WHAT IS THE MEANING OF SUBSTANCE-RELATED DISORDERS?
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) divides substance-related disorders (encompassing 10 separate classes of drugs) into (1) substance use disorders and (2) substance-induced disorders (e.g., intoxication, withdrawal, and substance-induced mental disorders).
The diagnosis of substance use disorder is based on a pathologic pattern of behaviours related to use of the substance. Diagnostic criteria fall into the categories of (1) impaired control, (2) social impairment, (3) risky use, and (4) pharmacological criteria, including tolerance and withdrawal.
DSM-5 does not separate the diagnoses of substance abuse and substance dependence. Criteria are provided for substance use disorder, accompanied by criteria for intoxication, withdrawal, substance-induced disorders, and unspecified substance-related disorders in some cases.
Addiction: A primary chronic neurologic disease characterised by one or more of the following five Cs: chronicity, impaired control over drug use, compulsive use, continued use despite harm, and craving.
Intoxication: Development of a substance-specific syndrome after recent ingestion and presence in the body of a substance; it is associated with maladaptive behaviour during the waking state caused by effects of the substance on the central nervous system (CNS).
Physical dependence: A state of adaptation manifested by a drug class– specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing the blood level of the drug, and/or administration of an antagonist.
Substance dependence: The characteristic feature is a continued maladaptive pattern of substance use in spite of repeated adverse consequences related to the repeated use.
Tolerance: A state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug’s effects over time.
Withdrawal: A substance-specific syndrome occurring after cessation of or reduction in intake of a substance that was used regularly.
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