Severity and Specifiers

Substance use disorders occur in a broad range of severity, from mild to severe. As a general estimate of severity, a mild substance use disorder is suggested by the presence of 2-3 symptoms, moderate by 4-5 symptoms, and severe by 6 or more symptoms.

Severity can change across time with the person either reducing or increasing the symptoms for which they meet. In the case that an individual no longer meets for a substance use disorder (e.g., if a person had a past substance use disorder but became “clean & sober”), “in early remission,” “in sustained remission,” “on maintenance therapy,” or “in a controlled environment” may be added to the diagnosis (e.g., Alcohol use disorder in sustained remission).

Substances for which a person can establish a substance use disorder:

  • Alcohol
  • Cannabis
  • Phencyclidine
  • Other Hallucinogen
  • Inhalants
  • Opioid
  • Sedative, hypnotic, or anxiolytic
  • Stimulant: Specify amphetamine or cocaine
  • Tobacco
  • Other (Unknown)

This criteria has been adapted for 2013 DSM-5.