This category applies to presentations in which symptoms characteristic of a stimulant- 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 stimulant-related disorder or any of the disorders in the substance-related and addictive disorders diagnostic class.
Coding note: The |CD-9-CM code is 292.9. The |CD-10-CM code depends on whether the stimulant is an amphetamine, cocaine, or another stimulant. The |CD-10-CM code for an unspecified amphetamine- or other stimulant-related disorder is F15.99. The |CD-10-
CM code for an unspecified cocaine-related disorder is F14.99.
A. A problematic pattern of tobacco use leading to clinically significant impairment or dis- tress, as manifested by at least two of the following, occurring within a 12-month period: 10.
11.
Tobacco 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 tobacco use.
A great deal of time is spent in activities necessary to obtain or use tobacco.
Craving, or a strong desire or urge to use tobacco.
Recurrent tobacco use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., interference with work).
sonal problems caused or exacerbated by the effects of tobacco (e.g., arguments with others about tobacco use).
Important social, occupational, or recreational activities are given up or reduced be- cause of tobacco use.
Recurrent tobacco use in situations in which it is physically hazardous (e.g., smok- ing in bed).
Tobacco use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by tobacco.
Tolerance, as defined by either of the following: a. A need for markedly increased amounts of tobacco to achieve the desired effect.
b. A markedly diminished effect with continued use of the same amount of tobacco.
Withdrawal, as manifested by either of the following: a. The characteristic withdrawal syndrome for tobacco (refer to Criteria A and B of the criteria set for tobacco withdrawal).
b. Tobacco (or a closely related substance, such as nicotine) is taken to relieve or avoid withdrawal symptoms.
Specify it:
In early remission: After lull criteria for tobacco use disorder were previously met, none of the criteria for tobacco use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, "Craving, or a strong de- sire or urge to use tobacco,” may be met).
In sustained remission: After full criteria for tobacco use disorder were previously met, none of the criteria for tobacco use disorder 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 tobacco," may be met).
Specify if:
On maintenance therapy: The individual is taking a long-term maintenance medica- tion, such as nicotine replacement medication, and no criteria for tobacco use disorder have been met for that class of medication (except tolerance to, or withdrawal from, the nicotine replacement medication).
In a controlled environment: This additional specifier is used if the individual is in an environment where access to tobacco is restricted.