Home > The Complex Nature of Abused Substances and Getting Help for Addiction > DSM-IV Substance Abuse Disorders
Alcohol and drug abuse is a real problem these days. It is the cause of much suffering and dysfunction within society. This problem falls under different labels such as alcoholism, alcohol abuse, alcohol dependence, drug addiction, drug abuse, substance abuse, substance addiction and substance dependence. With so many labels for the problem, it can become a bit confusing, especially as each of these designations can be used to refer to different symptoms. This is why it can be helpful to understand the official definition of what these words mean.
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders (DSM) offers a classification system for the diagnosis of the different mental health problems. It is published by the American Psychiatric Association and is influential around the world. The first DSM appeared in 1953 and it is currently in its fourth edition. The next edition is due for release in 2013.
Some people abuse alcohol or drugs for a short period in their life. They may suffer negative consequences as a result of their actions, but they have not become psychologically or physically dependent on these substances. It would therefore be inappropriate to classify such people in the same category as addicts. Instead, they are labeled substance abusers. Such people are taking a risk, and if they are not careful they will slide into full dependence. Those who have not yet developed any type of addiction should find it much easier to walk away from substance abuse.
Alcohol and drug abuse were classified as sociopathic personality disturbances in the first edition of the DSM. In the third edition of the book, substance dependence was given a separate classification from substance abuse. The DSM IV –TR defines substance abuse as the clinically harmful use of alcohol or drugs.
Those individuals who abuse alcohol or drugs will exhibit symptoms. If an individual experiences at least one of the following symptoms during a 12-month period, they are likely to be engaging in substance abuse:
* Repeated substance abuse in situations where it would be considered hazardous. A good example of this would be people who drive their car after drinking alcohol.
* Interference with the individual’s ability to fulfill their work, school or home obligations. This might include regularly turning up late to work or not spending enough time with dependant family members.
* Continued use of these substances even though it is causing interpersonal difficulties.
* Any legal problems that occurred as a result of substance abuse.
The criteria for substance dependence include the following:
* The individual has developed a tolerance for the substance. This means that they have to use more in order to get the same effect.
* The user continues to abuse these substances despite obvious evidence that it is causing them harm.
* The individual experiences withdrawal symptoms when they stop taking the substance
* The user finds it difficult to cut down on the amount they are using
* Lack of control over the amount they consume.
* Loss of interest in other activities that they once enjoyed.
* Devoting increasing amounts of time to the substance abuse. This includes time spent obtaining the substance, time spent using it and time spent recovering from the effects.
If the individual experiences three or more of the above symptoms within a 12-month period then it indicates that they have become dependent.
The best way to avoid substance dependence is to never abuse alcohol or drugs. This means sticking to safe drinking limits, which are:
* Two alcoholic drinks per day for men
* One alcoholic drink per day for women
* One alcoholic drink per day for people over 65 years of age
* No alcohol for people younger than 21
* No alcohol for pregnant women
* People who have a history of alcohol dependence need to avoid drinking completely
In this instance, an alcoholic drink would be considered a standard beer, a standard glass of wine or a shot of spirits.
In order to avoid abuse and dependence of recreational drugs, it is recommended that people avoid these substances completely.
The sooner people can quit their substance abuse, the better it will be for them. Those individuals who have not yet developed a physical or psychological addiction will find it easiest to quit. All these people really need is the right motivation. If they develop new healthier interests, then this might be enough to end the abuse. Learning about the dangers or continued abuse may also be enough to motivate them to change their ways.
Substance dependence can be much harder to deal with, particularly when physical addiction has developed. If the individual tries to quit the substance, they may develop unpleasant withdrawal symptoms. Those who have become dependent will usually find that it is easier to quit if they seek professional help or enter rehab.
It is expected that the next edition of the Diagnostic and Statistical Manual of Mental Disorders will have modified definitions for substance abuse and substance dependence. This is because there is currently some confusion as to the exact meaning behind each diagnosis. For example, it is possible to be diagnosed with alcohol dependence without the individual actually being physically dependent on the substance.
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