Substance-Related and Addictive Disorders Flashcards
Alcohol Use Disorder Diagnostic Criteria
A. A problematic pattern of alcohol use leading to clinically significant impairment/distress, as manifested by ≥2 of the following 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 recover from its effects.
4. Craving, or a strong desire/urge to use alcohol
5. Recurrent alcohol use resulting in failure to fulfill major role obligations at work, school, or home.
6. Continued alcohol sue despite having persistent or recurrent social/interpersonal problems caused/exacerbated by alcohol effects.
7. Important social/occupational/recreational activities are givne up or reduced because of alcohol use.
8. Recurrent alcohol use in situations in which it is physically hazardous.
9. Alcohol use is continued despite having a persistent/recurrent physical/psychological problem likely caused/exacerbated by alcohol.
10. Tolerance, as defined by either of the following:
* A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
* A markedly diminisehd effect wiht continued use of the same amount of alcohol.
11. Withdrawal, as manifested by either of the following:
* The characteristic withdrawal syndrom for alcohol (i.e., Criterion A or B for alcohol withdrawal)
* Alcohol (or a closely related substance, such as benzodiazipene) is taken to relieve or avoid withdrawal symptoms.
Alcohol Use Disorder Specifiers
Specify if:
* In early remission: None of the criteria have been met for >3 months but <12 months (with the exception of Criterion A4 [cravings]).
* In sustained remission: None of the criteria have been met for ≥12 months (except Criterion A4)
Specify if:
* In a controlled environment: If the individual is in an environment where access to alcohol is restricted
Specify current severity:
* Mild: Presence of 2-3 symptoms
* Moderate: 4-5 symptoms
* Severe: ≥6 symptoms
Specifiers are the same for other substances
Alcohol Intoxication Diagnostic Criteria
A. Recent ingestion of alcohol
B. Clinically significant problematic behavioural/psychological changes that developed in the course of alcohol ingestion
C. ≥1 of the following signs/symptoms:
1. Slurred speech
2. Incoordination
3. Unsteady gait.
4. Nystagmus
5. Impairment in attention or memory
6. Stupour or coma
D. Not attributable to another medical condition; not better explained by another mental disorder.
Alcohol Withdrawal Diagnostic Criteria
A. A cessation of (or reduction in) alcohol use that has been heavy and prolonged.
B. ≥2 of the following, developing within several hours to a few days after cessation/reduction:
1. Autonomic hyperactivity (e.g., sweating or pulse greater than 100bpm)
2. Increased hand tremor
3. Insomnia
4. Nausea/vomiting
5. Transient visual/tactile/auditory hallucinations/illusions.
6. Psychomotor agitation
7. Anxiety
8. Generalized tonic-clonic seizures
C. Causes clinically significant distress/functional impairment
D. Not attributable to another medical condition; not better explained by another mental disorder.
Alcohol Withdrawal Specifiers
Specify if:
* With perceptual disturbances: Applies in rare instances where hallucinations occur with intact reality testing or illusions occur in the absence of a delirium.
General Substance Use Disorder Diagnostic Criteria Format
A. A problematic pattern of [SUBSTANCE] use leading to clinically significant impairment/distress, as manifested by ≥2 of the following within a 12-month period:
1. [SUBSTANCE] 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 [SUBSTANCE] use.
3. A great deal of time is spent in activities necessary to obtain [SUBSTANCE], use alcohol, or recover from its effects.
4. Craving, or a strong desire/urge to use [SUBSTANCE]
5. Recurrent [SUBSTANCE] use resulting in failure to fulfill major role obligations at work, school, or home.
6. Continued [SUBSTANCE] use despite having persistent or recurrent social/interpersonal problems caused/exacerbated by [SUBSTANCE] effects.
7. Important social/occupational/recreational activities are givne up or reduced because of [SUBSTANCE] use.
8. Recurrent [SUBSTANCE] use in situations in which it is physically hazardous.
9. [SUBSTANCE] use is continued despite having a persistent/recurrent physical/psychological problem likely caused/exacerbated by [SUBSTANCE].
10. Tolerance, as defined by either of the following:
* A need for markedly increased amounts of [SUBSTANCE] to achieve intoxication or desired effect.
* A markedly diminisehd effect wiht continued use of the same amount of [SUBSTANCE].
11. Withdrawal, as manifested by either of the following:
* The characteristic withdrawal syndrom for [SUBSTANCE] (i.e., Criterion A or B for [SUBSTANCE] withdrawal)
* [SUBSTANCE] (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.
Note that the withdrawal criterion is only present if it’s a substance where withdrawal is possible (i.e., not for hallucinogens or inhalants)
Gambling Disorder Diagnostic Criteria
A. Persistent and recurrent problematic gambling behaviour leading to clinically significant disress/functional impairment as indicated by ≥4 of the following within 12 months:
1. Needs to gamble with increasing amounts of money in order to achieve the desired excitement
2. Is restless/irritable when attempting to cut back or stop gambling
3. Has made repeared unsuccessful efforts to control, cut back, or stop gambling
4. Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venturem thinking of ways to get money to gamble)
5. Often gambles when feeling distressed
6. After losing money gambling, often returns on another day to get even (“chasing” losses)
7. Lies to conceal the extent of involvement with gambling
8. Has jeopardized or lost a significant relationship, job, or educational/career opportunity because of gambling
9. Relies on others to provide money to releive desperate financial situations caused by gambling.
B. Not better explained by a manic episode.
Gambling Disorder specifiers
Specify if:
* Episodic: diagnostic criteria met at more than one time point, with symptoms subsiding in between for ≥several months
* Persistent: Continuous symptoms meeting diagnostic criteria for multiple years
Specify if:
* In early remission: No criteria met for ≥3 months but <12 months
* In sustained remission: No criteria met for ≥12 months
Specify current severity:
* Mild: 4-5 criteria met
* Moderate: 6-7 criteria met
* Severe: 8-9 criteria met
