For example, the DSM currently distinguishes substance dependence – essentially addiction (a disorder) – from substance abuse, a weaker category that includes dubious criteria such as driving while intoxicated or arguing with others about substance use. The DSM-5 proposes to eliminate the weak “abuse” category, but only by combining its misconceived criteria with current dependence criteria to form a unified “substance use disorder” category, and reducing the number of symptoms needed for diagnosis from three to two.
还有一些更改则破坏了现有分类的有效性。比如手册目前将物质依赖（恋物癖）——就是物质成瘾（一种失调症）——和物质滥用区分开来，后者（一个较为弱势的门类）包含了一些模糊的条件，比如酒后驾车或者因为物品的使用而跟他人发生争吵。而第五版手册则想要取消掉这个弱势的“滥用”门类，但要求将该门类中那些模糊性条件与“依赖”的条件相混合，整合成一个叫做“物质使用失调”的门类，并将确定诊断所需要的症状数量从三个减少到两个。