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Substance-Induced Disorders

Introduction

The overall category of substance-induced disorders includes intoxication, withdrawal, and other substance/medication-induced mental disorders (e.g., substance-induced psychotic disorder, substance-induced depressive disorder).

Substance Intoxication and Withdrawal

Intoxication

The development of a reversible substance-specific syndrome due to the recent ingestion of a substance.
The clinically significant problematic behavioral or psychological changes associated with intoxication (e.g., belligerence, mood lability, impaired judgment) are attributable to the physiological effects of the substance on the central nervous system and develop during or shortly after use of the substance.
The symptoms are not attributable to another medical condition and are not better explained by another mental disorder.
Substance intoxication is common among those with a substance use disorder but also occurs frequently in individuals without a substance use disorder.
This category does not apply to tobacco.
The most common changes in intoxication involve:

Disturbances of perception.
Wakefulness.
Attention.
Thinking.
Judgment.
Psychomotor behavior.
Interpersonal behavior.

Withdrawal

The essential feature is the development of a substance-specific problematic behavioral change, with physiological and cognitive concomitants, that is due to the cessation of, or reduction in, heavy and prolonged substance use.
The substance-specific syndrome causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The symptoms are not due to another medical condition and are not better explained by another mental disorder.
Most individuals with withdrawal have an urge to re-administer the substance to reduce the symptoms.

Substance/Medication-Induced Mental Disorders

The disorder represents a clinically significant symptomatic presentation of a relevant mental disorder.
There is evidence from the history, physical examination, or laboratory findings of both of the following:

The disorder developed during or within 1 month of a substance intoxication or withdrawal or taking a medication; and
The involved substance/medication is capable of producing the mental disorder.

The disorder is not better explained by an independent mental disorder (i.e., one that is not substance- or medication-induced).
The disorder does not occur exclusively during the course of a delirium.
The disorder causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

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