A critical appraisal of the current criteria for a diagnosis of substance abuse and dependence is underway in preparation for the publication of a fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Some proposed changes include combining abuse and dependence criteria into a single diagnosis, for which considerable evidence exists as these criteria form a single latent variable with criteria arrayed across the severity spectrum (Martin et al., 2008, Saha et al., 2006). Other issues under consideration include adding a criterion indicating quantity/frequency (Keyes et al., in press, Li et al., 2007b, Saha et al., 2007) and creating a dimensional, scalable form of diagnosis that would include diagnostic criteria and correlates of substance use (Helzer et al., 2007, Li et al., 2007a). Another area under discussion is whether the diagnosis would benefit from the addition of a new criterion indicating craving for alcohol and/or other illicit drugs.
