JACK FRIEDMAN M.D.

Criteria for Substance Abuse

A manipulative pattern of substance leading to clinically significant impairment or distress, as manifested by one (or more) of the following, Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household).
occurring within a 12-month period.

The symptoms have never met the criteria for Substance Dependence for this class of substance.
Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use).
Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct).
Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights).

A.The symptoms have never met the criteria for

Substance Dependence for this class of

substance

Criteria for Substance Dependence

A manipulative pattern of substance leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period.

1.Tolerance, as defined by either of the following:

The need for markedly increased amounts of the substance to achieve intoxication or desired effect.
Markedly diminished effect with continued use of the same amount of the substance.

Withdrawal, as manifested by either of the following:
- The characteristic withdrawal syndrome for the substance.
- The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.

1. Taking the substance often in larger amounts

or over a longer period than was intended.

2. A persistent desire or unsuccessful efforts to

cut down or control substance use.

Spending a great deal of time in activities necessary to obtain or use the substance or to recover from its effects.
Giving up or reducing important social, occupational, or recreational activities because of substance use.
Continued substance use despite knowledge of having had a persistent or recurrent physical or psychological problem that was likely to have been caused or exacerbated by the substance.