Changes in ICD-11: Disorders Due to Substance Use or Addictive Behaviours

Abstract

ICD-11 will discriminate 3 subcategories of harmful patterns of substance use and 5 subcategories of dependence. According to a pre-version, the 6 diagnostic criteria of substance dependence in ICD-10 will be condensed in 3 pairs in ICD-11. The term "persistent substance use despite clear evidence of overly harmful consequence" shall be replaced by "substance use often continues despite the occurrence of problems". Pathological gambling and pathological gaming will be listed as addictive behaviors next to substance use disorders.The reduction from 6 to 3 criteria of substance dependence may be problematic in some cases. First studies report an increase of alcohol and cannabis dependence under use of ICD-11. The change of the description of "persistent substance use despite clear evidence of overly harmful consequence" to "substance use often continues despite the occurrence of problems" could imply legal and social problems, which could lead to pathologization of social problems.