By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
How does the DSM-5 classify drugs?
There are lots of ways to categorize drugs depending on why you are doing the categorizing. In the DSM-5 the drugs are primarily classified by the way they affect the body of the person who is using the drugs. This perspective is a medical one and the doctors likely have a different perspective on this than substance abuse or mental health counselors.
This classification of drugs appears in the substance use disorder section. Substance Use Disorders largely excludes the effects or side effects of prescribed medications. This classification system emphasizes drugs with similar effects on the body and which might be medically treated with similar medications. Counselors will likely see some of this from a somewhat different treatment perspective.
It is important to note that to get a diagnosis in the section the person does not have to intend to use the drug. Someone exposed to fumes or accidental exposure, say to pesticide, could meet criteria for a diagnosis if the chemical resulted in symptoms that fit one of these classifications.
Here are the 11 categories. Listed in the DSM in alphabetic order.
Cannabis (Primarily Marijuana) F12.XX
Opioids (Heroin and RX pills) F11.XX
Sedatives, Hypnotics, and Anxiolytics. F13.XX
Stimulants. (This combines Cocaine F14.XX and Amphetamines F15.XX, the DSM does not separate Meth from other amphetamines the way substance abuse treatment does.)
Other or Unknown Substance Use Disorder F19.XX
Each particular drug may or may not have additional specifiers after the initial F number. Some have three digits after and some have only two available.
This DSM-5 classification system is only marginally related to the Federal Drug Schedules used here in the U. S. to regulate sale and prescription of drugs. Various groups and authors have classified drugs, both drugs of abuse and prescribed drugs, using a number of other systems. Some things we know are drugs are often not regulated because they are sold with a label “not for human consumption.” Herbal products and supplements fall into a gray area and regulation of these products along with classification is more problematic.
Substance use disorders are included in the DSM-5 and hence qualify as a “mental disorder.” As with the other things we are calling a mental illness or disorder this problem needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise, you may have the issues but you will not get the diagnoses if this is a preference, not a problem.
One major reason people get this diagnosis is that they get arrested for breaking a drug-related law. This qualifies as a problem with some sort of functioning. With other mental illnesses, there is an exclusion if your problems only happen when you are under the influence of drugs or medicines or because of some other physical or medical problem. For substance use disorders we do not need to rule out drug use or exposure as causes.
FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.
You might also want to check out these other counselorssoapbox posts.
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For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.