Substance disorders

Question 1

Alcohol Use Disorder

Answer 1

A. A problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

1. Alcohol is often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recovôr from its effects.
4. Craving, or a strong desire or urge to use alcohol.
5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work,
   school, or home.
6. Continued alcohol use despite having persistent or recurrent social or interpersonal
   problems caused or exacerbated by the effects of alcohol.
7. Important social, occupational, or recreational activities are given up or reduced be­
   because of alcohol use.
8. Recurrent alcohol use in situations in which it is physically hazardous.
9. Alcohol use is continued despite knowledge of having a persistent or recurrent
   physical or psychological problem that is likely to have been caused or exacerbated
   by alcohol.
10. Tolerance, as defined by either of the following:
    A: A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
    B: A markedly diminished effect with continued use of the same amount of alcohol.
11. Withdrawal, as manifested by either of the following:
    A. The characteristic withdrawal syndrome for alcohol (refer to Criteria A and B of the criteria set for alcohol withdrawal, pp. 499-500).
    B: Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.

Question 2

Alcohol Withdrawal

Answer 2

A Reduction in alcohol use that has been heavy and prolonged.
B. Two (or more) of the following,developing within several hours to a few days after the cessation of (or reduction in) alcohol use described in Criterion A:
1. Autonomic hyperactivity (e.g., sweating or pulse rate greater than 100 bpm).
2. Increased hand tremor.
3. Insomnia.
4. Nausea or vomiting.
5. Transient visual, tactile, or auditory hallucinations or illusions.
6. Psychomotor agitation.
7. Anxiety.
8. Generalized tonic-clonic seizures.