230 Alcohol Dependence (303.90)
DSM-IV-TR criteria
A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
(1) Tolerance, as defined by either of the following:
- A need for markedly increased amounts of the substance to achieve intoxication or desired effect
- Markedly diminished effect with continued use of the same amount of the substance
(2) Withdrawal, as manifested by either of the following:
- The characteristic withdrawal syndrome for the substance (refer to criteria A and B of the criteria sets for Withdrawal from the specific substances)
- The same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms
(3) The substance is often taken in larger amounts or over a longer period than was intended
(4) There is a persistent desire or unsuccessful efforts to cut down or control substance use
(5) A great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or recover from its effects
(6) Important social, occupational, or recreational activities are given up or reduced because of substance use
(7) The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption)
Specify if:
- With Physiological Dependence
- Without Physiological Dependence
- Early Full Remission
- Early Partial Remission
- Sustained Full Remission
- Sustained Partial Remission
- In a Controlled Environment
Associated features
- Statistics show that: in the United States about one out of ten people are alcohol dependent; there is either an intoxicated driver or pedestrian involved in approximately one half of all highway fatalities; and among individuals with alcohol dependence, approximately ten percent commit suicide (this is shown to be related to Substance Induced Mood Disorders) . Other studies show a connection between long term heavy alcohol use and the development of Dementia and Wernicke’s disease. In pregnant women alcohol dependence can also cause different birth defects such as Fetal Alcohol Effects (FAE) and Fetal Alcohol Syndrome (FAS).Fetal Alcohol Syndrome is more severe and usually causes some form of mild Mental Retardation and physical defects leading to intellectual deficiencies and learning disabilities. The statistics concerning FAS are staggering. It is estimated that out of every 1000 infants born alive, approximately 1.5 has FAS. Not only is Fetal Alcohol Syndrome the primary preventable cause of Mental Retardation in the United States, it is also the third leading cause of birth d