title: Substance use disorder: abuse, dependence and dyscontrol.
abstract: The purpose of this paper is to review the diagnostic concepts of substance abuse and substance dependence provided in DMS-III, DSM-III-R, and the forthcoming DSM-IV. The review incorporates the principles that there are no infallible criteria for identifying when a person lacks sufficient control over the usage of a drug, that dyscontrol exists on a continuum, that substance use dyscontrol shares many formal properties with behavioral dyscontrol within other domains, and that the diagnosis of a mental disorder should be free of moralistic connotations. We conclude the paper with an alternative proposal, wherein the DSM-IV diagnoses of abuse and dependence are collapsed within one diagnosis of substance dyscontrol disorder and physiological substance dependence is placed with the diagnoses of substance intoxication and substance withdrawal.
authors.affiliation: Department of Psychology, University of Kentucky, Lexington 40506-0044.
authors.forename: T A
authors.initials: TA
authors.lastname: Widiger
authors.forename: G T
authors.initials: GT
authors.lastname: Smith
mesh_terms: D015897:Comorbidity; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis / Q000534:rehabilitation; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000009:adverse effects; D013375:Substance Withdrawal Syndrome / Q000209:etiology; D019966:Substance-Related Disorders / Q000145:classification / Q000175:diagnosis* / Q000534:rehabilitation
chemical_list: D013287:Illicit Drugs; D011619:Psychotropic Drugs