Addiction Treatment – Diagnostic and Statistical Manual Changes Proposed For Addictions

Image (c) Ivan Petrov

The long-awaited proposed criteria for the next edition of the Diagnostic and Statistical Manual (DSM), due to be published in 2013, have been revealed, and are available for public viewing and commentary online.

Fundamental changes to the way that addictions are categorized are proposed, including:

A shift in focus from “dependence,” which is proposed to refer exclusively to physiological dependence as a normal process, to “addiction,” which is proposed to refer to “compulsive, out-of-control” behaviors.
A move towards including behavioral addictions, such as gambling and internet addictions.
Re-naming the “Substance-Related Disorders” category “Addiction and Related Disorders,” a move which reflects both of the above changes.

These are very positive changes. In addition, I applaud the DSM working group for recognizing the difficulty that the past focus on substance dependence has caused for both physicians and their patients, particularly when the prescription of dependence-causing drugs is involved. They even give examples of scenarios where patients in severe pain are denied adequate doses of drugs such as opioids, beta-blockers, antidepressants, anti-anxiety agents and other drugs which may cause tolerance and withdrawal without addiction, because of fear on the part of the physician of producing “addiction” in these patients .

Great news for people who need prescriptions for potentially dependence-forming drugs!

Sex addiction is not included in this category, although Hypersexual Disorder, which refers to “out-of-control” sexual behavior, including cybersex, is proposed to be added to the Sexual and Gender Identity Disorders category.

Nor is food addiction included in the Addictions and Related Disorders category, although given the problem of widespread obesity and related problems, I am pleased to see Binge Eating Disorder is proposed to be promoted from the appendix of the manual to a specific diagnostic disorder.

The DSM working group also invites feedback, so if you are affected by addictions, or care about those who are, now is the time to have your say.

Diagnostic and Statistical Manual Changes Proposed For Addictions originally appeared on About.com Addictions on Wednesday, February 10th, 2010 at 19:00:40.

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