What is the DSM-5?
What is the DSM-5, and what type of information does it include about addiction?
Contact Bright Future Recovery today to begin addiction treatment in Northern California.
Table of Contents
What Is the DSM-5?
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is a reference book that establishes standardized criteria for an extensive list of mental health disorders. It is published by the American Psychiatric Association (APA), though its use is not limited to clinicians in the U.S.
The first edition of the DSM was published in 1952. Since then, the APA has released six revised editions:
- DSM II (1968)
- DSM III (1974)
- DSM III-R (1978)
- DSM IV (1980)
- DSM-5 (2013)
- DSM-5-TR (2022)
DSM-III-R and DSM-5-TR included updates in a few areas, but they do not reflect comprehensive reviews of the entire book, as the other editions do.
Why Is Addiction in the DSM-5?
The terms “mental illness” and “mental health disorder” typically refer to disorders that primarily affect how a person thinks, feels, and/or perceives their environment. Examples of these types of conditions include anxiety, depression, bipolar disorder, schizophrenia, and posttraumatic stress disorder (PTSD).
For conditions that are characterized by behavior – such as eating disorders or addictions to alcohol and other drugs – people often use the term “behavioral health disorder.”
However, behavioral health disorders like these also involve psychological symptoms such as overwhelming urges and maladaptive thought processes.
Including eating disorders and addictions in the DSM-5 acknowledges that these are actual diseases, not (as some people mistakenly believe) merely evidence of flawed character or insufficient self-discipline.
How Does the DSM-5 Define Addiction?
The DSM-5 uses the term “substance use disorder” when referring to addiction.
The book describes the general characteristics of this condition as “a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems.”
For most types of substance use disorders, the DSM-5 includes the following 11 criteria:
- Frequently using the substance in larger amounts or over longer periods than you intended.
- Having persistent desire and/or a history of unsuccessful efforts to control your substance use.
- Spending a great deal of time obtaining the substance, using it, and recovering from its effects.
- Experiencing cravings, or powerful urges to use the substance.
- Failing to fulfill obligations at work, at home, or in school due to your substance use.
- Continued use of the substance despite experiencing social or interpersonal problems that were caused or worsened by the effects of the substance.
- Ending or reducing your participation in important social, recreational, or work-related activities due to substance use.
- Recurrent substance use in situations in which it is physically hazardous.
- Continuing to use the substance despite experiencing a physical or psychological problem that is likely to have been caused or exacerbated by the substance.
- Tolerance, meaning you need to use more of the substance to experience its effects
- Withdrawal symptoms when you stop using the substance.
The DSM-5 also includes specifiers to note how many symptoms a person has been experiencing:
- Mild substance use disorder: two or three symptoms
- Moderate substance use disorder: four or five symptoms
- Severe substance use disorder: six or more symptoms
What Types of Addiction Are in the DSM-5?
In the DSM-5, addictions are included in a chapter titled Substance-Related and Addictive Disorders. That chapter includes entries for the following 10 disorders:
- Alcohol use disorder
- Cannabis use disorder
- Phencyclidine use disorder
- Other hallucinogen use disorder
- Inhalant use disorder
- Opioid use disorder
- Sedative, hypnotic, or anxiolytic use disorder
- Stimulant use disorder
- Tobacco use disorder
- Other (or unknown) substance use disorder
Types of Addictive Drugs
Some substance use disorders describe addictions to specific drugs, such as alcohol, phencyclidine (PCP), cannabis (marijuana), and tobacco.
Others encompass addictions to a variety of substances, such as:
- Other hallucinogen use disorder includes LSD, psilocybin, mescaline, MDMA (molly), and DMT
- Opioid use disorder includes heroin, morphine, fentanyl, and many prescription painkillers
- Stimulant use disorder includes cocaine, amphetamine, and methamphetamine
- Sedative, hypnotic, or anxiolytic use disorder includes benzodiazepines such as alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin); and barbiturates such as pentobarbital (Nembutal) and secobarbital (Seconal)
- Inhalant use disorder includes hydrocarbons that are present in many products, such as paints, glues, fuels, and solvents
- Other (or unknown) substance use disorder applies to dependence on any substances that aren’t included in one of the other types of addiction
When a person is diagnosed with one of these disorders, the DSM-5 directs that the specific drug should be named if it is known.
So, for example, instead of being diagnosed with opioid use disorder, a person may instead receive a diagnosis for heroin use disorder, fentanyl use disorder, or oxycodone use disorder.
Additional Addictions
At the end of the Substance-Related and Addictive Disorders chapter, there is a section titled Non-Substance Related Disorders. That section includes one condition: gambling use disorder.
The DSM-5 defines gambling use disorder as “persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress.” Examples of the diagnostic criteria for this condition include:
- Restlessness or irritability when attempting to cut down or stop gambling.
- Making repeated unsuccessful efforts to control, cut back, or stop gambling.
- Needing to gamble with increasing amounts of money in order to achieve the desired excitement. (This is similar to the “tolerance” entry in the list of substance use disorder criteria.)
- Jeopardizing losing a significant relationship, job, or educational or career opportunity because of gambling.
The final chapter in the DSM-5 is titled Conditions for Further Study. It includes criteria for disorders that may be included in a later edition of the DSM. The current descriptions, the book notes, are included to establish “a common language for researchers and clinicians who are interested in studying these disorders.”
The chapter contains two addiction-related conditions:
- Caffeine use disorder, or the compulsive consumption of coffee or other substances that contain caffeine
- Internet gaming disorder, which is similar to gambling disorder in that it involves a preoccupation with online gaming, psychological distress when prevented from gaming, and an inability to control how long or how often a person plays online games
Can Anyone Use the DSM-5?
Anyone can purchase the DSM-5, and it is also available to be borrowed from most libraries. However, only a qualified professional can use the information it contains to accurately diagnose a person with a substance use disorder or any other mental or behavioral health disorder.
If you believe that you have developed an addiction, you should consult with your doctor or schedule an assessment with a reputable addiction treatment provider in your area. In addition to providing you with a correct diagnosis, the professional who conducts your assessment should also be able to recommend appropriate treatment options.
Find Addiction Treatment in Northern California
Bright Future Recovery offers a full continuum of customized services for adults who have become addicted to alcohol and other drugs. Treatment options at our rehab in Northern California include detox, residential care, and several outpatient options.
To learn more about how we can help you or a loved one, or to schedule a free assessment, please visit our Admissions page or call us today.
