The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria for alcohol use disorders (AUD), released in 2013 [1], represent a significant departure from previous criteria. For the previous 20 years, since the 4th edition of the DSM (DSM-IV), alcohol dependence and abuse had been considered mutually exclusive diagnoses that together made up alcohol use disorders [2]. The diagnosis of these distinct disorders was based on “a maladaptive pattern of alcohol use leading to clinically significant impairment or distress” as manifested by separate criteria, with DSM-IV dependence requiring at least 3 of 7 criteria and DSM-IV alcohol abuse requiring exclusion of DSM-IV dependence and at least 1 of 4 separate criteria (Fig. 1). In part because of recent studies calling into question the hierarchical distinction between abuse and dependence [3–5], DSM-5 replaces these two diagnoses with a single spectrum of AUD with a continuum of severity. Removal of “abuse” from DSM-5 may also serve to reduce the stigma and negative judgment associated with such terminology [6]. The DSM-5 includes 11 criteria: 10 of the 11 combined DSM-IV abuse
