Substance Use Disorders & Diagnostic Criteria Flashcards

A patient with opioid use disorder reports that their usual heroin dose no longer produces the same euphoria and they need more to feel the same effect. In DSM-5, this is best categorized as which criterion?

Answer: Tolerance

Tolerance is marked by a need for markedly increased amounts of the substance to achieve intoxication or desired effect, or diminished effect with the same dose.

Which of the following statements about DSM-5 severity ratings for substance use disorder is CORRECT?

Answer: Mild SUD requires 2-3 criteria

In DSM-5, mild SUD = 2-3 criteria, moderate SUD = 4-5 criteria, and severe SUD = 6 or more of the 11 criteria.

According to DSM-5, which of the following is an example of the 'role impairment' criterion for substance use disorder?

Answer: Missing work repeatedly due to hangover

Recurrent substance use resulting in failure to fulfill major role obligations (work, school, home) — such as repeated absences due to hangovers — meets the role impairment criterion.

Which feature distinguishes substance use disorder from substance intoxication in DSM-5?

Answer: Substance intoxication is a reversible syndrome while SUD is a chronic pattern with 11 diagnostic criteria

Substance intoxication is a reversible, time-limited syndrome from recent use, whereas SUD is a chronic pattern assessed across 11 criteria over 12 months.

A clinician suspects opioid use disorder in a patient but the patient takes prescribed oxycodone for chronic pain. Which approach aligns with DSM-5 guidance?

Answer: Exclude tolerance and withdrawal from the criterion count since they result solely from prescribed use

DSM-5 explicitly states that tolerance and withdrawal should not be counted toward OUD diagnosis when occurring solely as a result of prescribed medications taken as directed.

Which of the following substances has its own specific intoxication AND withdrawal diagnosis listed in DSM-5?

Answer: Alcohol

Alcohol has both a well-characterized intoxication and a clinically significant, potentially life-threatening withdrawal syndrome, both formally recognized in DSM-5.

When coding a substance use disorder with a co-occurring substance-induced disorder in ICD-10-CM, the correct approach is to:

Answer: Use a single combination code reflecting both the SUD and the induced condition

ICD-10-CM uses combination codes (e.g., F10.259) that capture both the substance use disorder and the associated substance-induced disorder in a single code.