From the Diagnostic and Statistical Manual (Fourth Edition) of the American Psychiatric Association
DSM-IV checklist for alcohol abuse and alcohol dependence
Substance Abuse
A definite diagnosis of abuse is made when any one of A and both B and C are "yes."
A. Has the client experienced the following?  1. Recurrent failure to meet important responsibilities 
due to use? 

2. Recurrent use in situations when this is likely to be 
physically dangerous? 

3. Recurrent legal problems arising from use 

4. Continued to use despite recurrent problems aggravated by the substance use: 


  1. These symptoms have occurred within a 12 month period
  • Client had never met the criteria for dependence
    Substance Dependence
    A definite diagnosis of dependence is made when any three of A and B are "yes."
    A. Has the client experienced the following?  1. tolerance (needing more to become intoxicated or discovering less effect with same amount) 

    2. withdrawal* (characteristic withdrawal associated with type of drug) 

    3. Using more or for longer periods than intended? 

    4. Desire to and/or unsuccessful efforts to cut down on use? 

    5. Considerable time spent in obtaining the substance 
    or using, or recovering from its effects? 

     6. Important social, work, or recreational activities give 
    up because of use? 

    7. Continued use despite knowledge of problems caused by or aggravated by use?

    B. Have these positive items been present during the same 12 month period?    

    The number of items checked as positive? ____________

    Are three or more of the above positive?

    Footnote: * A clear cut withdrawal syndrome is not present with some classes of drugs: caffeine, marijuana, phencyclidine, or hallucinogens.


    "Alcoholism" is a colloquial term generally understood to refer to alcohol dependence, as defined above.