Box 2: Criteria for substance use dependence in ICD-10

"Criteria for substance use dependence in ICD-10

Three or more of the following must have been experienced or exhibited at some time during the previous year:

  1. A strong desire or sense of compulsion to take the substance;
  2. Difficulties in controlling substance-taking behaviour in terms of its onset, termination, or levels of use;
  3. A physiological withdrawal state when substance use has ceased or been reduced, as evidenced by: the characteristic withdrawal syndrome for the substance; or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms;
  4. Evidence of tolerance, such that increased doses of the psychoactive substance are required in order to achieve effects originally produced by lower doses;
  5. Progressive neglect of alternative pleasures or interests because of psychoactive substance use, increased amount of time necessary to obtain or take the substance or to recover from its effects ;
  6. Persisting with substance use despite clear evidence of overtly harmful consequences, such as harm to the liver through excessive drinking, depressive mood states consequent to heavy substance use, or substance-related impairment of cognitive functioning. Efforts should be made to determine that the user was actually, or could be expected to be, aware of the nature and extent of the harm.

Source: reproduced from reference 9."

Source: WHO  Neuroscience of psychoactive substance use and dependence, Summary (2004),
Substance use and dependence in relation to neuroscience, Box 2, p.14

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Box 2: Criteria for substance use dependence in ICD-10