DSM 5

Question 1

DSM 5 lists 11 sx 2 or more which must be present at anytime during the last 12months for a dx of SUD

Answer 1

1. Taking the substance in larger amounts or for longer than you’re meant to
2. Wanting to cut down or stop using the substance but not managing to.
3. Spending a lot of time getting, using, or recovering from use of the substance.
4. Cravings and urges to use the substance.
5. Not managing to do what you should at work, home, or school because of substance use.
6. Continuing to use, even when it causes problems in relationships.
7. Giving up important social, occupational, or recreational activities because of substance use.
8. Using substances again and again, even when it puts you in danger.
9. Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.
10. Needing more of the substance to get the effect you want (tolerance).
11. Development of withdrawal symptoms, which can be relieved by taking more of the substance.

Question 2

Early vs

Sustained Remission

Answer 2

More than 3 months but less than 12 except craving

Not met SUD criteria for more than 12 month except cravings

Question 3

DSM Specifiers

Answer 3

Mild: 2 to 3 sx (outpatient)

Moderate: 4 to 5 sx (intensive outpatient/residential)

Severe: 6 or more sx (inpatient/residential)

Can indicate early or sustained remission, “On maintenance therapy” or “in a controlled environment “

Question 4

Two Substance related disorders

Answer 4

Substance Use Disorders: patterns of sx resulting from a substance an individual continually takes despite experiencing problems.

Substance Induced Disorders: include intoxication, withdrawl, substance induced mental disorders (i.e. substance induced psychosis, bipolar, anxiety, ocd, depression etc and related disorders.

Question 5

DSM 5 describes opioid use disorder as a problematic pattern of opioid use leading to problems or distress, with at least two of the following occurring within a 12-month period:

Answer 5

Taking larger amounts or taking drugs over a longer period than intended.

Persistent desire or unsuccessful efforts to cut down or control opioid use.

Spending a great deal of time obtaining or using the opioid or recovering from its effects.

Craving, or a strong desire or urge to use opioids

Problems fulfilling obligations at work, school or home.

Continued opioid use despite having recurring social or interpersonal problems.

Giving up or reducing activities because of opioid use.

Using opioids in physically hazardous situations.

Continued opioid use despite ongoing physical or psychological problem likely to have been caused or worsened by opioids.

Tolerance (i.e., need for increased amounts or diminished effect with continued use of the same amount)

Experiencing withdrawal (opioid withdrawal syndrome) or taking opioids (or a closely related substance) to relieve or avoid withdrawal symptoms.

While opioid use disorder is similar to other substance use disorders in many respects, it has several unique features. Opioids can lead to physical dependence within a short time, as little as 4-8 weeks.2In chronic users, the abruptly stopping use of opioids leads to severe symptoms, including generalized pain, chills, cramps, diarrhea, dilated pupils, restlessness, anxiety, nausea, vomiting, insomnia, and very intense cravings. Because these symptoms are severe it creates significant motivation to continue using opioids to prevent withdrawal.