title: Truth or consequences in the diagnosis of substance use disorders.
abstract: OBJECTIVE
  This commentary critically evaluates the use of substance-related negative psychosocial and health consequences to define and diagnose alcohol and other substance use disorders.
  
  
  METHODS
  Narrative review.
  
  
  RESULTS
  The consequences of substance use cause much suffering and are major public health and economic problems. However, there are a number of conceptual and measurement problems with using consequences as diagnostic criteria for substance disorders. Data indicate that substance-related consequences introduce systematic bias and degrade the validity of diagnostic systems.
  
  
  CONCLUSIONS
  Negative psychosocial and health consequences of substance use should play a fundamentally reduced role in modern diagnostic systems for, and definitions of, addictive disorders.
authors.affiliation: Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Center of Alcohol Studies, Rutgers University, Piscataway, NJ, USA.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Martin
authors.forename: James W
authors.initials: JW
authors.lastname: Langenbucher
authors.forename: Tammy
authors.initials: T
authors.lastname: Chung
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Sher
mesh_terms: D006801:Humans; D015203:Reproducibility of Results; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000523:psychology
keywords: Addiction; Alcohol Use Disorders; Substance Use Disorders; diagnosis; health consequences; psychosocial consequences