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DSM-IV & DSM-IV-TR:

Substance Abuse

When repeated use of alcohol or other drugs leads to problems but does not include compulsive use or addiction, and stopping the drug does not lead to significant withdrawal symptoms the term substance abuse applies. This, along with Substance Dependence are considered substance use disorders.

Harmful use of a specific psychoactive substance. The term also applies to one category of psychoactive Substance Use Disorder. While recognizing that "abuse" is part of present diagnostic terminology, ASAM recommends that an alternative term be found for this purpose because of the pejorative connotations of the word "abuse."*

Criteria for Substance Abuse
(cautionary statement)  

A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period: 

(1) recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household) 
(2) recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use) 
(3) recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct) 
(4) continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of Intoxication, physical fights) 

B. The symptoms have never met the criteria for Substance Dependence for this class of substance.

Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994 American Psychiatric Association

Associated with these drugs: alcohol, amphetamine-like, cannabis, cocaine, hallucinogens, inhalants, opioids, phencyclidine, sedatives, hypnotics

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*Excerpt with permission from Graham, Allan W. & Schultz, Terry K. (Editors) Principles of Addiction Medicine, 2nd Edition Hardcover 1998 (American Society of Addiction Medicine)


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