Substance-Related and Addictive Disorders

A problematic pattern of alcohol use leading to clinically significant impairment or distress, assessed across a cluster of behavioral, physiological, and craving-related indicators within a 12-month period.

Clinically significant symptoms following recent caffeine consumption (Caffeine Intoxication) or following abrupt reduction/cessation of regular caffeine use (Caffeine Withdrawal) -- notably, DSM-5-TR does not include a formal Caffeine Use Disorder in its main diagnostic section.

A problematic pattern of cannabis use leading to clinically significant impairment or distress, evidenced by at least 2 of 11 criteria spanning impaired control, social impairment, risky use, and pharmacological indicators (tolerance, withdrawal), within a 12-month period.

Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress, evidenced by 4 or more of 9 criteria within a 12-month period -- the only non-substance behavioral addiction formally recognized in DSM-5-TR's Substance-Related and Addictive Disorders chapter.

A problematic pattern of hallucinogen use (phencyclidine-type or other hallucinogens such as LSD or psilocybin) leading to clinically significant impairment or distress, evidenced by at least 2 of 11 characteristic indicators within a 12-month period, plus recognized hallucinogen-induced conditions including intoxication and, distinctively, Hallucinogen Persisting Perception Disorder.

A category covering problematic use of, and intoxication from, volatile hydrocarbon-based substances (such as glues, aerosols, paint thinners, and fuels) inhaled for their psychoactive effects, distinguished from other substance classes by the specific substances involved and their acute and potentially serious toxic effects.

A problematic pattern of opioid use leading to clinically significant impairment or distress, reflected in a cluster of behavioral, physiological, and craving-related symptoms occurring within a 12-month period.

A residual category covering substance use disorders, intoxication, and withdrawal involving a substance not covered by the ten specifically named classes in this chapter (such as anabolic steroids, nitrous oxide, or other over-the-counter or unknown substances), or presentations where the specific substance cannot be identified.

A problematic pattern of use of sedative, hypnotic, or anxiolytic medications (e.g., benzodiazepines, barbiturates, and similar prescription sedative/sleep medications) leading to clinically significant impairment or distress, evidenced by at least 2 of 11 characteristic indicators within a 12-month period, with a recognized, medically significant withdrawal syndrome similar in profile to alcohol withdrawal.

A problematic pattern of amphetamine-type substance, cocaine, or other stimulant use leading to clinically significant impairment or distress, evidenced by at least 2 of 11 criteria spanning impaired control, social impairment, risky use, and pharmacological indicators, within a 12-month period.

A problematic pattern of tobacco/nicotine use leading to clinically significant impairment or distress, evidenced by at least 2 of 11 characteristic indicators within a 12-month period, with a recognized withdrawal syndrome (irritability, frustration/anger, anxiety, difficulty concentrating, increased appetite, restlessness, depressed mood, insomnia) distinct from, but using the same diagnostic framework as, other substance use disorders.