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Criteria Needed to Make a Diagnosis of Substance Abuse

Criteria or diagnostic criteria are the symptoms that are needed to make a diagnosis. Any diagnosis is a label attached to a collection of these symptoms. Substance abuse is listed among the mental disorders in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-IV) published by the American Psychiatric Association. This is the standard reference used to make a diagnosis. A clinician who believes her client has a substance use disorder compares the client's symptoms with the criteria listed in the DSM-IV.

  1. Life Functions

    • Substance use qualifies as abuse if it interferes with major areas of a person's life. For instance, the use of the substance has contributed to the individual being in physically harmful or risky situations, such as driving under the influence. Other problems caused by the substance can include absences from work or school, difficulty completing work or school assignments and problems with interpersonal relationships caused by the substance. For instance, recurring arguments with a significant other while intoxicated are a sign that the substance is interfering with the individual's ability to fulfill major life functions and obligations -- and that she has a substance abuse problem.

    Substance Dependence

    • The clinician must rule out a diagnosis of substance dependence in order to diagnose a client with substance abuse. The primary concern in making this differentiation is whether or not the individual is physiologically addicted to the substance. Signs of physiological dependence include having a tolerance for the substance, experiencing withdrawal symptoms when not using regularly, and showing a pattern of compulsive use of the substance. Compulsive use means that the person feels he must use the substance, as opposed to someone who uses regularly and is abusing the substance, but is not dependent upon it for daily functioning, according to psychiatryonline.com.

    Harm

    • Criteria for a diagnosis of Substance Abuse includes that the abuse is part of an overall maladaptive pattern of use. Substance Abuse is distinguished from a physiological dependency but requires that the substance is causing the individual harm. Harm can include effects on physical health, such as fatty liver, alcohol-induced pancreatitis, or hepatitis from needle sharing. Harm may also include the mental harm done by the drug. For instance, use of certain drugs can lead to symptoms of depression or psychosis.

    Considerations

    • The diagnosis of substance abuse should be made with consideration of all the needed criteria. The diagnosing clinician must consider length of use -- the individual must have experienced this pattern of abuse for at least a 12-month period. Similarly, the criteria specify that the individual has continued using despite adverse consequences. When making a diagnosis it is important for the clinician to understand the ways in which the criteria are linked together and the purpose of diagnosing the individual. When done properly, a diagnosis can be an important tool for helping to get the individual needed treatment.

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