For DSM-5, craving is proposed to be defined as “strong desire or urge to use a specific substance”. The preliminary rationale for the addition of craving arose from three sources – its inclusion in the International Classification of Disease (ICD-10) (World Health Organization, 2007) definition of substance use disorders, neurobiological experiments supporting cue-elicited craving (Childress et al., 1999; Kalivas & O’Brien, 2008; Volkow et al., 2006; Kalivas & Volkow, 2005), and clinical observations of its significance in relapse (Monti et al., 1990; O’Brien, 2005; Flannery et al., 2001). There is little doubt that craving is an integral aspect of substance use disorders – numerous epidemiological (Mewton, Slade, McBride, Grove, & Teesson, 2010; Keyes, Krueger, Grant, & Hasin, 2011) and emergency room (Cherpitel et al., 2010) studies report high factor loadings for alcohol craving, indicating considerable correlation between self-reported craving and the underlying liability to substance use disorders as indexed by DSM-IV dependence criteria However, whether it adds unique information to the diagnosis of substance use disorder remains unclear.
