BUPRENORPHINE MAINTENANCE TREATMENT

PHYSICIAN/OFFICE INFORMATION

DSM-IV criteria for substance dependence and substance abuse

Once a thorough patient assessment has been performed, a formal diagnosis of either opioid dependence or abuse should be made. A substance dependence or abuse diagnosis, according to current DSM-IV diagnostic schema, is based on clusters of behaviors and physiological effects occurring within a specific time frame. The diagnosis of dependence always takes precedence over that of abuse, e.g., a diagnosis of abuse is made only if DSM-IV criteria for dependence have never been met.

The following page provides the DSM-IV criteria for diagnosing substance dependence and abuse.

DSM-IV Criteria for Substance Dependence and Substance Abuse

| | |
|Dependence |Abuse |
| | |
|(3 or more in a 12-month period) |(1 or more in a 12-month period) |
| |Symptoms must never have met criteria for substance dependence for |
| |this class of substance. |
| | |
|Tolerance (marked increase in amount; marked decrease in effect) |Recurrent use resulting in failure to fulfill major role obligation at|
| |work, home or school |
| | |
|Characteristic withdrawal symptoms; substance taken to relieve | |
|withdrawal | |
| |Recurrent use in physically hazardous situations |
| | |
|Substance taken in larger amount and for longer period than intended | |
| |Recurrent substance related legal problems |
| | |
|Persistent desire or repeated unsuccessful attempt to quit | |
| |Continued use despite persistent or recurrent social oar interpersonal|
| |problems caused or exacerbated by substance |
|Much time/activity to obtain, use, recover | |
| | |
|