Support for the validity of craving as a component of addiction comes from many lines of evidence, including behavioral research (Heinz et al., 2008, Miller and Goldsmith, 2001, O’Brien et al., 1998, Weiss, 2005), imaging (Bencherif et al., 2004, Kalivas and O’Brien, 2008, Oslin et al., 2009, Weiss, 2005), pharmacology (O’Brien, 2005), and genetic epidemiology (Foroud et al., 2007). In fact, some have suggested that reduction of craving is central to the treatment of addiction (O’Brien et al., 2005). If so, then craving might be useful to add to the alcohol and drug disorder criteria in DSM-V, an option that is currently under consideration by the DSM-V Substance Disorders Workgroup. Further, craving is one of the substance dependence criteria in the International Classification of Disease, tenth edition (ICD-10) of the World Health Organization (World Health Organization, 1993), thus inclusion of craving in DSM-V would increase the comparability of these two diagnostic systems. However, in considering the addition of a new criterion to the DSM-V, several issues must simultaneously be balanced. A new criterion should be an observable indicator of the
