234990 Terminology of substance use disorders for DSM-V

Monday, October 31, 2011: 12:30 PM

Wilson Compton, MD, MPE , Division of Epidemiology, Prevention and Services Research, National Institute on Drug Abuse, Bethesda, MD
Starting with DSM III, the major substance use disorder categories have been called “abuse” and “dependence” in each successive version of the diagnostic manual. In DSM IV, the categories of abuse and dependence were designed to be non-overlapping entities where the dependence diagnosis supersedes abuse. In preparation for DSM-V, the substance disorders workgroup has taken up the challenge of considering alternative terminology. Because of the elimination of the categorical distinctions between abuse and dependence, the change in terminology takes on particular importance. In addition, potential confusion about multiple competing uses of the term dependence by DSM and pharmacologists (for whom the term dependence refers specifically to tolerance and withdrawal) has motivated the workgoup to consider alternatives. Following a series of conference calls and consultations, the workgroup considered three major alternatives for the name of the DSM-V Chapter on substance disorders and several alternatives for the main disorder (e.g. “dependence”, “addiction”, “substance use disorder”, etc.). Methods for studying the potential stigma and bias associated with different terminology will be reviewed, and the available findings presented. This presentation will review the major alternatives and provide an opportunity for the audience to participate in discussion about their strengths and weaknesses.

Learning Areas:
Public health or related research
Social and behavioral sciences

Learning Objectives:
Explain the importance of changes in terminology for the naming and definition of diagnostic categories for substance use disorders in successive versions of the DSM. 2) Describe methods for assessing the potential strengths and weaknesses of alternative naming conventions for substance use disorders.

Keywords: Alcoholism, Substance Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal of multiple federally funded grants focusing on the epidemiology of drug abuse, HIV prevention and co-occurring mental and drug use disorders. Among my scientific interests has been the development of strategies for preventing HIV and STDs in out-of-treatment drug users. As well, I am an investigator on the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and a member of the DSM-V Task Force, the Lifespan Developmental Approaches Study Group, and the Substance-Related Disorders Workgroup, and have been a member of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN) Advisory Committee.
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.