Hazardous substance use [which is most often endorsed for alcohol and most commonly involves driving while intoxicated (DWI)] is the criterion that most often results in a DSM-IV alcohol abuse diagnosis. However, it has been argued that DWI should not be the sole basis for a psychiatric diagnosis (Hasin et al., 1999) or at the extreme that it should not be a diagnostic criterion at all (Martin et al., 2011). A diagnosis of alcohol abuse based exclusively on hazardous drinking was associated with lower rates of problematic drinking, alcohol dependence, and help-seeking behavior at a 3-year follow up than alcohol abuse diagnosed using the other criteria, suggesting that it represents a less extreme form of Alcohol Use Disorder (AUD) (Agrawal et al., 2010). The requirement in DSM-5 that two criteria be met for a diagnosis of a SUD excludes individuals for whom the only criterion for a SUD is hazardous use.
