Substance Use Disorders – The epidemiological mess more than a decade in the making

January 27, 2025January 27, 2025 ~ Jason Schwartz ~ 2 Comments

Yesterday, I posted about the epidemiological crisis being reported regarding an explosion in substance use disorders resulting in increases in untreated SUDs and low rates of problem recognition. (There's been a parallel explosion in recovery prevalence.) All of this was predictable. In fact, we were writing about it here 13 years ago. Despite the foreseeability … Continue reading Substance Use Disorders – The epidemiological mess more than a decade in the making

a spectrum of apples, oranges, lemons, plums?

November 15, 2013November 14, 2023 ~ Jason Schwartz ~ 1 Comment

Howard Wetsman picks apart the spectrum approach of the DSM5 Making a spectrum out of the illnesses that have been put in the substance use category of DSM IV is like making a spectrum out of an apple, an orange, a lemon, a lime, a blue fruit (if there was one) and a plum. You’d … Continue reading a spectrum of apples, oranges, lemons, plums?

DSM 5 Substance Use Disorders: A Concise Summary

November 12, 2013February 28, 2022 ~ Jason Schwartz ~ 2 Comments

Terry 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 … Continue reading DSM 5 Substance Use Disorders: A Concise Summary

2012’s most popular posts #10 – Almost Alcoholic

January 3, 2013February 28, 2022 ~ Jason Schwartz ~ 2 Comments

This article demonstrates a big problem in understanding addiction and the a big problem in the current diagnostic categories. ...when we think about alcohol abuse or alcoholism, our thoughts often go to situations like this where someone is at a stage where they are doing immediate damage to themselves or others, but what about the stage … Continue reading 2012’s most popular posts #10 – Almost Alcoholic

The DSM-5 is coming

December 2, 2012February 28, 2022 ~ Jason Schwartz

Change is coming, but is it good? At its December meeting today, APA’s Board of Trustees approved the final diagnostic categories and criteria for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The trustees’ action marks the end of the manual’s comprehensive revision process, which has spanned over a decade and included … Continue reading The DSM-5 is coming

Addiction diagnoses to rise

May 13, 2012February 28, 2022 ~ Jason Schwartz ~ 3 Comments

I've posted before about problems with the proposed approach to addiction in the DSM-5. These changes were intended to clear up language problems, specifically the conflation of dependence and addiction leading to "false positives" for addiction. Looks like the DSM-5 is causing its own language problems before it's even adopted. [emphasis mine] Many scholars believe … Continue reading Addiction diagnoses to rise

Almost alcoholic?

April 8, 2012February 28, 2022 ~ Jason Schwartz ~ 4 Comments

Even more on the DSM-V

February 17, 2012February 28, 2022 ~ Jason Schwartz ~ 5 Comments

The Fix follows up on the previous piece about the coming changes in the DSM-V. The writer captures my concerns: I don’t foresee any negative results from dropping those two misguided terms. (abuse and dependence) But what does concern me is the fact that rather than still having two separate and distinct conditions—one, a short-term, … Continue reading Even more on the DSM-V

More on the DSM-V

February 11, 2012February 28, 2022 ~ Jason Schwartz ~ 2 Comments

The Fix has a good opinion piece on the DSM-V, praising its movement away from dependence and abuse. The focus on dependence also implied that cocaine—which does not produce physical dependence—isn’t “really” addictive. That lulled many people in the '80s—including yours truly—to think that cocaine wasn’t likely to be hard to kick. We all know better now. … Continue reading More on the DSM-V