Substance Use Disorder: What Does Not Apply?
Substance Use Disorders and the DSM
The Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM, is the American Psychological Association’s guide to recognized mental health and substance use disorders. The DSM is used by insurance companies to determine what will and will not be covered by a patient’s policy. Usually insurance companies will only cover treatment for those disorders that are included in the DSM.
Though other disorders exist outside of the DSM, those that are included have been agreed upon by the vast majority of psychology professionals and have standardized diagnostic criteria. Substance use disorders that are not yet covered in the DSM may require further research in order for the psychology profession as a whole to come to an agreement as to how to identify and treat such disorders.
What the DSM Does Not Cover
There are many conditions that are recognized by mental health professionals and are treated in formal settings but are not included in the DSM. For example, many behavioral addictions such as exercise addiction, Internet addiction and sex or pornography addiction have not yet been included in the DSM. When it comes to substance use disorders, however, there is only one class of substance that is not defined by a use disorder: caffeine.
In order for a drug to be considered capable of causing a substance use disorder, it must cause impaired physiological or psychological control and social impairment. A substance will also only cause a substance use disorder if it can be associated with risky use, tolerance and withdrawal. Though individuals can build a tolerance to caffeine and may experience caffeine withdrawal, caffeine is not associated with risky use and does not cause impaired control or social impairment. All other drug categories, such as alcohol, hallucinogens, inhalants, opioids, sedatives, stimulants and more, cause substance use disorders.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: American Psychiatric Association.
Horvath, A, T., Misra, K., Epner, A. K., & Cooper, G. M. (2016). The Diagnostic Criteria for Substance Use Disorders (Addiction). https://www.mentalhelp.net/articles/the-diagnostic-criteria-for-substance-use-disorders-addiction/