Criteria for Substance Abuse

A pattern of substance use leading to significant impairment or distress, as manifested by one or more of the following during in the past 12 month period:

1. Failure to fulfill major role obligations at work, school, home such as repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household
   
   
2. Frequent use of substances in situation in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
   
   
3. Frequent legal problems (e.g. arrests, disorderly conduct) for substance abuse
   
   
4. Continued use despite having persistent or recurrent social or interpersonal problems (e.g., arguments with spouse about consequences of intoxication, physical fights)

Criteria for Substance Dependence

Dependence or significant impairment or distress, as manifested by 3 or more of the following during a 12 month period:

1. Tolerance or markedly increased amounts of the substance to achieve intoxication or desired effect or markedly diminished effect with continued use of the same amount of substance
   
   
2. Withdrawal symptoms or the use of certain substances to avoid withdrawal symptoms
   
   
3. Use of a substance in larger amounts or over a longer period than was intended
   
   
4. persistent desire or unsuccessful efforts to cut down or control substance use
   
   
5. Involvement in chronic behavior to obtain the substance, use the substance, or recover from its effects
   
   
6. Reduction or abandonment of social, occupational or recreational activities because of substance use
   
   
7. Use of substances even though there is a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance