234979 New approaches to diagnosing substance use disorders in DSM-V

Monday, October 31, 2011: 12:50 PM

Deborah S. Hasin, PhD , Columbia University/New York State Psychiatric Institute, New York, NY
The DSM-V Substance Related Disorders Workgroup was charged with making improvements on previous diagnostic criteria that were data-based, that moved the classification towards clinical neuroscience and, above all, improved the system's utility for clinicians. The proposed changes are consistent with these goals and are on schedule for a 2012 publication. Each speaker will address one area of major change that is under consideration for DSM-5. One topic is the accumulated body of research indicating that the two diagnostic categories, “abuse” and “dependence”, are not sufficiently distinct for any substance to warrant continued separation of the diagnostic criteria into two hierarchical disorders. Related to this topic are the questions of whether craving should be added as a diagnostic criterion, and whether any of the criteria, particularly legal problems, can be removed. A second topic is whether the criteria for nicotine use disorders, up to now including only nicotine dependence, can be aligned with the new criteria set for the other substances to include abuse criteria and craving. A third topic is the appropriate terminology to use in referring to the disorders of principal interest in this section of the DSM-5. A final topic is whether the data support incorporation of non-substance compulsive or addictive behaviors such as gambling disorders into the DSM-5 chapter that previously only included disorders involving maladaptive use of psychoactive substances. The speakers will address these issues, providing an overview of the DSM-5 workgroup activities and an opportunity for conference participants to discuss and provide feedback.

Learning Areas:
Basic medical science applied in public health
Public health or related research

Learning Objectives:
Describe the mission of the DSM-V Substance Related Disorders Workgroup. Identify at least two areas of major change to the criteria for substance use and other addictive disorders that are under consideration for DSM-V.

Keywords: Substance Abuse, Alcoholism

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been conducting state-of-the-science substantive and methodologic research both in the U.S. and internationally on alcohol and other substance use and associated disorders for over 25 years. My research activities include studies of the epidemiology, natural history, and course of alcohol, drug, nicotine, and other psychiatric disorders, many of which have contributed to the evidence base for the classification of substance use disorders in DSM-V. In addition, I have investigated the interaction of genetic and environmental influences on heavy drinking and alcohol dependence, and the development of innovative behavioral interventions to reduce risky substance use in HIV primary care and other clinical settings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.