This category applies to presentations in which symptoms characteristic of a tobacco- related disorder that cause clinically significant distress or impairment in social, occupa- tional, or other important areas of functioning predominate but do not meet the full criteria for any specific tobacco-related disorder or any of the disorders in the substance-related and addictive disorders diagnostic class.
A. A problematic pattern of use of an intoxicating substance not able to be classified within the alcohol; caffeine; cannabis; hallucinogen (phencyclidine and others); inhal- ant; opioid; sedative, hypnotic, or anxiolytic; stimulant; ortobacco categories and lead- ing to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period: 1.
2.
The substance is often taken in larger amounts or over a longer period than was intended.
There is a persistent desire or unsuccessful efforts to cut down or control use of the substance.
A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
Craving, or a strong desire or urge to use the substance.
Recurrent use of the substance resulting in a failure to fulfill major role obligations at work, school, or home.
Continued use of the substance despite having persistent or recurrent social or in- terpersonal problems caused or exacerbated by the effects of its use.
Important social, occupational, or recreational activities are given up or reduced be- cause of use of the substance.
Recurrent use of the substance in situations in which it is physically hazardous.
Use of the substance is continued despite knowledge of having a persistent or re- current physical or psychological problem that is likely to have been caused or ex- acerbated by the substance.
10. Tolerance, as defined by either of the following: a. A need for markedly increased amounts of the substance to achieve intoxication or desired effect.
b. A markedly diminished el'lect with continued use of the same amount of the sub- stance.
11. Withdrawal, as manifested by either of the following: a. The characteristic withdrawal syndrome for other (or unknown) substance (refer to
Criteria A and B of the criteria sets for other [or unknown] substance withdrawal, p. 583).
b. The substance (or a closely related substance) is taken to relieve or avoid with- drawal symptoms.
Specify if:
In early remission: Afterfull criteria for other (or unknown) substance use disorder were previously met, none of the criteria for other (or unknown) substance use disorder have been met for at least 3 months but for less than 12 months (with the exception that Cri- terion A4, “Craving, or a strong desire or urge to use the substance," may be met).
In sustained remission: After full criteria for other (or unknown) substance use disor- der were previously met, none of the criteria for other (or unknown) substance use dis- order have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the substance," may be met).
Specify if:
In a controlled environment: This additional specifier is used if the individual is in an environment where access to the substance is restricted.
Coding based on current severity: Note for |CD-10-CM codes: If an other (or unknown) sub- stance intoxication, other (or unknown) substance withdrawal, or another other (or unknown) substance—induced mental disorder is present, do not use the codes below for other (or un- known) substance use disorder. Instead, the comorbid other (or unknown) substance use dis- order is indicated in the 4th character of the other (or unknown) substance—induced disorder code (see the coding note for other (or unknown) substance intoxication, other (or unknown) substance withdrawal, or specific other (or unknown) substance—induced mental disorder).