Polysubstance Dependence - Diagnosis

Diagnosis

According to the DSM-IV, a diagnosis of polysubstance dependence must include a person who has used at least three different substances (not including caffeine or nicotine) indiscriminately, but does not have a preference to any specific one. In addition they must show a minimum of three of the following symptoms listed below, all within the past twelve months. There is a distinct difference between a person having three separate dependence issues and having Polysubstance dependence the main difference is polysubstance dependence means that they are not specifically addicted to one particular substance. This is often confused with multiple specific dependences present at the same time. To elaborate, if a person is addicted to three separate substance such as cocaine, methamphetamines and alcohol and is dependent on all three then they would be diagnosed with three separate dependence disorders existing together (cocaine dependence, methamphetamine dependence and alcohol dependence,) not polysubstance dependence. In addition to using three different substances without a preference to one, there has to be a certain level of dysfunction in a person’s life to qualify for a diagnosis of polysubstance dependence. One of the bigger challenges that often occurs when trying to diagnose is the fact that people don't always report what they are taking because they are afraid of getting into legal trouble. When coding polysubstance Dependence in a DSM-IV it would be a multiaxial diagnosis 304.80- Polysubstance Dependence", next to the classification, it is accompanied by a list of other types of Substance dependence (e.g. "305.00 Alcohol Abuse" or "305.60 Cocaine Abuse").

The DSM-IV requires at least three of the following symptoms present during a 12 month period for a diagnoses of polysubstance dependence.

• Tolerance: Use of increasingly high amounts of a substance or they find the same amount less and less effective ( the amount has to be at least 50% more of the original amount needed.)

• Withdrawal: Either withdrawal symptoms when drug stops being used or the drug is used to prevent withdrawal symptoms.

• Loss of control: Repeated use of more drugs than planned or use of the drugs over longer periods of time than planned.

• Inability to stop using: Either unsuccessfully attempted to cut down or stop using the drugs or a persistent desire to stop using.

• Time: Spending a lot of time obtaining drugs, using drugs, being under the influence of drugs, and recovering from the effects of drugs.

• Interference with activities: Give up or reduce the amount of time involved in recreational activities, social activities, and/or occupational activities because of the use of drugs.

• Harm to self: Continuous use of drugs despite having a physical or psychological problem caused by or made worse by the use of drugs.