For most diagnoses of substance dependence in DSM-IV, withdrawal is one of seven criteria that jointly reflect dependence as a combination of physiological and psychological processes. 5,6 In DSM-IV, withdrawal is defined as symptoms occurring after cessation of regular, heavy use of a substance. While withdrawal is not required to make a DSM-IV dependence diagnosis, withdrawal symptoms predict poorer prognosis among both alcohol- and drug-dependent individuals. 7,8 Withdrawal is also included in DSM-IV as a separate diagnosis, with specific withdrawal criteria for most substance categories (e.g., stimulants, sedatives).
