The DSM 5 allows clinicians to specify how severe the substance use disorder is, depending on how many symptoms are identified.
MILD: Two or three symptoms indicate a mild substance use disorder;
MODERATE: Four or five symptoms indicate a moderate substance use disorder, and
SEVERE: Six or more symptoms indicate a severe substance use disorder.
DSM: Severe Addiction
SEVERE: six or more symptoms indicate a severe substance use disorder. Clinicians can also add “in early remission,” “in sustained remission,” “on maintenance therapy,” and “in a controlled environment.”
Here are the eleven symptoms (DSM Criteria):
Substance use disorders span a wide variety of problems arising from substance use, and cover 11 different criteria:
1. Taking the substance in larger amounts or for longer than the you meant to
2. Wanting to cut down or stop using the substance but not managing to
3. Spending a lot of time getting, using, or recovering from use of the substance
4. Cravings and urges to use the substance
5. Not managing to do what you should at work, home or school, because of substance use
6. Continuing to use, even when it causes problems in relationships
7. Giving up important social, occupational or recreational activities because of substance use
8. Using substances again and again, even when it puts the you in danger
9. Continuing to use, even when the you know you have a physical or psychological problem that could have been caused or made worse by the substance
10. Needing more of the substance to get the effect you want (tolerance)
11. Development of withdrawal symptoms, which can be relieved by taking more of the substance.
Take an alcohol and drug use history. Then ask the patient if he/she has ever experienced this (the symptom/criteria). Keep going between the patient’s discussion of each criteria and what they reported in the alcohol and drug use history.
Then you can add a recovery specifier. They offer four options:
Clinicians can also add one of four specifiers
1. In early remission,
2. In sustained remission,
3. On maintenance therapy (such as methadone or Suboxone);
4. In a controlled environment (such as detox, residential living, sober living home, jail/prison,etc.)
Try it with patient or in a group and let me know how it goes by posting on my Facebook Page: www.facebook.com/GorskiRecovery