DSM 5: Ten Updated Facts regarding Substance Use Disorders

1. Combining abuse and dependence criteria into a single substance use disorder

2. Dropping legal problems from diagnostic criteria:
Due to low prevalence in adult samples.

3. Adding craving as criteria.
Work group was also planning to add "Consumption" as other criteria, but was later dropped.

4. Diagnostic threshold for substance use disorder set at two or more criteria.
To identify all cases meriting intervention (including milder cases).

5. Specifiers:
(a) Early Remission: ≥3 to <12 months without meeting substance use disorders criteria (except craving)
(b) Sustained remission: ≥12 months without meeting substance use disorders criteria (except craving).
(c) Update the maintenance therapy category with examples of agonists (e.g., methadone and buprenorphine), antagonists (e.g., naltrexone), and tobacco cessation medication (bupropion and varenicline).

6. Biomarkers: Do not include biomarkers in making diagnosis.

7. Adding Cannabis and Caffeine withdrawal syndromes.

8. Aligning tobacco use disorder criteria with other substance use disorders.

9. Include neurobehavioral disorder associated with prenatal alcohol exposure.

10. Including gambling disorders to the substance use disorders section.

For details of each revisions --> Am J Psychiatry 2013;170:834-851.