DSM-IV Diagnostic Criteria: Substance Dependence

A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:

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

• (2) Withdrawal, as manifested by either of the following:
  • a. The characteristic withdrawal syndrome for the substance
  • b. The same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms.

• (3) The substance is often taken in larger amounts or over a longer period than was intended (loss of control).

• (4) There is a persistent desire or unsuccessful efforts to cut down or control substance use (loss of control).

• (5) A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects (preoccupation).

• (6) Important social, occupational, or recreational activities are given up or reduced because of substance use (continuation despite adverse consequences).

• (7) The substance 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 the substance. (adverse consequences).