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Commonalities and Differences Across Substance Use Disorders: Phenomenological and Epidemiological Aspects
Dvora Shmulewitz1,2, Emily R Greene3, Deborah Hasin1,2,3
1Department of Psychiatry, Columbia University, New York City, New York.
Alcoholism, Clinical and Experimental Research
|September 3, 2015
Summary
The Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for substance use disorders (SUDs) apply across various psychoactive substances. Alcohol, cannabis, and tobacco have the greatest public health impact due to early onset and high prevalence.
Area of Science:
- Psychiatry
- Addiction Medicine
- Neuroscience
Background:
- Psychoactive substances share commonalities in addiction potential despite varied effects.
- A comprehensive review of substance use disorders (SUDs) across diverse substances is needed.
- Existing literature lacks an updated comparison of the phenomenology of alcohol, cannabis, tobacco, stimulants, opioids, hallucinogens, sedatives, and inhalants.
Purpose of the Study:
- To review commonalities and differences in the phenomenology of various psychoactive substances and their related SUDs.
- To evaluate the applicability of DSM-IV and DSM-5 SUD diagnostic criteria across different substances.
- To identify substances with the greatest public health impact.
Main Methods:
- Reviewed DSM-IV and DSM-5 SUD diagnostic criteria.
- Analyzed recent epidemiological and clinical research, including psychometric studies and physiological indicators.
- Incorporated data from literature searches (PubMed, Scopus) and large U.S. national surveys.
Main Results:
- DSM-IV dependence and DSM-5 SUD criteria demonstrate test-retest reliability and unidimensionality across substances.
- Criteria are most informative for moderate-to-severe SUD in general populations.
- Alcohol, tobacco, and cannabis show the earliest onset, highest prevalence of use, and highest prevalence of disorder.
Conclusions:
- Generic DSM SUD criteria are applicable across most psychoactive substances.
- Further research on tolerance and hazardous use is recommended for future diagnostic systems.
- Alcohol, cannabis, and tobacco pose the greatest public health challenges due to high prevalence, early onset, and addiction potential.
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