Inspirational Quotes

"I have learned that people will forget what you said; people will forget what you did, but people will never forget how you made them feel."

--Maya Angelou

"Live as if your were to die tomorrow. Learn as if you were to live forever. You must learn to be still in the midst of activity and be vibrantly alive in repose."

--Gandhi

Substance Dependence

A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:

  • Tolerance, as defined by either of the following:

    • A need for markedly increased amounts of the substance to achieve desired effect.

    • Diminished effect with continued use of the same amount of the substance.

  • Withdrawal, as manifested by either of the following:

    • The characteristic withdrawal syndrome for the substance.

    • The same substance is taken to relieve or avoid withdrawal symptoms.

  • The substance is often taken in larger amounts or over a longer period than was intended.

  • There is a persistent desire or unsuccessful efforts to cut down or control substance use.

  • A great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or recover from its effects.

  • Important social, occupational, or recreational activities are given up or reduced because of substance use.

  • The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption).

    Specify if:

    With Physiological Dependence: evidence of tolerance or withdrawal.

    Without Physiological Dependence: no evidence of tolerance or withdrawal.

        Diagnostic criteria summarized from:

        American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.



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