Table 2.

DSM-IV Criteria for Substance Abuse and Dependence

Criteria for Substance Abuse
A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following occurring within a 12-month period:
1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (eg, repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household)
2. Recurrent substance use in situations in which it is physically hazardous (eg, driving in an automobile or operating a machine when impaired by substance use)
3. Recurrent substance-related legal problems (eg, arrests for substance-related disorderly conduct)
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of substance (eg, arguments with spouse about consequences of intoxication, physical fights)
Criteria for Substance Dependence
A. A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
1. Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of the substance to achieve intoxication or desired effect
b. Markedly diminished effect with continued use of the same amount of the substance
2. Withdrawal, as manifested by either of the following:
a. Characteristic withdrawal syndrome
b. Substance use to relieve or avoid withdrawal symptoms
3. Substance is taken in larger amounts or over a longer period than intended
4. There is a persistent desire or unsuccessful effort to cut down or control use
5. A great deal of time is spent in activities necessary to obtain the substance (eg, visiting multiple doctors or driving long distances)
6. Important social, occupational, or recreational activities are given up or reduced because of substance use
7. The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance

DSM-IV=Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.