The second key change in DSM-5 is the inclusion of craving defined by the working group as “Craving or a strong desire or urge to use a specific substance”. In NESARC (wave 2 only), two items were used to assess craving: “wanting a drink so badly you couldn’t think about anything else” (endorsed by 183 individuals) and “feeling a very strong desire to drink” (endorsed by 889 individuals). A total of 924 individuals reported craving attributed to either of these two items, with only 35 stemming solely from endorsement of the less common item. Thus, the DSM-5 proposed phrasing of “strong desire or urge” results in the inclusion of more individuals than if “want a drink so badly” were used. However, this addition is exceedingly modest. Of the 3026 individuals who endorsed one of 10 DSM-5 criteria (i.e. not including craving), an additional 124 (4.1%) receive a diagnosis of DSM-5 AUDs due to their endorsement of craving alone.
