Substance-Related and Addictive Disorders

Question 1

Inhalant Use Disorder

Answer 1

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

Question 2

Specify if:

the particular inhalant:

Answer 2

When possible, the particular substance involved should be named (e.g., “solvent use disorder”):

Question 3

Opioid Use Disorder

Answer 3

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

Question 4

Opioid Use Disorder
Withdrawal
Note:
This criterion is not considered to be met for those individuals taking opioids solely under appropriate medical supervision.

Answer 4

a. The characteristic opioid withdrawal syndrome

b. Opioids (or a closely related substance) are taken to relieve or avoid withdrawal symptoms

Question 5

Opioid Use Disorder

On maintenance therapy

Answer 5

This additional specifier is used if the individual is taking a prescribed agonist medication such as methadone or buprenorphine and none of the criteria for opioid use disorder have been met for that class of medication (except tolerance to, or withdrawal from, the agonist.) This category also applies to those individuals being maintained on a partial agonist, an agonist/antagonist, or a full antagonist such as oral naltrexone or depot naltrexone.

Question 6

DSM-5 Substance Use Disorder

Answer 6

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

Question 7

1.

Answer 7

The substance is often taken in larger amounts or over a longer period than was intended.

Question 8

2.

Answer 8

There is a persistent desire or unsuccessful efforts to cut down or control use of the substance.

Question 9

3.

Answer 9

A great deal of time is spent in activities necessary to obtain the substance, use it, or recover from its effects.

Question 10

4.

Answer 10

Craving, or a strong desire or urge to use the substance.

Question 11

5.

Answer 11

Recurrent use of the substance resulting in a failure to fulfil major role obligations at work, school, or home.

Question 12

6.

Answer 12

Continued use of the substance despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of its use.

Question 13

7.

Answer 13

Important social, occupational, or recreational activities are given up or reduced because of the use of the substance.

Question 14

8.

Answer 14

Recurrent use of the substance in situations in which it is physically hazardous.

Question 15

9.

Answer 15

Use of the substance is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.

Question 16

10.

Answer 16

10. Tolerance, as defined by either of the following:
    a. A need for markedly increased amounts of the inhalant substance to achieve intoxication or desired effects.
    b. A markedly diminished effect with the continued use of the same amount of the inhalant substance.

Question 17

11.

Answer 17

Withdrawal, as manifested by either of the following:

a. The characteristic withdrawal syndrome for the substance (refer to criteria A and B of the criteria sets for Withdrawal from the specific substances)
b. the same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms.

Question 18

Severity

Answer 18

Mild: 2-3 Symptoms
Moderate: 4-5 Symptoms
Severe: 6+ Symptoms

Question 19

Specifiers

In early remission:

Answer 19

No criteria met for at least 3 months but less than 12 months (exception for “Craving”, which can also be met)

Question 20

Specifiers

In sustained remission:

Answer 20

No criteria met for at least 12 months (exception of “Craving”)

Question 21

Specifiers

In a controlled environment:

Answer 21

If in the environment where access to the substance is restricted.

Question 22

Specifiers

On maintenance therapy:

Answer 22

If the individual taking prescribed agonist medication (e.g., methadone for opiate disorder) and no substance use disorder criteria met for the agonist, (with exception of tolerance and withdrawal)

Question 23

Sedative, Hypnotic, or Anxiolytic Use Disorder

Answer 23

1. • 11.

Question 24

Sedative, Hypnotic, or Anxiolytic Use Disorder

Note withdrawal

Answer 24

This criterion is not considered to be met for individuals taking sedatives, hypnotics, or anxiolytics under medical supervision.

Question 25

Stimulant Use Disorder

Answer 25

amphetamine-type substance, cocaine, or other stimulant use

1. - 11.

Question 26

Stimulant Use Disorder

Note tolerance and withdrawal

Answer 26

This criterion is not considered to be met for those taking stimulant medications solely under appropriate medical supervision, such as medications for attention-deficit/hyperactivity disorder or narcolepsy.

Question 27

Tobacco Use Disorder

Answer 27

1. • 11.

Question 28

Other (or Unknown) Substance Use Disorder

Answer 28

1. • 11.

Question 29

Unspecified Other (or Unknown) Substance-Related Disorder

Answer 29

This category applies to presentations in which symptoms characteristic of another (or unknown) substance-related disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any specific other (or unknown) substance-related disorder or any of the disorders in the substance-related disorders diagnostic class.

Question 30

Gambling Disorder

A.

Answer 30

Persistent and recurrent problematic gambling behaviour leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period:

Question 31

Gambling Disorder

1.

Answer 31

Needs to gamble with increasing amounts of money in order to achieve the desired excitement.

Question 32

Gambling Disorder

2.

Answer 32

Is restless or irritated when attempting to cut down or stop gambling.

Question 33

Gambling Disorder

3.

Answer 33

Has made repeated unsuccessful efforts to control, cut back, or stop gambling.

Question 34

Gambling Disorder

4.

Answer 34

Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble).

Question 35

Gambling Disorder

5.

Answer 35

Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed).

Question 36

Gambling Disorder

6.

Answer 36

After losing money gambling, often returns another day to get even (“chasing” one’s losses).

Question 37

Gambling Disorder

7.

Answer 37

Lies to conceal the extent of involvement with gambling.

Question 38

Gambling Disorder

8.

Answer 38

Has jeopardised or lost a significant relationship, job, or educational or career opportunity because of gambling.

Question 39

Gambling Disorder

9.

Answer 39

Relies on others to provide money to relieve desperate financial situations caused by gambling.

Question 40

Gambling Disorder

B.

Answer 40

The gambling behaviour is not better explained by a manic episode.

Question 41

Gambling Disorder
Specify if:
Episodic:

Answer 41

Meeting the diagnostic criteria at more than one time point, with symptoms subsiding between periods of gambling disorder for at least several months.

Question 42

Gambling Disorder
Specify if:
Persistent:

Answer 42

Experiencing continuous symptoms, to meet diagnostic criteria for multiple years.

Question 43

Gambling Disorder

Specify current severity:

Answer 43

Mild: 4-5 criteria met.
Moderate: 6-7 criteria met.
Severe: 8-9 criteria met.