ICD-10 classification of substance-use disorders

MRCPsych addiction psychiatry seminars

Dr Stuart Mclaren 2nd March 2012

Block F10-F19

Mental and behavioural disorders due to:

F10 alcohol F17 tobaccoF11 opioids F18 volatile solventF12 cannabinoids F19 multiple andF13 sedatives otherF14 cocaineF15 stimulantsF16 hallucinogens

1. Clinical conditions resulting from substance use

F1x.0 acute intoxicationF1x.1 harmful useF1x.2 dependence syndromeF1x.3 withdrawal stateF1x.4 withdrawal state with delirium

2. Clinical conditions resulting from substance use

F1x.5 psychotic disorderF1x.6 amnesic disorderF1x.7 residual and late-onset psychotic

disorderF1x.8 other mental or behavioural

disordersF1x.9 unspecified mental and

behavioural disorder

ICD-10 Dependence syndrome

3 or more evident some time in the previous year:

• Desire or compulsion to use the substance• Difficulties in controlling use behaviour• Withdrawal states• Tolerance• Neglect of other pleasures or interests

‘salience’• Persistent use despite harm

Classification of dependence syndrome

F1x.20 currently abstinentF1x.21 currently abstinent, but in protected

environmentF1x.22 on clinically supervised maintenanceF1x.23 currently abstinent on aversive drugF1x.24 currently using the substanceF1x.25 continuous useF1x.26 episodic use

Residual and late-onset psychotic disorder F1x.7

F1x.70 flashbacksF1x.71 personality or behavioural disorderF1x.72 residual affective disorderF1x.73 dementiaF1x.74 other persisting cognitive impairmentF1x.75 late-onset psychotic disorder

Problem of the majority or minority?

Cigarettes SexAlcohol ExerciseIllicit drug use WorkEating ShoppingGamblingInternetLove

Definitions of addiction

‘Addiction is not an elephant!’

From ‘Theory of addiction’ by Robert West (2006)