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The DSM-IV-TR Diagnostic Criteria
for Drug (substance) Dependency / Addiction

 

Notice

  • NB: There has been some controversy over the DSM, and apparently, doctors can also use these criteria to their advantage, so in my case, there was sufficient consultation with my lawyer.
  • The DSM-IV-TR Diagnostic Criteria for Drug (substance) Dependency/Addiction are quoted from Section 2 of Addiction Report One. These helped to define the issues for litigation in my case.

   

The 7 DSM-IV-TR Criteria

Quoted from Section Two of Addiction Report One:

The criteria we used to diagnose Wayne’s Benzodiazepine dependence is that used by the American Psychiatric Association, namely the DSM-IV-TR. The DSM-IV-TR has 7 Criteria of which 3 need to be met for a diagnosis of substance dependence to be determined. These 7 Criteria are as follows:

  1. Has this person developed tolerance to Benzodiazepines?
  2. Has this person developed withdrawal Symptoms to Benzodiazepines
  3. Was the substance (Benzodiazepines) taken in larger amounts or over longer periods than intended?
  4. Does this person have a persistent desire or made one or more unsuccessful efforts to cut down or control use?
  5. Was a great deal of time spent in activities necessary to get Benzodiazepines, take Benzodiazepines or recovery from its effects?
  6. Has this person reduced other activities as a result of their Benzodiazepine use?
  7. Has this person continued Benzodiazepine use despite problems caused by or exacerbated by use?

As noted in the DSM-IV-TR, drug dependence is a maladaptive pattern of drug use leading to clinically significant impairment or distress, which is manifested by 3 or more of the Criteria occurring at any time in the same 12 month period.

Of the 7 Criteria above, Wayne met numbers: 1, 2, 4, 6, 7 above, in other words, Wayne met 5 out of the 7 Criteria, for which only 3 need to be met in order to determine dependence.

See Section Two of Addiction Report One for a detailed explanation on how the dependence diagnosis was made in my case.


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All 7 Criteria Applicable in My Case

As stated above, criteria 1, 2, 4, 6, 7 were applied to my case. However, upon closer inspection of the remaining two criteria (3 & 5) and my history, it becomes clear that they could have been applied also.

As explained in article 4 of my statement, the prescribing doctor told me that I could expect a recovery within 4 months. However, the prescriptions continued for more than twice as long as this, which is consistent with the later part of criterion 3 above where it says “or over longer periods than intended”

As explained in article 2.3 of Addiction Report One (6. Impact on Life), it took well over a year for me to recover enough to be able to return to employment following abstinence from benzodiazepines. This is consistent with the later part of criterion 5 above, where it says “or recovery from its effects” because a great deal of time was spent on recovery from its effects.

It light of the above, it is clear my condition was such that the entire 7 DSM-IV-TR Diagnostic Criteria for Drug (substance) Dependency / Addiction were applicable in my case.

However, given the bias attitudes of the courts, together with the fact the judge ignored most of the above DSM criteria in the High Court Verdict anyway (See Justice or Not?), it probably wouldn’t have altered the court’s intended final decision at any rate...


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Notice

Despite claims from the defense in article 2.3.2-A of the verdict (“The DSM-IV-TR diagnostic criteria for substance dependency is only applied to case examples where the substance includes cocaine, alcohol, and tobacco…”), the DSM-IV-TR diagnostic criteria can in fact be applied to diagnosing dependence to prescription drugs, including benzodiazepines, which was confirmed in a letter from Dr. Judson.


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The primary language of this website is English. Japanese appears as translations only (except for some original court documents).

These translations have been done by many different translators including me. Therefore, there are differences in quality and styles.

Please understand that I am not native Japanese and subsequently there are parts that may sound unnatural in Japanese.

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