DSM‐V and the Definitions: Time to Get It Right

Over the decades, the Diagnostic and Statistical Manual of Mental Disorders (DSM) [1] has made very important contributions to the mental health field in the classification of mental illness. However, as the manual is updated, some members of the American Psychiatric Association DSM-V Committee believe the word “addiction” is still too stigmatizing and argue that the term “dependence” should remain [2]. In our opinion, perpetuating this ambiguity is in no one's best interest. Much in the same way as we in addiction treatment hope our patients will come to see things “the way they are, not the way they wish they were,” the so-called “Golden Moment”[3], we would encourage the DSM-V committee to approach this unique situation as a “golden opportunity” to restore the term “addiction” to its rightful place in the medical lexicon.Unfortunately, while the terms “physical dependence” and “addiction” are often used interchangeably, they are not the same at all. In fact, a joint committee comprised of members of the American Pain Society, the American Society of Pain Medicine, and the American Society of Addiction Medicine, the Liaison Committee for Pain and Addiction, in 2001 developed consensus definitions for physical dependence, addiction, and tolerance that were approved by the governing bodies of each organization [4]. The key point here is that physical dependence is an expected , neuroadaptive consequence of chronic exposure to an agonist class of drug while addiction is a complex, multidimensional biopsychosocial phenomenon that occurs in at risk individuals …