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Classification, Disorders due to substance use (DSM / ICD)

Care should be taken when defining drug use in terms of addiction or dependence as these terms are not necessarily used with consistent meaning and also have social and cultural implications to their use.

 •   Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) Classification

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by health care professionals in the United States and much of the world as the authoritative guide to the diagnosis of mental disorders. DSM contains descriptions, symptoms, and other criteria for diagnosing mental disorders. It provides a common language for clinicians to communicate about their patients and establishes consistent and reliable diagnoses that can be used in the research of mental disorders. It also provides a common language for researchers to study the criteria for potential future revisions and to aid in the development of medications and other interventions. 

Substance-related disorders: The essential feature of a substance use disorder is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems. The diagnosis of a substance use disorder can be applied to all 10 classes included except caffeine. For certain classes some symptoms are less salient, and in a few instances not all symptoms apply (e.g., withdrawal symptoms are not specified for phencyclidine use disorder, other hallucinogen use disorder, or inhalant use disorder). An important characteristic of substance use disorders is an underlying change in brain circuits that may persist beyond detoxification, particularly in individuals with severe disorders. The behavioral effects of these brain changes may be exhibited in the repeated relapses and intense drug craving when the individuals are exposed to drug-related stimuli. These persistent drug effects may benefit from long-term approaches to treatment. 

DSM-5 provides information on conditions including diagnostic criteria and diagnostic features for substance-related disorders including: alcohol, caffeine, cannabis, hallucinogen (including phencyclidine and other Hallucinogens), inhalants, opioids, Sedative-, hypnotic-, or anxiolytics, stimulants, tobacco and other substances. There is also a section for non-substance-related disorders (gambling disorder)

 •   World Health Organisation: International Classification of Diseases 11th edition (ICD-11) Classification

ICD–11 is the international standard for systematic recording, reporting, analysis, interpretation and comparison of mortality and morbidity data.

Disorders due to substance use (listed under ICD-11 06 Mental, behavioural or neurodevelopmental disorders) include disorders that result from a single occasion or repeated use of substances that have psychoactive properties, including certain medications. Disorders related to fourteen classes or groups of psychoactive substances are included. Typically, initial use of these substances produces pleasant or appealing psychoactive effects that are rewarding and reinforcing with repeated use. With continued use, many of the included substances have the capacity to produce dependence. They also have the potential to cause numerous forms of harm, both to mental and physical health. Disorders due to harmful non-medical use of non-psychoactive substances are also included in this grouping.

See WHO ICD-11