The APA is planning to eliminate substance dependence and substance abuse from the DSM-5 and is planning to replace them with “[insert drug name]-use disorder”. Here are the proposed alcohol-use disorder criteria.
They propose severity specifiers, which is interesting. However, at first glance, I’m concerned about putting abuse and dependence on the same continuum, though I was always pretty ambivalent about abuse as a diagnosis anyway.
UPDATE: Let’s hope they don’t group “internet addiction” and opiate addiction:
Among the work group’s proposals is the recommendation that the diagnostic category include both substance use disorders and non-substance addictions. Gambling disorder has been moved into this category and there are other addiction-like behavioral disorders such as “Internet addiction” that will be considered as potential additions to this category as research data accumulate.
Published by Jason Schwartz
I have been an addiction professional and social worker since 1994. I started blogging in 2005 as the Clinical Director at Dawn Farm. I no longer work at Dawn Farm and am now the Director of Behavioral Medicine at a community hospital, and a lecturer at Eastern Michigan University’s School of Social Work.
Views expressed here are my own.
Keep in mind that the field, the contexts in which the field operates, and my views have changed over time.
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5 thoughts on “Substance-Related Disorders | APA DSM-5”
My initial reaction is positive. The old classifications created an arbitrary distinction of status within a continuum of symptoms that served to confuse rather than clarify. I also like the substance "use" disorder rather than "abuse" which sounded a little like a relic of pre-recovery thinking. In short: I like it.
I'm with you on the latter point. I definitely like dropping the terms abuse and dependence, both have serious problems. However, the more I think about it, the more troubled I am by the direction this appears to be taking. I'm concerned about the old abuse and dependence being on the same continuum when I see them as categorically different–abuse being characterized by bad choices related to AOD use while dependence is characterized by impaired ability to make choices related to AOD use.I'm also very troubled by the possibility of including other compulsive behaviors. I worry that these changes might significantly set back acceptance of the disease model.
I agree with you on both points, I hope you posted your opinions on the DSM V site
from what i have been told the new criteria will eliminate some of the people who met abuse criteria in IV tr and will make it easier to identify those who are more likely advance from mild to more severe forms of the disorder
In spite of my participation in the treatment industrial complex, I'd like to see fewer people meet criteria for an SUD. The more I think about it, the more absurd it is to suggest that most people meeting criteria for DSM abuse suffer from a disorder.Thanks for the comment.
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