• Dx of last resort
• Substance use produces problems, but doesn't fill criteria for Dependence
• No withdrawal or tolerance or physiological sxs.
• Criteria:
• - failure to fulfill important roles
• - use despite recurrent legal problems
• -use despite being physically dangerous
• - despite interpersonal problems
• not caffeine or nicotine

• frequent substance use to produce clinically distress, impaired funx, behavioral characteristics
• Maladaptive and paterend use
• Can be unintentional (from medicinal use)

• Acute clinical condtn. from recent overuse of a substance
• Anyone can become intoxicated
• Can apply even if used only once
• ALL drugs (except nicotine) have a specific syndrome of intox.

• Collection of sxs specific to the class of substance that develops when a person who has frequently used a substance discontinues or markedly reduces amount used
• Mood changes/abnormal motor/insomnia/ other physical
• All substances (besides caffeine, inhalants, hallucinogens, PCP) have an officially recognized withdrawal syndrome

- Opiates (highest - 24.3)

- Cocaine (18.4)

- Alcohol (10)

- Marijuana (1.0)