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Drug use management is
important
Drug use happens in almost all communities
and all walks of life
Drug use is associated with substantial health
and social problems
Drug use can lead to harm and dependence
Injecting drug users have high rates of HIV
and Hepatitis C
Intensive cannabis use may result in
psychotic disorders
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Substance-Related & Addictive
Disorders
The DSM 5 SRAD encompasses 10 separate classes of
drugs:
Alcohol
Caffeine
Cannabis
Hallucinogens (w/ separate categories for PCP)
Inhalants
Opioids
Stimulants (ATS, Cocaine, & other stimulants)
Sedatives, Hypnotics, & Anxiolytics
Tobacco
Other (or Unknown) Substances
Substance-Related
Disorders
Substance Use Disorders
Substance-Induced Disorders:
Intoxication
Withdrawal
Other Substance/Medication-induced
mental disorders (psychotic d/o, bipolar &
related d/o, depressive d/o, anxiety d/o,
obsessive-compulsive & related d/o, sleep
d/o, sexual dysfunctions, delirium, and
neurocognitive d/o).
Substance Use Disorders
Essential Feature:
A cluster of cognitive,
behavioral, & physiological
symptoms indicating that the
individual continues using the
substance despite significant
substance-related problems
(except caffeine).
Substance Use Disorders
To assist with organization, Criterion
A can be considered to fit with
overall groupings of:
Impaired Control (Criteria 1-4)
Social Impairment (Criteria 5-7)
Risky Use (Criteria 8-9)
Pharmacological Criteria (Criteria
10-11)
Substance Use Disorders
Impaired Control (Criteria 1-4)
Criterion 1: The Individual may take the
substance in larger amounts or over a
longer period than was originally
intended
Criterion 2: The individual may express a
persistent desire to cut down or regulate
substance use & may report multiple
unsuccessful efforts to decrease or
discontinue use
Substance Use Disorders
Impaired Control (Criteria 1-4)
Criterion 3: The individual may spend a
great deal of time obtaining the
substance, using the substance, or
recovering from its effects.
Criterion 4: Craving is manifested by
an intense desire or urge for the drug
that may occur at any time but is more
likely when in an environment where the
drug previously was obtained or used.
Substance Use Disorders
Social Impairment: Criteria 5-7
Criterion 5: Recurrent substance use may result
in a failure to fulfill major role obligations at
work, school, or home
Criterion 6: The individual may continue
substance use despite having persistent or
recurrent social or interpersonal problems
caused or exacerbated by the effects of the
substance
Criterion 7: Important social, occupational, or
recreational activities may be given up or
reduced because of substance use.
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Substance Use Disorders
Risky Use of the Substance: Criteria 8-9
Criterion 8: Recurrent substance use in
situations in w/c it is physically hazardous
Criterion 9: The individual may continue
substance use despite knowledge of having a
persistent or recurrent physically or
psychological problem that is likely to have
been caused or exacerbated by the substance.
*The key issue in evaluating this criterion is not
the existence of the problem, but rather the
individuals failure to abstain from using the
substance despite the difficulty it is causing.
Substance Use Disorders
Pharmacological Criteria (Criteria 10-11)
Criterion 10: Tolerance is signaled by
requiring a markedly increased dose of
the substance to achieve the desired
effect of a markedly reduced effect when
the usual dose is consumed.
Criterion 11: Withdrawal a syndrome
that occurs when blood or tissue
concentration of a substance decline in
an individual who had maintained
prolonged heavy use of the substance.
Severity and Specifiers
SEVERITY:
Mild SUD: presence of 2 to 3 symptoms
Moderate SUD: by 4 to 5 symptoms
Severe SUD: 6 or more symptoms
SPECIFIERS:
In early remission
In sustained remission
In a controlled environment
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Remember
Always try to get a sense whether the
person with drug use problems is
sober, intoxicated or in a state of
withdrawal at time of the interview
If the person is intoxicated to the
point that their behaviour is
inappropriate, you may want to ask
them to come back later.
Treatme
nt of
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drug
Recovery from the
disease of addiction is
often a long-term
process, involving
multiple relapses before
a patient achieves
prolonged abstinence.
National Institute on Drug Abuse
QUIZ
Question:
What is more
addictive,
SEX or DRUGS?
ANSWER
It depends on
the pusher.