Table 2.

Substance Abuse and Dependence Symptoms in the DSM—IV

Brief symptom descriptor	Abstracted DSM—IV definition
Abuse symptoms
Role impairment	Frequent intoxication leading to a failure to fulfill major role obligations
Hazardous use	Recurrent use when it is physically hazardous (e.g., drunk driving)
Legal problems	Recurrent substance-related legal problems
Social problems	Continued use despite social or interpersonal problems caused or exacerbated by use
Dependence symptoms
Tolerance	Need to consume more to achieve same effect; decreased effect with same amount
Withdrawal	Signs of withdrawal syndrome; use to avoid withdrawal
Larger/longer	Often using more or for a longer period than intended
Quit/cut down	Persistent desire or unsuccessful attempts to quit or cut down substance use
Much time spent using	Lots of time spent using, obtaining, or being affected by a substance
Reduced activities	Important social activities given up or reduced due to substance use
Psychological/physical problems	Continued use despite psychological/physical problems caused or exacerbated by use

Note. Abuse is diagnosed when at least one of the four abuse criteria are present, and dependence is diagnosed when at least three of the seven dependence criteria occur within the same year. DSM—IV = Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994).