What symptoms meet Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria for Substance Use Disorder (SUD)?

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Last updated: April 25, 2025View editorial policy

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From the Guidelines

The DSM-5-TR criteria for substance use disorder include a pattern of problematic substance use causing significant impairment or distress, with at least two of the following symptoms occurring within a 12-month period: taking substances in larger amounts or for longer than intended; persistent desire or unsuccessful efforts to cut down use; spending excessive time obtaining, using, or recovering from substances; craving or strong urge to use; recurrent use resulting in failure to fulfill major obligations; continued use despite social or interpersonal problems caused by use; giving up important activities because of use; recurrent use in physically hazardous situations; continued use despite physical or psychological problems caused or worsened by the substance; tolerance (needing increased amounts for the same effect); and withdrawal symptoms when not using. The severity is classified as mild (2-3 symptoms), moderate (4-5 symptoms), or severe (6+ symptoms) 1. These criteria apply across different substances including alcohol, cannabis, stimulants, opioids, and others, though specific withdrawal symptoms vary by substance 1. Some key symptoms that meet the DSM-5-TR criteria for substance use disorder include:

  • Taking substances in larger amounts or for longer than intended
  • Persistent desire or unsuccessful efforts to cut down use
  • Spending excessive time obtaining, using, or recovering from substances
  • Craving or strong urge to use
  • Recurrent use resulting in failure to fulfill major obligations
  • Continued use despite social or interpersonal problems caused by use
  • Giving up important activities because of use
  • Recurrent use in physically hazardous situations
  • Continued use despite physical or psychological problems caused or worsened by the substance
  • Tolerance (needing increased amounts for the same effect)
  • Withdrawal symptoms when not using 1. The diagnosis represents a shift from the previous DSM-IV's separate "abuse" and "dependence" categories to a single disorder with varying severity levels 1. It's worth noting that the DSM-5-TR criteria are based on the latest research and evidence, and are intended to provide a more accurate and comprehensive diagnosis of substance use disorder 1.

From the Research

Symptoms of Substance Use Disorder

The DSM-5-TR criteria for substance use disorder include a range of symptoms, such as:

  • Recurrent use of substances, resulting in a failure to fulfill major role obligations at work, school, or home
  • Continued use of substances despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance
  • Use of substances in situations in which it is physically hazardous
  • Recurrent substance use resulting in legal problems
  • Continued use of substances despite having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance

DSM-5-TR Criteria

According to the studies, the DSM-5-TR criteria for substance use disorder are not explicitly listed, however, the characteristics of substance use disorders (SUDs) are described as a recurrent and maladaptive use of drugs and/or alcohol 2.

Treatment of Substance Use Disorder

The treatment of substance use disorder may involve cognitive behavioral therapy (CBT), which has been shown to be effective in reducing substance use 3. Additionally, medications such as buprenorphine may be used in conjunction with CBT to treat opioid use disorder 4, 5.

Cognitive Functioning in Opioid-Dependent Patients

Cognitive functioning in opioid-dependent patients may be affected by the type of medication used to treat the disorder, with buprenorphine potentially resulting in fewer cognitive deficits than methadone 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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