Chapter 14 Summary A substance-related disorder is a condition (such as intoxication, harmful use/abuse, dependence, withdrawal, and psychoses or amnesia associated with the use of the substance) associated with substance abuse, often involving maladaptive behaviors over a long period of time. In order to be diagnosed with substance dependence an individual must display at least three of the following for a 12 month period: development of tolerance to the substance, withdrawal symptoms, persistent desire/unsuccessful attempts to stop using the substance, ingestion of larger amounts of substance, declined life functioning, and persistent use of substance. Substance intoxication, substance withdrawal, substance abuse and substance dependence are the four substance-related conditions that are present in the DSM-IV-TR. Substance intoxication is a type of substance-induced disorder, consisting of reversible, substance-specific, maladaptive behavioral or psychological changes directly resulting from the physiologic effects on the central nervous system of recent ingestion of or exposure to a drug of abuse, medication, or toxin. Specific cases are named on the basis of etiology, e.g., alcohol intoxication. Substance withdrawal is physiologic and psychological readjustments made during discontinuation of use of a substance previously employed to induce intoxication. Substance abuse is a patterned use of a substance (drug) in which the user consumes the substance in amounts or with methods neither approved nor advised by medical professionals. Substance abuse/drug abuse is not limited to mood-altering or psycho-active drugs. If an activity is performed using the objects against the rules and policies of the matter (as in steroids for performance enhancement in sports), it is also called substance abuse. Therefore, mood-altering and psychoactive substances are not the