Substance-induced disorders are a type of substance-related disorder Substance Use Disorders Substance use disorders are a type of substance-related disorder that involve a pathologic pattern of behaviors in which patients continue to use a substance despite experiencing significant... read more that involve the direct effects of a drug; they include
Intoxication
Withdrawal
Substance-induced mental disorders
Substance-related disorders that involve pathologic patterns of behavior related to drug use (eg, patients continue to use a substance despite experiencing significant problems related to use of that substance) are considered substance use disorders Substance Use Disorders Substance use disorders are a type of substance-related disorder that involve a pathologic pattern of behaviors in which patients continue to use a substance despite experiencing significant... read more . The common terms "addiction," "abuse," and "dependence" are too loosely and variably defined to be useful in systematic diagnosis.
The specific manifestations and treatment of intoxication and withdrawal vary by the substance or substance class and are discussed elsewhere in THE MANUAL.
Intoxication
Intoxication refers to development of a reversible substance-specific syndrome of mental and behavioral changes that may involve altered perception, euphoria, cognitive impairment, impaired judgment, impaired physical and social functioning, mood lability, belligerence, or a combination. Taken to the extreme, intoxication can lead to overdose, significant morbidity, and risk of death.
Withdrawal
Withdrawal refers to substance-specific physiologic effects, symptoms, and behavioral changes that are caused by stopping or reducing the intake of a substance. To be classified as a substance-withdrawal disorder, the withdrawal syndrome must cause the patient significant distress and/or impair functioning (eg, social, occupational). Most patients with withdrawal recognize that readministering the substance will reduce their symptoms.
Although some patients with a withdrawal syndrome have a substance use disorder Substance Use Disorders Substance use disorders are a type of substance-related disorder that involve a pathologic pattern of behaviors in which patients continue to use a substance despite experiencing significant... read more , some drugs, particularly opioids Opioid Use Disorder and Rehabilitation “Opioid” is a term for a number of natural substances (originally derived from the opium poppy) and their semisynthetic and synthetic analogues that bind to specific opioid receptors. Opioids... read more , sedative/hypnotics Anxiolytics and Sedatives Anxiolytics and sedatives include benzodiazepines, barbiturates, and related drugs. High doses can cause stupor and respiratory depression, which is managed with intubation and mechanical ventilation... read more , and stimulants Amphetamines Amphetamines are sympathomimetic drugs with central nervous system stimulant and euphoriant properties whose toxic adverse effects include delirium, hypertension, seizures, and hyperthermia... read more , can result in withdrawal symptoms even when taken as prescribed for legitimate medical reasons and for relatively brief periods (< 1 week for opioids). Withdrawal symptoms that develop following appropriate medical use are not considered criteria for diagnosis of a substance use disorder.
Substance-induced mental disorders
Substance-induced mental disorders are mental changes produced by substance use or withdrawal that resemble independent mental disorders (eg, depression Depressive Disorders Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. Exact cause is unknown... read more , psychosis Introduction to Schizophrenia and Related Disorders Schizophrenia and related psychotic disorders—brief psychotic disorder, delusional disorder, schizoaffective disorder, schizophreniform disorder, and schizotypal personality disorder—are characterized... read more , anxiety Overview of Anxiety Disorders Everyone periodically experiences fear and anxiety. Fear is an emotional, physical, and behavioral response to an immediately recognizable external threat (eg, an intruder, a car spinning on... read more , or neurocognitive disorders).
To be considered substance-induced, the substance involved must be known to be capable of causing the disorder. Substances can be members of the 10 classes of drug that typically cause substance-related disorders Overview of Substance-Related Disorders Substance-related disorders involve drugs that directly activate the brain's reward system. The activation of the reward system typically causes feelings of pleasure; the specific pleasurable... read more or many others (eg, anticholinergics and corticosteroids may cause temporary psychotic syndromes). In addition, the mental disorder should
Appear within 1 month of substance intoxication or withdrawal
Cause significant distress or impaired functioning
Not have manifested before use of the substance
Not persist for a substantial period of time*
* Certain neurocognitive disorders caused by alcohol, inhalants, or sedative-hypnotics and perceptual disorders caused by hallucinogens may be long-lasting.
