Unknown substance use disorder

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Differential Diagnosis

• Other (or unknown) substance/medication-induced disorder

• Anxiety disorder
• Delirium
• Depressive disorder
• Major or mild neurocognitive disorder
• Psychotic disorder
• Sexual dysfunction
• Sleep disorder

• Other medical conditions
• Substance use disorders
• Use of Other or unknown substances without meeting criteria for other (or unknown) substance use disorder

Risk Factors

• Antisocial personality disorder
• Behavioral disinhibition
• Conduct disorder
• Childhood maltreatment or trauma
• Early onset of substance problems
• Easy availability of the substance
• Limited early self-control

Diagnostic Criteria

DSM-V Diagnostic Criteria for Other (or Unknown) Substance Use Disorder

“

A.A problematic pattern of use of an intoxicating substance not able to be classified within the alcohol; caffeine; cannabis; hallucinogen (phencyclidine and others); inhalant;opioid; sedative, hypnotic, or anxiolytic; stimulant; or tobacco categories and leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period: 1.The substance is often taken in larger amounts or over a longer period than was intended. 2.There is a persistent desire or unsuccessful efforts to cut down or control use of the substance. 3.A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects. 4.Craving, or a strong desire or urge to use the substance. 5.Recurrent use of the substance resulting in a failure to fulfill major role obligations at work, school, or home. 6.Continued use of the substance despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of its use. 7.Important social, occupational, or recreational activities are given up or reduced because of use of the substance. 8.Recurrent use of the substance in situations in which it is physically hazardous. 9.Use of the substance 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. 10.Tolerance, as defined by either of the following: a.A need for markedly increased amounts of the substance to achieve intoxication or desired effect. b.A markedly diminished effect with continued use of the same amount of the substance. 11.Withdrawal, as manifested by either of the following: a.The characteristic withdrawal syndrome for other (or unknown) substance. b.The substance (or a closely related substance) is taken to relieve or avoid withdrawal symptoms. Specify if: In early remission: After full criteria for other (or unknown) substance use disorder were previously met, none of the criteria for other (or unknown) substance use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the substance,” may be met). In sustained remission: After full criteria for other (or unknown) substance use disorder were previously met, none of the criteria for other (or unknown) substance use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the substance,”may be met). Specify if: In a controlled environment: This additional specifier is used if the individual is in an environment where access to the substance is restricted.

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References

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