSM IV also groups the drugs responsible for substance related disorders as follows: Alcohol, amphetamines, caffeine, cannabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, sedatives, hypnotics or anxiolytics.

Intoxication is a transient syndrome due to recent substance ingestion that causes clinically significant psychological and physical impairment. Abuse refers to maladaptive patterns of substance use that impair health.

Dependence is diagnosed if 3 or more of the following have been experienced or exhibited in the last year -:

• Tolerance, defined by either need for markedly increased amounts of substance to achieve intoxication or desired effect, or markedly diminished effect with continued use of the same amount of the substance.
• Withdrawal, as evidenced by either of the following:
  • The characteristic withdrawal syndrome for the substance
  • The same (or closely related substance) is taken to relieve or avoid withdrawal symptoms.
• The substance is often taken in larger amounts over a longer period than was intended.
• Persistent desire or repeated unsuccessful efforts to cut down or control substance use.
• A great deal of time is spent in activities necessary to obtain the substance, use of the substance, or recover from its effects
• Important social, occupational or recreational activities have been given up or reduced because of substance abuse.
• Continued substance use despite knowledge of having had a persistent or recurrent physical or psychological problem that was likely to have been caused or exacerbated by the substance.

Amended June 2008