Dr. Gary Small, M.D.

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Gary Small, M.D., is Chair of Psychiatry at Hackensack University Medical Center, and Physician in Chief for Behavioral Health Services at Hackensack Meridian Health, New Jersey’s largest, most comprehensive and integrated healthcare network. Dr. Small has often appeared on the TODAY show, Good Morning America, and CNN and is co-author (with his wife Gigi Vorgan) of 10 popular books, including New York Times bestseller, “The Memory Bible,” “The Small Guide to Anxiety,” and “The Small Guide to Alzheimer’s Disease.”

Tags: addiction | alchohol | abuse | psychiatry
OPINION

Measures for Defining Substance Abuse

Dr. Small By Friday, 20 February 2015 04:46 PM EST Current | Bio | Archive

In the American Psychiatric Association’s 5th edition of the Diagnostic and Statistical Manual (DSM-5), substance (i.e., drug or alcohol) use disorders include several criteria that are measured on a continuum from mild to severe.
 
The various criteria are clustered into four major groups.
 
IMPAIRED CONTROL
 
• Ingesting larger amounts of the substance over longer periods than intended
 
• Unsuccessful efforts to cut back or stop using the substance
 
• Spending considerable time seeking, using, or recovering from substance use
 
• Strong urges or cravings for the substance
 
 
SOCIAL IMPAIRMENT
 
• Failure fulfilling work, school, or home obligations because of substance use
 
• Persistent substance use despite social or interpersonal problems from such use
 
• Important activities given up or reduced because of substance use
 
 
RISKY BEHAVIOR
 
• Continued use in physically hazardous situations
 
• Persistent use despite physical or psychological problems due to such use
 
 
PHYSICAL DEPENDENCE
 
• Tolerance to the substance (i.e., need for increased amounts to achieve desired effects or diminished effect with continued use of the same amount)
 
• Withdrawal symptoms when use is decreased or discontinued
 
Alcoholics or drug abusers don’t necessarily have to meet all of these criteria for a diagnosis. Only two or more of the 11 criteria are necessary for the diagnosis.

 

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Dr-Small
In the American Psychiatric Association’s 5th edition of the Diagnostic and Statistical Manual, substance use disorders include several criteria that are measured on a continuum from mild to severe.
addiction, alchohol, abuse, psychiatry
209
2015-46-20
Friday, 20 February 2015 04:46 PM
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