The 11 Official Criteria for Addiction/Substance Use Disorder

What defines a substance use disorder? The Diagnostic and Statistical Manual of Mental Disorders (DSM), which is the official text on which diagnoses are based, contains criteria for substance use disorders and other mental health problems. The latest version of DSM, known as DSM-5, has some significant changes to the list of substance use disorders and the criteria that must be met in order to diagnose them.

In the last edition of the DSM, DSM-IV, there were two categories: substance abuse and substance dependence. The DSM-5 combines these two categories into one called "substance use disorder."

If substance use causes significant problems in someone's life, such as health issues, disability, and/or not meeting responsibilities at work, home, or school, they may have a substance use disorder.

Criteria for Substance Use Disorder

Substance use disorders are classified as mild, moderate, or severe, depending on how many of the diagnostic criteria a person meets. The 11 DSM-5 criteria for a substance use disorder are:

Hazardous use: You have used the substance in ways that are dangerous to yourself and/or others, i.e., overdosed, driven while under the influence, or blacked out.
Social or interpersonal problems related to use: Substance use has caused relationship problems or conflicts with others.
Neglected major roles to use: You have failed to meet your responsibilities at work, school, or home because of substance use.
Withdrawal: When you stop using the substance, you experience withdrawal symptoms.
Tolerance: You have built up a tolerance to the substance so that you have to use more to get the same effect.
Used larger amounts/longer: You have started to use larger amounts or use the substance for longer amounts of time.
Repeated attempts to control use or quit: You've tried to cut back or quit entirely, but haven't been successful.
Much time spent using: You spend a lot of your time using the substance.
Physical or psychological problems related to use: Your substance use has led to physical health problems, such as liver damage or lung cancer, or psychological issues, such as depression or anxiety.
Activities given up to use: You have skipped activities or stopped doing activities you once enjoyed in order to use the substance.
Craving: You have experienced cravings for the substance.

In order to be diagnosed with a substance use disorder, you must meet two or more of these criteria within a 12-month period.1 If you meet two or three of the criteria, you have a mild substance use disorder. Four to five is considered moderate, and if you meet six or more criteria, you have a severe substance use disorder.