Cocaine use disorder

Diagnostic and statistical manual of mental disorders, fifth edition, text revision (DSM-5-TR)[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.

Cocaine use disorder is defined as two or more of the following within a 12-month period:

• Using larger amounts of cocaine or over a longer period than was intended

• Persistent desire to cut down or unsuccessful efforts to control use

• Great deal of time spent obtaining, using, or recovering from use

• Craving, or a strong desire or urge to use substance

• Failure to fulfill major role obligations at work, school, or home due to recurrent cocaine use

• Continued use despite recurrent or persistent social or interpersonal problems caused or exacerbated by the effects of cocaine use

• Giving up or reducing social, occupational, or recreational activities due to cocaine use

• Recurrent cocaine use in physically hazardous situations

• Continued cocaine use despite knowledge of having a persistent or recurrent physical or psychologic problem caused or exacerbated by its use

• Tolerance (a need for markedly increased amounts; markedly diminished effect with continued use of the same amount)

• Withdrawal as manifested by cessation of cocaine or use of cocaine (or a closely related substance) to relieve or avoid withdrawal symptoms.

Severity of cocaine use disorder is categorized as mild (presence of 2-3 symptoms), moderate (4-5 symptoms), or severe (6 or more symptoms). It should be specified if the individual is in an environment where access to cocaine is restricted.

Remission of cocaine use disorder is categorized as:

• In early remission: where none of the criteria for cocaine use disorder have been met for at least 3 months but for less than 12 months (with the exception of craving, or a strong desire or urge to use cocaine), but full criteria for cocaine use disorder were previously met.

• In sustained remission: where none of the criteria for cocaine use disorder have been met at any time during a period of 12 months or longer (with the exception of craving, or a strong desire or urge to use cocaine), but full criteria for cocaine use disorder were previously met.