Eleven criteria turn use into a disorder
Substance use disorder means keeping going despite serious harm. DSM-5 merges older abuse and dependence labels and grades mild, moderate, or severe by how many of eleven criteria fit. In 2017, an estimated 35 million people had an illicit-drug SUD worldwide.
SUD is persistent drug use despite substantial harm to self and others. It sits with substance-induced disorders under substance-related disorders. Patterns often include guilt, failed quit attempts, intoxicated driving, and withdrawal. Common classes include alcohol, cannabis, opioids, stimulants such as nicotine, cocaine and amphetamines, benzodiazepines, and barbiturates. Co-occurring mental health disorders are frequent. Onset age varies; biological factors (genetics, developmental stage) and social ones (adverse childhood experiences) shape vulnerability or resilience.
DSM-5 (2013) fused DSM-IV abuse and dependence into one SUD category. Severity is mild (two or three criteria), moderate (four or five), or severe (six or more); severe SUD is treated as synonymous with drug addiction. ICD-11 instead splits harmful pattern of use from substance dependence. The eleven criteria cluster around loss of control, interpersonal strain, hazardous use, and pharmacologic effects. Prescribed opioids that cause only tolerance and withdrawal do not alone meet SUD criteria without other symptoms. Person-first language is often preferred over labels such as “addict.”
In 2017 about 271 million adults (5.5 percent) were estimated to have used illicit drugs; 35 million had a substance use disorder. Alcohol use disorder affected an estimated 237 million men and 46 million women as of 2016. Illicit-substance SUDs were linked to about 585,000 deaths in 2017; alcohol to about three million in 2016. Direct non-alcohol drug deaths rose more than sixty percent from 2000 to 2015. Children of parents with SUD have roughly double the risk of developing one. Early teen use, male sex, age under twenty-five, other mental illness, impulsivity, and weak family support also raise odds.
Source: Substance use disorder
