Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

Sections

Substance-Related Disorders | Substance Use Disorders | Substance-Induced Disorders | Alcohol-Related Disorders | Alcohol Use Disorder | Alcohol Intoxication | Alcohol Withdrawal | Other Alcohol-Induced Disorders | Unspecified Alcohol-Related Disorder | Caffeine-Related Disorders | Caffeine Intoxication | Caffeine Withdrawal | Other Caffeine-Induced Disorders | Unspecified Caffeine-Related Disorder | Cannabis-Related Disorders | Cannabis Use Disorder | Cannabis Intoxication | Cannabis Withdrawal | Other Cannabis-Induced Disorders | Unspecified Cannabis-Related Disorder | Hallucinogen-Related Disorders | Phencyclidine Use Disorder | Other Hallucinogen Use Disorder | Phencyclidine Intoxication | Other Hallucinogen Intoxication | Hallucinogen Persisting Perception Disorder | Other Phencyclidine-Induced Disorders | Other Hallucinogen-Induced Disorders | Unspecified Phencyclidine-Related Disorder | Unspecified Hallucinogen-Related Disorder | Inhalant-Related Disorders | Inhalant Use Disorder | Inhalant Intoxication | Other Inhalant-Induced Disorders | Unspecified Inhalant-Related Disorder | Opioid-Related Disorders | Opioid Use Disorder | Opioid Intoxication | Opioid Withdrawal | Other Opioid-Induced Disorders | Unspecified Opioid-Related Disorder | Sedative-, Hypnotic-, or Anxiolytic-Related Disorders | Sedative, Hypnotic, or Anxiolytic Use Disorder | Sedative, Hypnotic, or Anxiolytic Intoxication | Sedative, Hypnotic, or Anxiolytic Withdrawal | Other Sedative-, Hypnotic-, or Anxiolytic-Induced Disorders | Unspecified Sedative-, Hypnotic-, or Anxiolytic-Related Disorder | Stimulant-Related Disorders | Stimulant Use Disorder | Stimulant Intoxication | Stimulant Withdrawal | Other Stimulant-Induced Disorders | Unspecified Stimulant-Related Disorder | Tobacco-Related Disorders | Tobacco Use Disorder | Tobacco Withdrawal | Other Tobacco-Induced Disorders | Unspecified Tobacco-Related Disorder | Other (or Unknown) Substance–Related Disorders | Other (or Unknown) Substance Use Disorder | Other (or Unknown) Substance Intoxication | Other (or Unknown) Substance Withdrawal | Other (or Unknown) Substance–Induced Disorders | Unspecified Other (or Unknown) Substance–Related Disorder | Non-Substance-Related Disorders | Gambling Disorder

Excerpt

The substance-related disorders encompass 10 separate classes of drugs: alcohol; caffeine; cannabis; hallucinogens (with separate categories for phencyclidine [or similarly acting arylcyclohexylamines] and other hallucinogens); inhalants; opioids; sedatives, hypnotics, and anxiolytics; stimulants (amphetamine-type substances, cocaine, and other stimulants); tobacco; and other (or unknown) substances. These 10 classes are not fully distinct. All drugs that are taken in excess have in common direct activation of the brain reward system, which is involved in the reinforcement of behaviors and the production of memories. They produce such an intense activation of the reward system that normal activities may be neglected. Instead of achieving reward system activation through adaptive behaviors, drugs of abuse directly activate the reward pathways( Koob 2006 ). The pharmacological mechanisms by which each class of drugs produces reward are different, but the drugs typically activate the system and produce feelings of pleasure, often referred to as a “high.” Furthermore, individuals with lower levels of self-control, which may reflect impairments of brain inhibitory mechanisms, may be particularly predisposed to develop substance use disorders, suggesting that the roots of substance use disorders for some persons can be seen in behaviors long before the onset of actual substance use itself( Moffitt et al. 2011 ).

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