Substance use disorder

Diagnostic Criteria

At least 2 of the following 11 criteria over a 12-month period:
- Impaired control
  - The substance is used in larger amounts or for longer than intended
  - Unsuccessful efforts or desire to cut back or control substance use
  - Excessive amount of time spent obtaining, using, or recovering from the substance
  - Craving to use the substance
- Social impairment
  - Failure to fulfill major role obligations at work, school, or home as a result of recurrent substance use
  - Persistent or recurrent social or interpersonal problems that are exacerbated by the substance or continued use of the substance despite these problems
  - Reduced or given up important social, occupational, or recreational activities because of the substance use
- Risky use
  - Substance use in physically hazardous situations
  - Continued substance use despite knowledge of persistent physical or psychological problem that is likely caused by the substance
- Pharmacological properties
  - Tolerance, as demonstrated by increased amounts of the substance needed to achieve desired effect; diminished effect with continued use of the same amount
  - Withdrawal, as demonstrated by symptoms of withdrawal syndromes; substances taken to relieve or avoid withdrawal
Severity based on number of criteria
- Mild: 2 to 3
- Moderate: 4 to 5
- Severe: 6 or more

Early remission: 3 to 12 months not meeting any above criteria (except craving)
Sustained remission: 12 or more months not meeting any above criteria (except craving)
Maintenance therapy: on prescription methadone or buprenorphine and non of the criteria are met for that medication
Controlled environment: in an environment where substances are restricted