The DSM IV criteria for distinguishing substance use disorders, including substance abuse, dependence, and substance-induced disorders, are delineated in the next sections. The symptoms that practicing clinicians witness are frequently only the tip of the iceberg. Any concern on your part may indicate a more serious problem. Therefore, take action as soon as your screening protocols or the presence of any “red flag” suggests substance use problems. Refer all patients with evidence of a substance use disorder for further evaluation and possible treatment by a substance abuse professional.

Substance abuse specialists have the time and tools to make an exhaustive diagnostic inquiry; to distinguish between substance use, abuse, and dependence; and to adjust their interventions accordingly.