Withdrawal from some substances, such as alcohol, benzodiazepines, and barbiturates, can be fatal! Substance-induced disorders In the absence of other DSM-V criteria, tolerance and withdrawal do not necessarily indicate substance use disorder.Tolerance and withdrawal can be normal physiological adaptations.Exception: patients undergoing supervised treatment with certain psychoactive substances (e.g., stimulants, cocaine, opioids, nitrous oxide, sedative-hypnotic drugs, anxiolytic drugs, cannabis).Hallucinogens and inhalants do not cause withdrawal.Often, withdrawal symptoms are the opposite of intoxication effects, e.g., heroin intoxication causes sedation and constipation, whereas heroin withdrawal causes anxiety, insomnia, and diarrhea.Drug withdrawal : a substance-dependent collection of symptoms that appear after cessation of prolonged heavy drug use accompanied by a strong urge to readminister the substance.Drug tolerance : the need to continuously increase the dose of a substance to achieve the same desired effect.Continued use despite awareness of problems related to or exacerbated by substance use (e.g., continued alcohol use despite having cirrhosis ).Use in physically hazardous situation s ( e.g., driving a car under the influence, unprotected sex, operating heavy machinery).Reduced social, occupational, and recreational activities (e.g., less time socializing with friends, neglecting hobbies).Problems with interpersonal relationships directly related to substance use (withdrawal from relationships, marital issues).Problems fulfilling work, school, family, or social obligations (e.g., not attending work or school, neglecting children or partner).Intense desire to obtain and use substance ( craving).A great deal of time spent on substance-related activities (e.g., seeking out, buying, using, recovering from use).Repeated failed attempts to cut down on use.Using a substance in larger amounts and/or for a longer time than originally intended.Characteristics: features that are typical for all substance use disorders ( ≥ 2 features must occur within 1 year to fulfill the DSM-V criteria).Alcohol and nicotine use are most common.Description: a chronic condition in which an uncontrolled pattern of substance use leads to significant physical, psychological, and social impairment or distress, with continued use despite substance-related problems.DSM-5 classifies gambling disorder as a non-substance-related addictive disorder.Substance-induced disorders (intoxication, withdrawal, and substance-induced mental disorders).Substance-related disorders are divided into:.Alcohol, caffeine, cannabis, hallucinogens ( phencyclidine, other hallucinogens), inhalants, opioids, sedatives, hypnotics, or anxiolytics, stimulants ( amphetamines or amphetamine-type substances, cocaine, other stimulants), tobacco, other/unknown substances.
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