Table 1.

Eleven criteria for substance use disorder.

Using for longer periods of time than intended, or using larger amounts than intended. Wanting to reduce use, yet being unsuccessful doing so. Spending excessive time getting/using/recovering from the drug use. Cravings that are so intense it is difficult to think about anything else. Continuing to use despite problems with work, school or family/social obligations. Having interpersonal problems due to substance abuse. Important and/or meaningful activities are given up, such as time spent with family and friends, or pleasurable hobbies. Repeatedly using in dangerous situations, such as driving a car. Continuing to use despite awareness of impact/danger to health, such as still smoking cigarettes after developing chronic obstructive pulmonary disease (COPD). Tolerance symptoms such as needing to increase the amount of substance taken to achieve the same desired effect. In severe cases, the desired effect could be the avoidance of withdrawal symptoms rather than the feeling of a ‘high’. Some drugs cause withdrawal symptoms, which are exhibited when an individual has developed a physical tolerance to the substance, and then ceases to consume the substance, resulting in unpleasant and occasionally fatal symptoms.

American Psychiatric Association, 2013.