DSM 5 Substance Use Disorders: A Concise Summary

DSM_5_2Terry Gorski has a nice summary of substance use disorders in the DSM-5.

Here’s his analysis at the end of the post:

The DSM 5 is criticized for combining the the DSM IV categories of substance dependence (addiction marked by a pattern of compulsive use or loss of control) and substance abuse disorders (using in a manner that causes problems but does not have a pattern of compulsive use). The 2011 definition of addiction by the American Society of Addiction Medicine (ASAM) is consistent with DSM IV but not DSM 5.

The DSM IV, like the ASAM definition is based upon the idea that there is a DIFFERENCE IN KIND between substance abuse and dependence/addiction.

The DSM 5 is inconsistent with the ASAM definition because it is based upon the idea that there is only A DIFFERENCE IN DEGREE between abuse and addiction based upon the number of symptoms.

This is a critical difference in the underlying theory of addiction between the DSM IV and DSM 5 and a break in the progressive development of the fundamental concept if addiction which began with the DSM III.


2 thoughts on “DSM 5 Substance Use Disorders: A Concise Summary

  1. Thanks for posting this piece. Very nice way of summing up the difference in DSM editions. I have colleagues who were closer to the process of developing this than I, but this was one of the issues that I pointed out to those creating it upon my initial review of an early draft. I am not a fan of intertwining or putting so closely addiction and abuse. I think those of us who have worked in this field for any length of time will tell you the difference is more profound and complex than what is expressed in the DSM 5. I sincerely hope that those in addiction medicine and the recovering community speak up before the next revision of the DSM and hopefully provide some more accurate information to those tasked with developing the DSM. I seriously question the process that the DSM undergoes more and more. I have many differences of opinion with my colleagues in the substance abuse field, but I can not think of one of them that would sign off on the DSM 5 in regards to this topic, so who the heck did?


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